DIVERTICULOSIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 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., 1960Diverticulosis: 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: 0-597-83892-5 1. Diverticulosis-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on diverticulosis. 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 DIVERTICULOSIS ....................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Diverticulosis .............................................................................. 13 The National Library of Medicine: PubMed ................................................................................ 15 CHAPTER 2. NUTRITION AND DIVERTICULOSIS.............................................................................. 27 Overview...................................................................................................................................... 27 Finding Nutrition Studies on Diverticulosis............................................................................... 27 Federal Resources on Nutrition ................................................................................................... 29 Additional Web Resources ........................................................................................................... 29 CHAPTER 3. ALTERNATIVE MEDICINE AND DIVERTICULOSIS ....................................................... 31 Overview...................................................................................................................................... 31 National Center for Complementary and Alternative Medicine.................................................. 31 Additional Web Resources ........................................................................................................... 36 General References ....................................................................................................................... 38 CHAPTER 4. BOOKS ON DIVERTICULOSIS ........................................................................................ 39 Overview...................................................................................................................................... 39 Book Summaries: Federal Agencies.............................................................................................. 39 Book Summaries: Online Booksellers........................................................................................... 40 The National Library of Medicine Book Index ............................................................................. 41 Chapters on Diverticulosis........................................................................................................... 41 CHAPTER 5. MULTIMEDIA ON DIVERTICULOSIS ............................................................................. 43 Overview...................................................................................................................................... 43 Video Recordings ......................................................................................................................... 43 CHAPTER 6. PERIODICALS AND NEWS ON DIVERTICULOSIS .......................................................... 45 Overview...................................................................................................................................... 45 News Services and Press Releases................................................................................................ 45 Newsletter Articles ...................................................................................................................... 46 Academic Periodicals covering Diverticulosis ............................................................................. 47 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 51 Overview...................................................................................................................................... 51 NIH Guidelines............................................................................................................................ 51 NIH Databases............................................................................................................................. 53 Other Commercial Databases....................................................................................................... 56 The Genome Project and Diverticulosis....................................................................................... 56 APPENDIX B. PATIENT RESOURCES ................................................................................................. 61 Overview...................................................................................................................................... 61 Patient Guideline Sources............................................................................................................ 61 Finding Associations.................................................................................................................... 65 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 67 Overview...................................................................................................................................... 67 Preparation................................................................................................................................... 67 Finding a Local Medical Library.................................................................................................. 67 Medical Libraries in the U.S. and Canada ................................................................................... 67 ONLINE GLOSSARIES.................................................................................................................. 73 Online Dictionary Directories ..................................................................................................... 73 DIVERTICULOSIS DICTIONARY.............................................................................................. 75
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INDEX .............................................................................................................................................. 107
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with diverticulosis 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 diverticulosis, 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 diverticulosis, 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 diverticulosis. 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 diverticulosis, 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 diverticulosis. 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 DIVERTICULOSIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on diverticulosis.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and diverticulosis, 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 “diverticulosis” (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: •
Understanding Diverticular Disease Source: Ostomy Quarterly. 39(2): 56-57. Winter 2002. Contact: Available from Ostomy Quarterly. 36 Executive Park, Suite 120, Irvine, CA 92614-6744. (800) 826-0826 or (714) 660-8624. Summary: Diverticular disease is a condition where the diverticula form in the colon; it is associated with abdominal pain and disturbed bowel habits. The symptoms are caused by intestinal muscle spasms, not from an inflammation of the diverticula. Diverticulosis is the presence of diverticula in the colon with no symptoms. This newsletter article helps readers with ostomies understand diverticular disease. Diverticular disease is very common in the United States; roughly half of Americans develop diverticula by the age of 60 and nearly all of those over 80 do. Most people with
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diverticula have no complications. Unless a diverticulum becomes inflamed, it will produce no symptoms (including pain). The article considers the causes of diverticular disease, the symptoms, the causes of diverticulitis (inflammation), treatment strategies for diverticulitis, and the prevention of diverticular disease. A diet high in fiber may prevent the development of diverticula within the colon and may lessen the symptoms associated with diverticular disease. Most cases of diverticulitis respond to medical treatment. Surgery is reserved for patients with recurrent bouts of diverticulitis or when complications arise. 2 figures. •
Diverticular Disease of the Colon Source: Journal of Clinical Gastroenterology. 29(3): 241-252. October 1999. Contact: Available from Lippincott Williams and Wilkins, Inc. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2300. Summary: Diverticular disease of the colon is quite common in developed countries, and its prevalence increases with age. Although present in perhaps two thirds of the elderly population, the large majority of patients will remain entirely asymptomatic. Nonetheless, an estimated 20 percent of those affected may manifest clinical illness, mainly diverticulitis, with its potential complications. This article reviews the epidemiology, pathophysiology, clinical presentation, and treatment options for this disorder. Research into the etiology of diverticular disease focuses on three areas: colonic wall resistance, disordered gastrointestinal motility (movement through the digestive tract), and the role of dietary fiber. The observations that high fiber diets are associated with less colonic diverticulosis has led to the idea that higher fiber diets might prevent diverticular disease; research studies provide general support for the recommendation that patients may benefit from increasing their fruit and vegetable fiber intake, decreasing their fat and red meat intake, and increasing their physical activity. The author reviews the symptoms, differential diagnosis, diagnostic tests, treatment, and expected treatment outcomes for diverticulitis, and then discusses diverticulitis in special populations, including the young patient, the immunocompromised patient, and recurrent diverticulitis after resection. A final section reviews the complications of diverticulitis, including abscess, fistulas, obstruction, and hemorrhage; the author offers treatment strategies for each potential problem. 112 references.
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Flexible Sigmoidoscopy: A Pictorial Atlas Source: Patient Care. 35(18): 13-27. September 30, 2001. Contact: Available from Medical Economics. 5 Paragon Drive, Montvale, NJ 07645. (800) 432-4570. Fax (201) 573-4956. Summary: Endoscopy continues to play an important role in colorectal screening. It is important to identify the members of those families that are at high risk for colon cancer and diligently screen them using colonoscopy. This article helps readers update their clinical skills regarding colorectal screening with direct instruction and a full color pictorial atlas. The author notes that the entire 360 degrees of the colon wall in each segment should be scrutinized as the instrument is slowly and deliberately withdrawn. In order to maximize the depth of insertion, it is important to minimize overinflation of the colon. The majority of pathologies seen in primary care are diverticulosis, hemorrhoids, and polyps. Approximately 95 percent of all colorectal cancers arise from benign polyps. Some experts recommend colonoscopy for all average risk persons older than 50. Mixed screening strategies may be employed more frequently in the future, or it
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may be appropriate to switch strategies as people age. Performing flexible sigmoidoscopy can be time intensive for a busy primary care physician. Experts have suggested that nurse practitioners and physician assistants be trained so that more patients can be screened (one sidebar summarizes this concept). 9 figures. 12 references. •
Flexible Sigmoidoscopy Source: American Family Physician. 63(7): 1375-1380. April 1, 2001. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. Summary: Flexible sigmoidoscopy remains a common tool used for the periodic screening of colorectal cancer. This article reminds family care physicians of the recommendations for the use of flexible sigmoidoscopy. Most organizations recommend screening at three to five year intervals beginning at age 50 for persons with average risk. Extensive training in endoscopic maneuvering, colorectal anatomy, and pathologic recognition is required. Most physicians report comfort performing the procedure unsupervised after 10 to 25 supervised sessions. The procedure itself involves the insertion of the sigmoidoscope through the anus and distal rectum and advancement of the scope tip to an average depth of 48 to 55 centimeters in the sigmoid colon. Once the sigmoidoscope has been appropriately advanced, the scope is slowly withdrawn, allowing for the inspection of colon mucosa during withdrawal. Polyps less than 5 millimeters in diameter should be biopsied. Polyps 5 to 10 millimeters or greater can be assumed to be adenomatous, and follow up colonoscopy for complete polypectomy is required. Diverticulosis, hemorrhoids, nonspecific colitis and pseudomembranes may also be encountered during inspection. Use of preprocedural benzodiazepines can be helpful in reducing patient discomfort. 2 figures. 10 references.
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Diagnosis and Management of Gastrointestinal Bleeding Source: Journal of the American Academy of Nurse Practitioners. 11(10): 441-452. October 1999. Contact: Available from American Academy of Nurse Practitioners. Capitol Station, LBJ Building, P.O. Box 12846, Austin, TX 78711. Summary: Gastrointestinal bleeding is defined as a recent onset of blood loss from any part of the gastrointestinal (GI) tract, resulting in instability of vital signs, anemia, or need for blood transfusion. This article discusses the diagnosis and management of GI bleeding. The most common diagnoses for upper GI bleeding are peptic ulcers, gastric (stomach) erosions, gastritis, esophageal varices, and acute lacerations. The most common diagnoses for lower GI bleeding are diverticulosis, arteriovenous malformations, and neoplasms. The authors discuss epidemiology, etiology, history and physical examination, clinical approach to the patient with GI bleeding, laboratory and diagnostic tests, patient teaching and preparation for the diagnostic tests, and treatment options. Diagnostic tests discussed include: fecal occult blood, nasogastric tube, flexible rectosigmoidoscopy, endoscopy, colonoscopy, barium studies, arteriography, and nuclear medicine scan. The authors emphasize that the practitioner must always consider that 85 percent of GI bleeds will stop spontaneously and the patient can be managed with medication or general supportive measures. Patients presenting with mild bleeding and stable vital signs may be managed as outpatients with a referral to a gastroenterologist for elective procedures. The cost benefit of outpatient versus inpatient is significant and should be an important consideration. Once the patient has been stabilized and the source of bleeding identified, preventing the recurrence of bleeding
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and reduction of risk factors is the treatment goal. The article includes a patient care algorithm and related continuing education questions. 1 figure. 3 tables. 32 references. •
Diverticulitis Source: Medical Clinics of North America. 77(5): 1149-1167. September 1993. Contact: Available from W.B. Saunders Company, Periodicals Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 654-2452. Summary: In this article, the authors review the problem of diverticulitis. They cover the clinical presentation; complications of diverticulitis, including fistula, obstruction, abscess, and perforation and peritonitis; uncommon manifestations and associations, including arthritis and pyoderma gangrenosum, orthopedic complications, renal disease and diverticulosis, and the association between corticosteroids and nonsteroidal antiinflammatory drugs (NSAIDs) and diverticulitis; diagnostic evaluations, including contrast enema, computerized tomography, ultrasonography, and endoscopy; and treatment options, including the indications for surgery. The authors conclude that diverticulitis is a disease well known to clinicians that still demands understanding and careful good judgment for good patient outcome. 5 figures. 4 tables. 64 references.
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Controversies in the Investigation and Treatment of Lower Gastrointestinal Bleeding Source: Practical Gastroenterology. 24(1): 42, 52, 54, 58. January 2000. Contact: Available from Shugar Publishing. 12 Moniebogue Lane, Westhampton Beach, NY 11978. (516) 288-4404. Fax (516) 288-4435. Summary: Lower gastrointestinal (GI) bleeding may be intermittent, self limited, or produce a life threatening emergency. There are several options for diagnostic evaluation, but the location and etiology of the bleeding source may remain elusive. In this article, the authors review the diagnostic and treatment options and provide recommendations for developing an organized patient algorithm. The majority of patients with lower GI hemorrhage will stop bleeding during resuscitation. Once the bleeding has stopped, investigation of the source of the bleed usually proceeds with routine endoscopic and radiological studies, followed by elective segmental resection, if indicated. In patients where it is impossible to determine the precise location and etiology, both patient and physician must await the next bleeding episode. Patients who present with lower GI bleeding are usually adults older than 50 years. The most common etiologies of lower GI bleeding include diverticulosis, vascular ectasia, ischemic colitis, inflammatory bowel disease (IBD), and neoplasm (cancer). Diagnostic options include colonoscopy, traditional imaging techniques (CT scan or contrast studies), nuclear scintigraphy, or mesenteric angiography. Colonoscopy and mesenteric angiography both offer the means for potentially controlling the hemorrhage whereas scintigraphy does not. Colonoscopy can provide the means to treat bleeding lesions through electrocautery, epinephrine injection, or sclerotherapy. Angiography can provide access for vasopressin infusion or embolization. The unstable patient without a determined site of bleeding represents the most challenging dilemma, as blind total abdominal colectomy is associated with potential rebleeding from the small intestine and significant morbidity and mortality. 26 references.
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Effect of Gender on the Rates of Hospitalization for Gastrointestinal Illnesses Source: American Journal of Gastroenterology. 92(4): 621-623. April 1997.
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Contact: Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (800) 638-6423 or (410) 528-8555. Summary: Over the years, reports have indicated that many medical illnesses show a predilection for one of the genders. This article reports on a review of computerized data regarding all hospitalizations in the State of Illinois over a 1-year period for all gastrointestinal (GI) illnesses. The authors noted that the gender distribution for all GI illnesses is highly significant. They found 20 conditions with predominant female representation, including cholelithiasis (gallstones), diverticulosis, and nonspecific enteritis. They also noted eight conditions with predominantly male representation, including acute appendicitis, inguinal hernia, chronic liver disease, and duodenal ulcer. Twenty remaining conditions had no significant differences in female-male distribution: these included ulcerative colitis, GI hemorrhage, and esophageal illnesses. The authors conclude that the use of a large, computer-based database permits the observation of hospitalization rates based on gender, and that such differences may have impact on the perceptions and practices of medical care. The authors note that an explanation for these data could be differences in the severity of illness between the sexes, a difference in the true prevalence of the various illnesses, or gender bias in the treatment of the conditions. 2 tables. 12 references. (AA-M). •
Why Certain Foods May Be Upsetting Your Stomach Source: Digestive Health and Nutrition. 3(3): 28-30. May-June 2001. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email:
[email protected]. Summary: Special diets, specifically those intended to alleviate disease symptoms (as opposed to those for weight reduction), are a way of life for many individuals with gastrointestinal (GI) illnesses such as irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), peptic ulcers, diverticulosis, celiac sprue, gallbladder disease, and inflammatory bowel disease (IBD, including Crohn's disease and ulcerative colitis). This article reviews this phenomenon of avoiding or incorporating certain foods to alleviate the symptoms of GI diseases. The author stresses the fact that each person's diet will vary, even when they have the same disease, because certain foods may affect people differently. Many physicians recommend avoiding certain foods but ultimately leave the patient to experiment with trial and error. While diets vary from condition to condition, all diets should have the common goal of maintaining good health and proper weight through a diet rich in fruits and vegetables, moderate in the consumption of alcohol, and low in fat. The article concludes with a list of websites for additional information.
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Diverticular Disease in the Elderly Source: Gastroenterology Clinics of North America. 30(2): 475-496. June 2001. Contact: Available from W.B. Saunders Company. 6277 Sea Harbor Drive, Orlando, FL 32821-9816. (800) 654-2452. Summary: The term diverticular disease refers to the entire spectrum of asymptomatic to symptomatic disease associated with colonic diverticula (a pouch or sac created by herniation of the lining of mucus membrane in the intestine). Diverticulosis is the presence of one or more diverticula; diverticulitis is diverticulosis with clinical symptoms and evidence of inflammation. This article, from a special issue on
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gastrointestinal (GI) disorders in the elderly, addresses diverticular disease, a condition of special significance in the elderly. The incidence and severity of diverticular disease increases with age. Elderly patients often present with complicated diverticular disease, and because of their advanced age, poor ability to provide a history, and muted symptoms and signs, the diagnosis is particularly difficult to make. Consequently, great demands are placed on the physician to diagnose and treat diverticular disease in this population. In the past, advanced age made conservative therapy the standard of care for most patients; however, recent endoscopic, radiologic, and surgical advances have helped define more definitive therapies for patients with complicated diverticular disease. Complications of diverticulitis can include abscess, fistula (an opening between the colon and surrounding structures), obstruction, free perforation, and diverticular hemorrhage. Treatment strategies include bed rest, oral broad spectrum antibiotics, bowel rest, and oral hydration for uncomplicated diverticulitis; complicated diverticulitis generally requires surgery in addition to these primary care strategies. Lack of improvement with medical management may indicate a peridiverticular abscess. Recurrent diverticulitis is less likely to respond to medical management. Elective surgery should be considered after the second attack. 4 figures. 1 table. 82 references. •
Benefits of Dietary Fiber: Myth or Medicine? Source: Postgraduate Medicine. 99(2): 153-154, 156, 166-168, 171-172, 175. February 1996. Summary: This article describes the classification of dietary and supplemental fiber and reviews studies evaluating the role of fiber in disease prevention and treatment. An overview of current fiber supplements and recommendations for their use is included. The authors conclude that fiber has some preventive or therapeutic benefits in irritable bowel syndrome (IBS), diverticulosis, colorectal cancer, diabetes, and hypercholesterolemia. However, it appears to have no direct benefit in patients with inflammatory bowel disease (IBD), gallstones, or obesity. One sidebar explores the physiologic effects of dietary fiber. 1 figure. 4 tables. 34 references. (AA-M).
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Pathologic Basis of Chronic Intestinal Pseudo-Obstruction Source: A.S.A.P. Forum. Volume 3: 8-10. October 1992. Contact: Available from American Society for Adults with Pseudo-obstruction. International Corporate Headquarters, 19 Carroll Road, Woburn, MA 01801. (617) 9359776. Summary: This article describes the pathologic basis of chronic intestinal pseudoobstruction, a term that defines a heterogenous group of gastrointestinal motor disorders that result in failure of effective propulsion and signs and symptoms of intestinal obstruction. Topics covered include the physiology of normal propulsion; structural abnormalities of the smooth muscle (visceral myopathies); disorders of the nervous system of the bowel wall (visceral neuropathies); morphological studies of the smooth muscles and enteric nervous system; clinical symptoms of the patient; and the need for additional research in this area. The article concludes with an outline classification of neuromuscular disorders in three sections: disorders of the enteric nervous system, disorders of the smooth muscle, and small intestinal diverticulosis. 1 figure. (AA-M).
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Healthy Eating for Older Adults Source: Diabetes Self-Management. 16(6): 110-114. November-December 1999.
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Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Summary: This article discusses the importance of good nutrition for older adults. Although older adults usually need and consume fewer calories than younger people, they need about the same amount of vitamins and minerals. The best way for older adults to meet their nutritional needs is to choose nutrient dense foods. Important nutrients for older adults include vitamin B12, vitamin D, calcium, and water. Fiber is also an important nutrient for older adults because it helps prevent diverticulosis and constipation. In addition to having an increased need for specific nutrients, older people are also more likely to experience a decrease in the acuity of some of the senses, so they may not be able to smell or taste foods as well as they once did. Aging brings an increased likelihood of being affected by one or more medical conditions, such as type 2 diabetes or high blood pressure, that require making dietary changes. This increase in medical conditions means that older adults are more likely to be taking prescription or over the counter drugs that affect specific nutrients. In addition, older people may experience changes in family structure that affect their cooking and eating habits. A healthful diet for an older adult emphasizes whole grains, fruits, and vegetables with judicious amounts of dairy products, meat, fish, poultry, and eggs. A modified Food Guide Pyramid has been developed for people over 70 to reflect their need for fluid intake and potential need for some supplements. The article includes tips for shopping and cooking for one person. 1 figure. •
Sorting Out the Causes of Acute Lower GI Hemorrhage: When Direct Evidence is Lacking, Diagnosis is Often Presumptive Source: Journal of Critical Illness. 13(3): 177-180, 183-185. March 1998. Contact: Available from Cliggott Publishing Company. 55 Holly Hill Lane, Greenwich, CT 06831-0010. (203) 661-0600. Summary: This article focuses on the causes of acute lower gastrointestinal hemorrhage (ALGIH) and diagnostic considerations. ALGIH, most often caused by diverticulosis, colorectal malignancy, ischemic colitis, or colonic angiodysplasia, is a common cause of hospitalization. The initial manifestation is typically bloody stool; other signs include volume depletion, anemia, and, occasionally, abdominal pain. Colonoscopy is generally the preferred initial diagnostic test. Angiography may be used in those with massive bleeding after rectal purge and in some surgical candidates; radionuclide scanning may be a safer alternative and can detect bleeding occurring at a relatively slow rate. Barium radiography is reserved for examining the small bowel and the colon of patients who have had incomplete colonoscopy and in whom malignancy is suspected. In most patients, bleeding stops spontaneously during supportive therapy; treatment options include endoscopic hemostatis therapy, surgery, transcatheter arterial embolization, and intra-arterial vasopressin infusion. 6 figures. 1 table. 18 references. (AA-M).
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Shopping for Groceries? Source: Digestive Health and Nutrition. p. 17-19. May-June 1999. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email:
[email protected]. Summary: This article offers consumers with common digestive ailments strategies to improve their grocery shopping skills. The authors remind readers that food choices
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have a great impact on most digestive disorders and a proper diet can address the root cause of many gastrointestinal (GI) problems and help reduce and control symptoms. The authors offer suggestions for readers who have excess gas in the digestive tract, heartburn and gastroesophageal reflux (GERD), constipation, lactose intolerance, peptic ulcers, irritable bowel syndrome (IBS), and inflammatory bowel disease. In each section, the authors list foods that should go 'in the cart' (recommended) and that should stay 'out of the cart' (not recommended). One side bar reviews the impact of dietary fiber: because fiber absorbs water, it relieves constipation by making the stool softer, stops diarrhea by absorbing excess water, and helps to relieve the symptoms of hemorrhoids, diverticulosis, and IBS. Readers are also encouraged to actively read food labels in order to make better decisions about their food purchases. The article includes three resources for readers wishing additional information, including the website for the American Gastroenterological Association (www.gastro.org) and for the National Digestive Diseases Information Clearinghouse. 1 table. 3 references. •
Physiology and Pathophysiology of Colonic Motor Activity: Part Two of Two Source: Digestive Diseases and Sciences. 36(7): 998-1018. July 1991. Summary: This article presents a review of studies in the area of the physiology and pathophysiology of colonic motor activity. The studies are grouped under the following topics: colonic transit and its relationship to motor activity; motor response of the colon to a meal; the effect of physical exercise on pregnancy, sex steroid hormones, surgery, and aging on colonic motor activity; and colonic motor activity in disease states, including diarrhea, constipation, Hirschsprung's disease, irritable bowel syndrome, ulcerative colitis, diverticulosis, and systemic diseases and spinal cord injury. 197 references.
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Lower Gastrointestinal Bleeding and Ischemic Colitis Source: Canadian Journal of Gastroenterology. 16(9): 597-600. September 2002. Contact: Available from Pulsus Group, Inc. 2902 South Sheridan Way, Oakville, Ontario, Canada L6J 7L6. Fax (905) 829-4799. E-mail:
[email protected]. Summary: This article reports on a study that compared the incidence and clinical characteristics of lower gastrointestinal (LGI) bleeding due to ischemic colitis with those with LGI bleeding of other causes. A chart review was performed of patients admitted with LGI bleeding to Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, between July 1, 1997 and January 31, 2000. Of 124 patients with LGI bleeding, 24 cases were due to ischemic colitis, 62 to diverticulosis, 11 to inflammatory bowel disease (IBD), and 27 to all other causes ('others'). The average ages of patients in each group were 66.5, 76.5, 40.5, and 77.5 years, respectively. Patients with ischemic colitis were statistically younger than those with diverticular bleeding and 'others.' Patients with IBD were younger than those in the other three groups. The only statistical difference for vascular disease risks was hypertension, because of its absence from the IBD group. Three patients with ischemic colitis underwent blood transfusions, while 23 with diverticulosis, 15 'others' and none with IBD received blood. Three patients with ischemic colitis and one patient from the 'others' group died. More women (75) than men (49) had LGI bleeding, in total and within each subgroup. Of women with LGI bleeding, many more with ischemic colitis (44.4 percent) than with diverticulosis (3.0 percent), IBD (0 percent) or 'others' (5.6 percent) were taking estrogen. 16 references.
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Dietary Fiber Controversy: Three Gastroenterologists Speak Out at Symposium on the Subject Source: Practical Gastroenterology. 14(5). May-June 1990. Summary: This article reports on a symposium, The Dietary Fiber Controversy, that was held in New Orleans in October 1989. Three gastroenterologists discuss the role of dietary fiber in the prevention of disease, as well as the place of dietary fiber in medical practice. One of the participants discusses the beneficial effects of dietary fiber, including the reduction of serum cholesterol and the reduction in the frequency and incidence of colorectal cancer. Other topics include how dietary fiber exerts a beneficial effect; how common gastrointestinal disorders such as irritable bowel syndrome, diverticulosis, and hemorrhoids benefit from a high-fiber diet; and how to achieve a high-fiber diet. 4 references.
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Diverticulitis: Current Management Strategies Source: Patient Care. 31(12): 170-172, 175-177, 181-182, 185-186. July 15, 1997. Contact: Available from Medical Economics. Five Paragon Drive, Montvale, NJ 076451742. (800) 432-4570 or (201) 358-7200. Summary: This article reviews present recommendations for the management of patients with diverticulitis. The author notes that the incidence of colonic diverticulosis (diverticula or herniations of the mucosa and submucosa through the colonic wall) is increasing as the population ages. When diverticula become inflamed, diverticulitis ensues. Patients with diverticulitis most often have abrupt onset of pain and tenderness in the left lower quadrant. Other symptoms of diverticular disease include abdominal distention, diarrhea or constipation, flatulence, heartburn, nausea and vomiting, a palpable mass, and urinary symptoms. The author reviews the differential diagnosis, discriminating between diverticulitis and acute appendicitis, gynecologic conditions, peptic ulcer disease, Crohn's disease, carcinoma, irritable bowel syndrome (IBS), and ischemic colitis. Diagnostic tests are also discussed: roentgenography, contrast enema, CT scan, ultrasonography, and endoscopy. The author then discusses dietary therapy, noting that during an acute episode of diverticulitis, patients need to be on a clear liquid diet until the inflammation subsides. Subsequently, a high fiber, low fat diet should be initiated. Other topics covered include the role of antibiotic therapy, analgesics, surgery, and rare manifestations and complications. A detailed patient care algorithm is provided. 2 figures. 1 table. 9 references. (AA-M).
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Clinical Uses of Dietary Fiber Source: American Family Physician. 51(2): 419-426. February 1, 1995. Summary: This article reviews the medical uses of dietary fiber and fiber products. The author notes that fiber is a complex mixture of substances, and research on its effects is difficult to interpret. Topics include pitfalls in fiber research; food sources of dietary fiber; the use of fiber in the treatment of gastrointestinal tract diseases, including constipation, hemorrhoids, diverticulosis, diverticulitis, and hiatal hernia; the role of dietary fiber in the treatment of diabetes mellitus; hyperlipidemia; obesity; disease prevention; and side effects and adverse reactions. The author stresses that any increase in dietary fiber intake should be accompanied by an increase in water intake. The article concludes with a patient information handout on how to increase the amount of fiber in the diet that readers can photocopy and distribute to their patients. 7 tables. 18 references. (AA-M).
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House Call Source: Digestive Health and Nutrition. p. 26-27. May-June 2000. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email:
[email protected]. Summary: This column is a regular feature in Digestive Health and Nutrition; in each issue, the medical editor and associate editors answer reader questions about gastroenterological concerns. This entry addresses six topic areas: the outward symptoms of hepatitis C, diarrhea and gas with weight loss (possibly triggered by the use of herbal remedies), chronic hepatitis C, tests to monitor liver cancer, posttherapy complications of antibiotics, and uncontrollable weight loss. Chronic hepatitis C infection can result in cirrhosis (scarring) of the liver with ascites (fluid in the abdominal cavity) and low clotting factors, leading to easy bruising. Low response to the hepatitis C drugs is disappointing, but they should still be tried, since some responses are dramatic. In some patients, chronic hepatitis C may lead to cirrhosis followed by liver failure or the development of primary liver cancer (hepatocellular carcinoma), usually after 20 to 40 years of infection. It is generally recommended that patients with hepatitis C and cirrhosis undergo semiannual testing with ultrasound and alphafetoprotein. There are many herbs that can cause diarrhea, but in almost all cases the diarrhea stops when the patient stops taking the herbal remedy. Antibiotics can themselves cause diarrhea (notably the antibiotic induced infection Clostridium difficile). Ciprofeoxacin and metronidazole may help chronic diarrhea if the condition is due to bacterial overgrowth secondary to a blind loop syndrome, small intestinal diverticulosis, or a stagnant small intestine. The author concludes that weight loss is not a symptom of irritable bowel syndrome and usually indicates another condition.
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Trials of the Aging Gut Source: Digestive Health and Nutrition. 3(6): 16-18. November-December 2001. Contact: Available from American Gastroenterological Association. 7910 Woodmont Avenue, 7th Floor, Bethesda, MD 20814. (877) DHN-4YOU or (301) 654-2055, ext. 650. Email:
[email protected]. Summary: This health education article reviews the impact of aging on the gastrointestinal (GI) tract, notably in the areas of motility (movement through the system) and absorption of nutrients. Both men and women report problems with constipation, diarrhea, and fecal incontinence with greater frequency after age 50 and an increased number of potentially serious diseases, such as diverticulosis and colon cancer. Most of the GI changes that occur in older individuals can be pinned on small physiological changes and responses within the GI tract itself, on medications that must be taken for other conditions such as heart disease or depression, and on gastrointestinal diseases that occur in greater numbers after age 50. A lesser number of people have consequences of other diseases that either make them less mobile and prone to constipation or that affect the nerves of the intestinal system, such as diabetic neuropathy (nerve damage associated with diabetes mellitus). The GI tract of older individuals may not have the same ability to absorb nutrients, such as vitamin B12 (which helps the body to produce blood cells) and calcium (which helps maintain bone density). The author also considers the issues of malnutrition, swallowing disorders and choking, fecal incontinence, constipation, lack of fiber in the diet, drug side effects, diverticular diseases, gallbladder disease, and cancer of the colon or rectum. The article concludes with five related websites for readers who want additional information.
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Gastrointestinal Bleeding II Source: Gastroenterology Clinics of North America. 23(1): 1-188. March 1994. Contact: Available from W. B. Saunders Company. The Curtis Center, Independence Square West, Philadelphia, PA 19106. (800) 654-2452. Summary: This issue of Gastroenterology Clinics of North America, along with the previous issue, provides a cross-sectional look at gastrointestinal (GI) bleeding, with a focus on the patient and the illness, rather than on new therapeutic technologies. The volume includes six articles, about the role of vascular ectasia and diverticulosis as common causes of lower intestinal bleeding; less frequent causes of lower GI bleeding; occult GI bleeding; small intestinal bleeding; GI bleeding in infancy and childhood; and the role of the radiologist in the management of GI bleeding, including the current status of barium studies, radionuclide scans, and arteriography in diagnosis and management. Each article includes extensive references, and a subject index concludes the volume.
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Vegetarian Diet: Relevance in Renal Disease Source: Nephrology. 3(5): 397-405. October 1997. Contact: Available from Blackwell Science. Commerce Place, 350 Main Street, Malden, MA 02148-5018. (617) 388-8273. Summary: Vegetarian diets have stimulated medical and public interest because vegetarians typically maintain excellent health. In general, their diets are lower in energy and percentage of energy from fat and cholesterol. They have lower bodyweight, blood pressure, and plasma lipid levels than omnivores. The vegetarian diet contains sufficient essential amino acids, minerals, and trace elements for optimal nutrition, being deficient only in vitamin B12. This review article summarizes current information about vegetarian and other low protein diets in renal disease, which, in the viewpoint of the authors, strongly supports their beneficial role in disease management. The medical possibilities for using vegetable protein as therapy in renal disease are diverse, ranging from treating hyperlipidemia to protecting the kidney against experimental immune and ablation injury. A vegetarian diet, especially a vegetarian soy diet, has been shown to significantly reduce proteinuria disease progression in nephrotic patients with or without diabetes. Furthermore, the diet has the added benefit of affording some protection against concomitant conditions common in renal patients, such as diverticulosis, chronic constipation, and cholelithiasis (kidney stones). 129 references. (AA-M).
Federally Funded Research on Diverticulosis The U.S. Government supports a variety of research studies relating to diverticulosis. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. 2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to diverticulosis. 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 diverticulosis. The following is typical of the type of information found when searching the CRISP database for diverticulosis: •
Project Title: ASSESSING THE VARIABILITY IN TIME TO TREATMENT IN SURGER Principal Investigator & Institution: Bickell, Nina A.; Assistant Professor; Health Policy; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 29-SEP-2003 Summary: Many factors influence patients' decisions to seek medical care when they experience symptoms of illness. Different factors influence the ability of patients to enter the health care system once they decide they wish to. Yet a different set of considerations affect the provision of timely and effective care. For a number of surgical conditions, delays in providing definitive care are especially likely to increase the frequency of serious adverse outcomes, including death, immediate complications, and long-term disability. For these delay-sensitive conditions, we currently understand very little about the relationship between time to treatment and outcomes, which components of this total time are the most important determinants of outcome, and which components may be modifiable. Past work has focused on conditions such as myocardial infarction and trauma and has emphasized particular segments of time (e.g., time from injury to hospital; time from onset of chest pain to emergency room door). None has articulated a conceptual framework that encompasses the full range of factors that might influence delays. These include patient factors (knowledge, beliefs, and coping strategies), physician factors (knowledge, diagnostic acumen), hospital factors (availability of diagnostic tests and operating rooms), and health system factors (health insurance, utilization management, gatekeeping). We propose to study three delaysensitive conditions: appendicitis, ectopic pregnancy, and intestinal obstruction. In phase 1, we will review medical records retrospectively to establish the relationship between overall time to treatment and health outcomes and to examine variability in different components of this time. Multivariate analysis will permit us to examine the effect of time to treatment after adjustment for age and comorbid conditions. In phase 2, we will gather data concurrently from patients and their physicians, as well as from medical records, to assess the full range of patient, physician, and health system factors contributing to variability in time to treatment. These analyses will substantially improve our understanding of the relationship between time to treatment and health outcomes. Studying three conditions will permit some initial observations about how unique or generalizable these relationships are in different clinical settings. These data may also lead to hypotheses about which factors associated with delays might be modifiable, leading to the design of specific interventions to reduce delays and improve outcomes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GENE POLYMORPHISMS, INFLAMMATION AND OUTCOME FROM TRAUMA Principal Investigator & Institution: O'keefe, Grant E.; Surgery; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): Our overall aim is to identify and characterize genetic differences that are important to the human response to infection and inflammation. First, we will use in vivo and in vitro models of inflammation to determine the functional impact of single nucleotide polymorphisms (SNPs) in inflammation-related genes. Second, we propose to identify SNPs that will help characterize an individual patient's risk for severe infection and death after injury. This information will allow clinicians and researchers to more rationally investigate and use specific therapies aimed at reducing the devastating consequences of severe injury and infection. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PHYSIOLOGY OF COLONIC FUNCTION AND DEFECATION USING COLONIC MOTILITY Principal Investigator & Institution: Rao, Satish S.; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2001; Project Start 01-DEC-2000; Project End 30-NOV-2001 Summary: The goal of the study is to examine physiological changes in motor function throughout the defecation unit recording the intraluminal pressure activity in healthy subjects and subjects with constipation, diverticular disease and fecal incontinence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with diverticulosis, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “diverticulosis” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for diverticulosis (hyperlinks lead to article summaries):
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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A 38-year-old man with tracheomegaly, tracheal diverticulosis, and bronchiectasis. Author(s): Lazzarini-de-Oliveira LC, Costa de Barros Franco CA, Gomes de Salles CL, de Oliveira AC Jr. Source: Chest. 2001 September; 120(3): 1018-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11555541&dopt=Abstract
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A case of enterolith small bowel obstruction and jejunal diverticulosis. Author(s): Hayee B, Khan HN, Al-Mishlab T, McPartlin JF. Source: World Journal of Gastroenterology : Wjg. 2003 April; 9(4): 883-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679956&dopt=Abstract
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A case of systemic sclerosis and diverticulosis coli complicated by intestinal haemorrhage. Author(s): Pirildar T, Saruc M, Aydede H, Ayhan S. Source: Clinical Rheumatology. 2002 November; 21(6): 541-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12447647&dopt=Abstract
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Addition of methyl cellulose enema to double-contrast barium imaging of sigmoid diverticulosis. Author(s): Olsson R, Adnerhill I, Bjorkdahl P, Ekberg O, Fork FT. Source: Acta Radiologica (Stockholm, Sweden : 1987). 1997 January; 38(1): 73-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9059405&dopt=Abstract
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Association of diverticulosis coli and vascular ectasias and the results of fecal occult blood test. Author(s): Nakama H, Fattah AS, Zhang B, Kamijo N, Uehara Y. Source: Hepatogastroenterology. 2000 September-October; 47(35): 1277-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11100332&dopt=Abstract
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Behcet's disease and diverticulosis. Author(s): Sahan C, Akpolat T, Ucer T, Guner E, Dilek M, Danaci M. Source: Digestive Surgery. 2001; 18(5): 421-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11721120&dopt=Abstract
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By the way, doctor. I recently had a sigmoidoscopy and was told I have diverticulosis. Is this a serious condition? Is there anything I can do about it? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 2001 August; 8(12): 7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11546641&dopt=Abstract
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Case report: gastrointestinal haemorrhage from jejunal diverticulosis, probably induced by low dose aspirin. Author(s): Kaushik SP, D'Rozario JM, Chong G, Bassett ML. Source: Journal of Gastroenterology and Hepatology. 1996 October; 11(10): 908-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8912125&dopt=Abstract
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Clinical behavior of complicated right-sided and left-sided diverticulosis. Author(s): Wong SK, Ho YH, Leong AP, Seow-Choen F. Source: Diseases of the Colon and Rectum. 1997 March; 40(3): 344-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9118752&dopt=Abstract
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Colonic diverticulosis in Hong Kong: distribution pattern and clinical significance. Author(s): Chan CC, Lo KK, Chung EC, Lo SS, Hon TY. Source: Clinical Radiology. 1998 November; 53(11): 842-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9833789&dopt=Abstract
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Colonoscopic diagnosis of unsuspected diverticulosis. Author(s): Lee JG, Leung JW. Source: Gastrointestinal Endoscopy. 2002 May; 55(6): 746-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11979265&dopt=Abstract
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Colovesical fistula complicating colonic diverticulosis. Author(s): Wig JD, Kochhar R, Goenka MK, Singh SK, Nagi B, Suri S, Vaiphei K. Source: Indian J Gastroenterol. 1995 April; 14(2): 73-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7797284&dopt=Abstract
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Complicated diverticulosis. Author(s): Boulos PB. Source: Best Practice & Research. Clinical Gastroenterology. 2002 August; 16(4): 649-62. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12406457&dopt=Abstract
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Complicated jejunal diverticulosis: report of a case. Author(s): Fronticelli CM, Bellora P, Ferrero A, Anselmetti GC, Passarino G, Burlo P. Source: Surgery Today. 1996; 26(3): 192-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8845613&dopt=Abstract
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Complicated sigmoid diverticulosis. Author(s): Balsara KP, Dubash C. Source: Indian J Gastroenterol. 1998 April; 17(2): 46-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9563217&dopt=Abstract
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Congenital small bowel diverticulosis and intestinal atresia: a rare association. Author(s): Shenoy MU, Robson K, Broderick N, Kapila L. Source: Journal of Pediatric Surgery. 2000 April; 35(4): 636-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10770404&dopt=Abstract
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Crohn's colitis-like changes in sigmoid diverticulitis specimens is usually an idiosyncratic inflammatory response to the diverticulosis rather than Crohn's colitis. Author(s): Goldstein NS, Leon-Armin C, Mani A. Source: The American Journal of Surgical Pathology. 2000 May; 24(5): 668-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10800985&dopt=Abstract
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Cross linking of collagen is increased in colonic diverticulosis. Author(s): Wess L, Eastwood MA, Wess TJ, Busuttil A, Miller A. Source: Gut. 1995 July; 37(1): 91-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7672689&dopt=Abstract
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Dietary habits and right-sided colonic diverticulosis. Author(s): Lin OS, Soon MS, Wu SS, Chen YY, Hwang KL, Triadafilopoulos G. Source: Diseases of the Colon and Rectum. 2000 October; 43(10): 1412-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11052519&dopt=Abstract
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Diffuse colonic lipomatosis with giant hypertrophy of the epiploic appendices and diverticulosis of the colon. Report of a case and review of the literature. Author(s): Catania G, Petralia GA, Migliore M, Cardi F. Source: Diseases of the Colon and Rectum. 1995 July; 38(7): 769-75. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7607042&dopt=Abstract
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Diffuse intramural pseudodiverticulosis. Author(s): Caroli-Bosc FX, Conio M, Diaine B, Arab K, Demarquay JF, Hastier P, Delmont JP. Source: Endoscopy. 1997 February; 29(2): 146-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9101169&dopt=Abstract
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Diverticulosis and diverticulitis in the immunocompromised patients. Author(s): Detry O, Honore P, Meurisse M, Jacquet N. Source: Acta Chir Belg. 1999 May-June; 99(3): 100-2. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10427342&dopt=Abstract
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Diverticulosis in the defunctioned limb of a long-standing colostomy. Author(s): Moorthy K, Mihssin N, Houghton PW. Source: Journal of the Royal Society of Medicine. 1999 July; 92(7): 359-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10615275&dopt=Abstract
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Diverticulosis of the appendix with diverticulitis: case report. Author(s): Lin CH, Chen TC. Source: Changgeng Yi Xue Za Zhi. 2000 November; 23(11): 711-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11190382&dopt=Abstract
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Diverticulosis: fibre is the key. Author(s): Cheek C, Radley S. Source: The Practitioner. 1999 April; 243(1597): 321-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10492975&dopt=Abstract
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Diverticulosis--a primary cause of life-threatening complications in rheumatoid arthritis. Author(s): Myllykangas-Luosujarvi R. Source: Clin Exp Rheumatol. 1995 January-February; 13(1): 79-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7774108&dopt=Abstract
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Dysphagia from esophageal diverticulosis responding to botulinum toxin injection. Author(s): DeVault KR. Source: The American Journal of Gastroenterology. 1997 May; 92(5): 895-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9149211&dopt=Abstract
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Dysphagia in oesophageal intramural pseudo-diverticulosis: fibrosis, dysmotility or web? Author(s): Shand A, Papachrysostomou M, Ghosh S. Source: European Journal of Gastroenterology & Hepatology. 1999 November; 11(11): 1331-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10563550&dopt=Abstract
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Enterolith ileus as a complication of jejunal diverticulosis: two case reports and a review of the literature. Author(s): Steenvoorde P, Schaardenburgh P, Viersma JH. Source: Digestive Surgery. 2003; 20(1): 57-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12637808&dopt=Abstract
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Enterolith ileus as a complication of small bowel diverticulosis. Author(s): Bowley D, Royle CA. Source: J R Army Med Corps. 1997 October; 143(3): 169. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9403829&dopt=Abstract
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Enterolith ileus complicating jejunal diverticulosis. Author(s): Lobo DN, Braithwaite BD, Fairbrother BJ. Source: Journal of Clinical Gastroenterology. 1999 September; 29(2): 192-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10478885&dopt=Abstract
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Esophageal hypermotility associated with intramural pseudodiverticulosis. Primary esophageal disease or epiphenomena? Author(s): Ritz JP, Germer CT, Zimmer T, Isbert C, Buhr HJ. Source: Surgical Endoscopy. 2000 July; 14(7): 681. Epub 2000 May 10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11265072&dopt=Abstract
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Esophageal inflammatory pseudotumor associated with a pseudodiverticulosis cyst: two inter-related lesions? Author(s): Pimenta AP, Lopes JM, Gouveia A. Source: Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus / I.S.D.E. 1998 October; 11(4): 272-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10071813&dopt=Abstract
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Esophageal intramural pseudodiverticulosis (diffuse type). Author(s): Koyama S, Watanabe M, Iijima T. Source: Journal of Gastroenterology. 2002; 37(8): 644-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12203081&dopt=Abstract
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Esophageal intramural pseudodiverticulosis associated with a web in a 12-year-old boy. Author(s): Lingaraj K, Prabhakaran K, Quak SH. Source: Journal of Pediatric Surgery. 1999 October; 34(10): 1573-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10549779&dopt=Abstract
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Esophageal intramural pseudodiverticulosis associated with achalasia. Author(s): Dua KS, Stewart E, Arndorfer R, Shaker R. Source: The American Journal of Gastroenterology. 1996 September; 91(9): 1859-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8792718&dopt=Abstract
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Esophageal intramural pseudodiverticulosis associated with esophageal perforation. Author(s): Murakami M, Tsuchiya K, Ichikawa H, Kawaguchi K, Sugiyama A, Ishida K, Chisuwa H, Kawasaki S. Source: Journal of Gastroenterology. 2000; 35(9): 702-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11023042&dopt=Abstract
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Esophageal intramural pseudodiverticulosis with esophageal cancer improved by target rotation irradiation: case report. Author(s): Naoi Y, Katayama H, Tomiyoshi H. Source: Nippon Igaku Hoshasen Gakkai Zasshi. 1997 July; 57(8): 526-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9267144&dopt=Abstract
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Esophageal intramural pseudodiverticulosis with Mallory-Weiss syndrome: report of a case. Author(s): Yamamoto N, Nakamura M, Tachibana S, Konno H, Nakamura S, Nishino N. Source: Surgery Today. 2002; 32(6): 519-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12107778&dopt=Abstract
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Esophageal intramural pseudodiverticulosis. Author(s): Flora KD, Gordon MD, Lieberman D, Schmidt W. Source: Digestive Diseases (Basel, Switzerland). 1997 January-April; 15(1-2): 113-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9101133&dopt=Abstract
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Esophageal intramural pseudodiverticulosis. Author(s): van der Putten AB, Loffeld RJ. Source: Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus / I.S.D.E. 1997 January; 10(1): 61-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9079277&dopt=Abstract
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Esophageal intramural pseudodiverticulosis: a characteristically unusual path to diagnosis. Author(s): Gillessen A, Konturek J, Roos N, Domschke W. Source: Endoscopy. 1996 September; 28(7): 640. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8911816&dopt=Abstract
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Esophageal intramural pseudodiverticulosis: a congenital or acquired condition? Author(s): Freud E, Golinsky D, Ziv N, Mor C, Zahavi I, Zer M. Source: Journal of Pediatric Gastroenterology and Nutrition. 1997 May; 24(5): 602-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9161959&dopt=Abstract
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Esophageal intramural pseudodiverticulosis: review of symptoms including upper gastrointestinal bleeding. Author(s): Hahne M, Schilling D, Arnold JC, Riemann JF. Source: Journal of Clinical Gastroenterology. 2001 November-December; 33(5): 378-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11606853&dopt=Abstract
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Esophageal peridiverticulitis: an unusual complication of esophageal intramural pseudodiverticulosis. Author(s): Abrams LJ, Levine MS, Laufer I. Source: European Journal of Radiology. 1995 January; 19(2): 139-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7713088&dopt=Abstract
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Esophageal tuberculosis with intramural pseudodiverticulosis. Author(s): Upadhyay AP, Bhatia RS, Anbarasu A, Sawant P, Rathi P, Nanivadekar SA. Source: Journal of Clinical Gastroenterology. 1996 January; 22(1): 38-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8776094&dopt=Abstract
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EUS appearance of esophageal pseudo-diverticulosis. Author(s): Devereaux CE, Savides TJ. Source: Gastrointestinal Endoscopy. 2000 February; 51(2): 228-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10650278&dopt=Abstract
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Image of the month. Appendiceal and sigmoid diverticulosis. Author(s): Triadacilopoulos G. Source: Gastroenterology. 1997 October; 113(4): 1062, 1424. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9340298&dopt=Abstract
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Images of interest. Gastrointestinal: oesophageal intramural pseudodiverticulosis. Author(s): Al Samman M, Wheeler NS. Source: Journal of Gastroenterology and Hepatology. 2000 March; 15(3): 325. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10764036&dopt=Abstract
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Infantile esophageal intramural pseudodiverticulosis. Author(s): Solomon NS, Berseth CL, Braverman RM, Munden MM, Ferry GD. Source: Journal of Pediatric Gastroenterology and Nutrition. 2000 July; 31(1): 76-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10896076&dopt=Abstract
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Insights into the pathophysiology and mechanisms of constipation, irritable bowel syndrome, and diverticulosis in older people. Author(s): Camilleri M, Lee JS, Viramontes B, Bharucha AE, Tangalos EG. Source: Journal of the American Geriatrics Society. 2000 September; 48(9): 1142-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10983917&dopt=Abstract
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Intestinal motility in small bowel diverticulosis: a case report and review of the literature. Author(s): Kongara KR, Soffer EE. Source: Journal of Clinical Gastroenterology. 2000 January; 30(1): 84-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10636218&dopt=Abstract
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Intramural pseudodiverticulosis of the esophagus detected on barium esophagograms: increased prevalence in patients with esophageal carcinoma. Author(s): Plavsic BM, Chen MY, Gelfand DW, Drnovsek VH, Williams JP 3rd, Kogutt MS, Terry JA, Plenkovich D. Source: Ajr. American Journal of Roentgenology. 1995 December; 165(6): 1381-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7484570&dopt=Abstract
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Intramural pseudodiverticulosis of the esophagus. Author(s): Bhattacharya S, Mahmud S, McGlinchey I, Nassar AH. Source: Surgical Endoscopy. 2002 April; 16(4): 714-5. Epub 2002 February 08. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11972224&dopt=Abstract
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Intramural pseudodiverticulosis of the esophagus: a case series. Author(s): Herter B, Dittler HJ, Wuttge-Hannig A, Siewert JR. Source: Endoscopy. 1997 February; 29(2): 109-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9101148&dopt=Abstract
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Intramural tracking: a feature of esophageal intramural pseudodiverticulosis. Author(s): Canon CL, Levine MS, Cherukuri R, Johnson LF, Smith JK, Koehler RE. Source: Ajr. American Journal of Roentgenology. 2000 August; 175(2): 371-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10915677&dopt=Abstract
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Jejunal diverticulosis and gastrointestinal bleeding. Author(s): Rodriguez HE, Ziauddin MF, Quiros ED, Brown AM, Podbielski FJ. Source: Journal of Clinical Gastroenterology. 2001 November-December; 33(5): 412-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11606860&dopt=Abstract
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Jejunal diverticulosis: a rare entity with multiple presentations, a series of cases. Author(s): Zager JS, Garbus JE, Shaw JP, Cohen MG, Garber SM. Source: Digestive Surgery. 2000; 17(6): 643-645. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11155015&dopt=Abstract
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Jejunal lipomatosis with diverticulosis: report of a case. Author(s): Yakabe S, Muranaka T, Sumii T, Takeshita M, Yamashita T, Tsuruta S, Saku M, Yoshida K. Source: Surgery Today. 1998; 28(8): 846-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9719009&dopt=Abstract
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Laparoscopic left hemihepatectomy combined with right hemicolectomy for liver tumor and hemorrhagic diverticulosis. Author(s): Inagaki H, Kurokawa T, Sakamoto J, Nonami T. Source: Surgical Endoscopy. 2003 January; 17(1): 158-9. Epub 2002 October 29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399864&dopt=Abstract
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Lipomatous polyposis of the colon with multiple lipomas of peritoneal folds and giant diverticulosis: report of a case. Author(s): Brouland JP, Poupard B, Nemeth J, Valleur P. Source: Diseases of the Colon and Rectum. 2000 December; 43(12): 1767-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11156466&dopt=Abstract
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Multiple pelvoureteric diverticulosis in a 1-month-old infant with a del(10p) chromosomal abnormality presenting with UTI and VUR. Author(s): Geller E, Wolfson BJ, Rabinovitch H. Source: Pediatric Radiology. 2000 June; 30(6): 398-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10876824&dopt=Abstract
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Occlusive ileus as a complication of large intestinal diverticulosis (contribution of two cases). Author(s): Novakov IP, Uchikov PA, Nedev PI, Mishev GG, Uchikov AP. Source: Folia Med (Plovdiv). 2003; 45(1): 46-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12943069&dopt=Abstract
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Oesophageal intramural pseudodiverticulosis: a cause of dysphagia in a 10-year-old boy. Author(s): Daud AS, O'Connor F. Source: European Journal of Pediatrics. 1997 July; 156(7): 530-2. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9243234&dopt=Abstract
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Prevalence of diverticulosis and incidence of bowel perforation after kidney transplantation in patients with polycystic kidney disease. Author(s): Dominguez Fernandez E, Albrecht KH, Heemann U, Kohnle M, Erhard J, Stoblen F, Eigler FW. Source: Transplant International : Official Journal of the European Society for Organ Transplantation. 1998; 11(1): 28-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9503551&dopt=Abstract
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Prevalence of polyps and diverticulosis of the large bowel in the Cretan population. An autopsy study. Author(s): Paspatis GA, Papanikolaou N, Zois E, Michalodimitrakis E. Source: International Journal of Colorectal Disease. 2001 August; 16(4): 257-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11515686&dopt=Abstract
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Recent trends in diverticulosis of the right colon in Japan: retrospective review in a regional hospital. Author(s): Miura S, Kodaira S, Shatari T, Nishioka M, Hosoda Y, Hisa TK. Source: Diseases of the Colon and Rectum. 2000 October; 43(10): 1383-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11052515&dopt=Abstract
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Retrograde urogram for ureteral pseudodiverticulosis. Author(s): Russi MF. Source: Urology. 1997 August; 50(2): 316-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9255316&dopt=Abstract
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Segmental colitis associated with diverticulosis. Author(s): Jani N, Finkelstein S, Blumberg D, Regueiro M. Source: Digestive Diseases and Sciences. 2002 May; 47(5): 1175-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018918&dopt=Abstract
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Small bowel diverticulosis. A forgotten diagnosis. Author(s): Cools P, Bosmans E, Onsea J, Verboven H, Mertens A. Source: Acta Chir Belg. 1995 November-December; 95(6): 261-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8571716&dopt=Abstract
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Small-bowel diverticulosis: perceptions and reality. Author(s): Akhrass R, Yaffe MB, Fischer C, Ponsky J, Shuck JM. Source: Journal of the American College of Surgeons. 1997 April; 184(4): 383-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9100684&dopt=Abstract
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Small-bowel pandiverticulosis--a potential source of recurrent gastrointestinal bleeding. Report of a case and review of the literature. Author(s): Hazzan D, Reissman P, Meshulam J, Golijanin D, Shiloni E. Source: Scandinavian Journal of Gastroenterology. 1998 December; 33(12): 1321-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9930397&dopt=Abstract
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Sonographic features of diverticulitis and diverticulosis of the vermiform appendix. Author(s): Macheiner P, Hollerweger A, Gritzmann N. Source: Journal of Clinical Ultrasound : Jcu. 2002 September; 30(7): 456-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12210468&dopt=Abstract
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Traumatic diverticulosis and seromuscular rupture of the sigmoid colon as a result of non-penetrating abdominal trauma. Author(s): Molina-Navarro C, Hosking SW. Source: Injury. 2001 July; 32(6): 510-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11476822&dopt=Abstract
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Trichomoniasis complicating esophageal intramural pseudodiverticulosis: diagnosis by transmission electron microscopy. Author(s): Guccion JG, Ortega LG. Source: Ultrastructural Pathology. 1996 March-April; 20(2): 101-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8882356&dopt=Abstract
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Type I and III collagens in human colon cancer and diverticulosis. Author(s): Bode MK, Karttunen TJ, Makela J, Risteli L, Risteli J. Source: Scandinavian Journal of Gastroenterology. 2000 July; 35(7): 747-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10972180&dopt=Abstract
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Ureteral pseudodiverticulosis. Author(s): van der Molen AJ, Speelman RH. Source: Jbr-Btr. 2000 February; 83(1): 29. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10769515&dopt=Abstract
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Ureteral pseudodiverticulosis: the case for the retrograde urogram. Author(s): Socher SA, Dewolf WC, Morgentaler A. Source: Urology. 1996 June; 47(6): 924-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8677594&dopt=Abstract
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CHAPTER 2. NUTRITION AND DIVERTICULOSIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and diverticulosis.
Finding Nutrition Studies on Diverticulosis The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “diverticulosis” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
4
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “diverticulosis” (or a synonym): •
Addition of methyl cellulose enema to double-contrast barium imaging of sigmoid diverticulosis. Author(s): Department of Diagnostic Radiology, Malmo University Hospital, Sweden. Source: Olsson, R Adnerhill, I Bjorkdahl, P Ekberg, O Fork, F T Acta-Radiol. 1997 January; 38(1): 73-5 0284-1851
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An association between maternal diet and colonic diverticulosis in an animal model. Author(s): Department of Biological and Molecular Sciences, University of Stirling. Source: Wess, L Eastwood, M Busuttil, A Edwards, C Miller, A Gut. 1996 September; 39(3): 423-7 0017-5749
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Collagen alteration in an animal model of colonic diverticulosis. Author(s): Department of Biological and Molecular Sciences, University of Stirling. Source: Wess, L Eastwood, M A Edwards, C A Busuttil, A Miller, A Gut. 1996 May; 38(5): 701-6 0017-5749
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Colonic diverticulosis in Hong Kong: distribution pattern and clinical significance. Author(s): Department of Diagnostic Radiology and Organ Imaging, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong. Source: Chan, C C Lo, K K Chung, E C Lo, S S Hon, T Y Clin-Radiol. 1998 November; 53(11): 842-4 0009-9260
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Dietary habits and right-sided colonic diverticulosis. Author(s): Division of Gastroenterology, ChangHua Christian Medical Center, Taiwan. Source: Lin, O S Soon, M S Wu, S S Chen, Y Y Hwang, K L Triadafilopoulos, G DisColon-Rectum. 2000 October; 43(10): 1412-8 0012-3706
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Diverticulosis: fibre is the key. Author(s): Dept of Surgery, Queen Elizabeth Hospital, Birmingham. Source: Cheek, C Radley, S Practitioner. 1999 April; 243(1597): 321-4 0032-6518
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Epidemiological evaluation of colonic diverticulosis and dietary fiber in Japan. Author(s): First Department of Internal Medicine, Hirosaki University School of Medicine, Japan. Source: Munakata, A Nakaji, S Takami, H Nakajima, H Iwane, S Tuchida, S Tohoku-JExp-Med. 1993 October; 171(2): 145-51 0040-8727
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Etiology and pathogenesis of diverticulosis coli: a new approach. Source: Sikirov, B A Med-Hypotheses. 1988 May; 26(1): 17-20 0306-9877
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Prevalence of colon diverticulosis in Europe. Author(s): Medical Division, University of Wurzburg, FRG. Source: Kasper, H Bach, M Bibl-Nutr-Dieta. 1989; (44): 144-50 0067-8198
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Should people with diverticulosis avoid certain foods? Source: Anonymous Johns-Hopkins-Med-Lett-Health-After-50. 2002 September; 14(7): 8 1042-1882
Nutrition
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Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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The following is a specific Web list relating to diverticulosis; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Food and Diet Complex Carbohydrates Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,993,00.html Vegetarian Diet Source: Healthnotes, Inc.; www.healthnotes.com
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CHAPTER 3. DIVERTICULOSIS
ALTERNATIVE
MEDICINE
AND
Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to diverticulosis. 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 diverticulosis 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 “diverticulosis” (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 diverticulosis: •
A case of ruptured diverticulum of the left ventricle with hemopericardium in a neonate, treated successfully by surgery. Author(s): Pettersson G, Bergstrom T. Source: Scand J Thorac Cardiovasc Surg. 1969; 3(2): 203-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4245507&dopt=Abstract
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A prospective study of diet and the risk of symptomatic diverticular disease in men. Author(s): Aldoori WH, Giovannucci EL, Rimm EB, Wing AL, Trichopoulos DV, Willett WC. Source: The American Journal of Clinical Nutrition. 1994 November; 60(5): 757-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7942584&dopt=Abstract
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Answers to 10 key questions on diverticular disease of the colon. Author(s): Kennedy MV, Zarling EJ. Source: Compr Ther. 1998 August; 24(8): 364-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9740981&dopt=Abstract
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Case report. Small bowel obstruction due to phytobezoar formation within Meckel diverticulum: CT findings. Author(s): Frazzini VI Jr, English WJ, Bashist B, Moore E. Source: Journal of Computer Assisted Tomography. 1996 May-June; 20(3): 390-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8626897&dopt=Abstract
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Cereal dietary fiber consumption and diverticular disease: a lifespan study in rats. Author(s): Fisher N, Berry CS, Fearn T, Gregory JA, Hardy J. Source: The American Journal of Clinical Nutrition. 1985 November; 42(5): 788-804. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2998175&dopt=Abstract
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Chili bean colonic pseudopolyp. Author(s): Tawil S, Brandt LJ. Source: Gastrointestinal Endoscopy. 1991 January-February; 37(1): 106-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2004674&dopt=Abstract
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Clinical picture of diverticular disease of the colon. Author(s): Thompson WG, Patel DG. Source: Clin Gastroenterol. 1986 October; 15(4): 903-16. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3536213&dopt=Abstract
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Clinical use of high-fiber diets. Author(s): Floch MH. Source: Del Med J. 1985 October; 57(10): 643-4, 649-52. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3000839&dopt=Abstract
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Colonic diverticula. Author(s): Eastwood M. Source: The Proceedings of the Nutrition Society. 2003 February; 62(1): 31-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740054&dopt=Abstract
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Colonic diverticula. When complications require surgery and when they don't. Author(s): Elfrink RJ, Miedema BW. Source: Postgraduate Medicine. 1992 November 1; 92(6): 97-8, 101-2, 105, 108 Passim. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1332012&dopt=Abstract
Alternative Medicine 33
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Colonic diverticulosis in Hong Kong: distribution pattern and clinical significance. Author(s): Chan CC, Lo KK, Chung EC, Lo SS, Hon TY. Source: Clinical Radiology. 1998 November; 53(11): 842-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9833789&dopt=Abstract
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Colonic muscle in diverticular disease. Author(s): Smith AN. Source: Clin Gastroenterol. 1986 October; 15(4): 917-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3536214&dopt=Abstract
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Comparison of etiology of right-sided diverticula in Japan with that of left-sided diverticula in the West. Author(s): Nakaji S, Danjo K, Munakata A, Sugawara K, MacAuley D, Kernohan G, Baxter D. Source: International Journal of Colorectal Disease. 2002 November; 17(6): 365-73. Epub 2002 May 09. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12355211&dopt=Abstract
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Diagnosis of occult gastrointestinal lesions by stool guaiac testing in a geriatric hospital. Author(s): Mangla JC, Pereira M, Murphy J. Source: Journal of the American Geriatrics Society. 1981 October; 29(10): 473-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7276414&dopt=Abstract
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Dietary fiber research. Author(s): Madar Z, Odes HS. Source: Prog Biochem Pharmacol. 1990; 24: Iii-Viii, 1-137. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2155433&dopt=Abstract
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Dietary fibre and asymptomatic diverticular disease of the colon. Author(s): Gear JS, Ware AC, Nolan DJ, Fursdon PS, Brodribb AJ, Mann JI. Source: The Proceedings of the Nutrition Society. 1978 May; 37(1): 13A. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=662838&dopt=Abstract
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Dietary fibre and coronary heart disease. Author(s): Trowell H. Source: Rev Eur Etud Clin Biol. 1972 April; 17(4): 345-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4562450&dopt=Abstract
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Diverticular colitis: diagnosis and management. Author(s): Rampton DS.
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Source: Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland. 2001 May; 3(3): 149-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790980&dopt=Abstract •
Diverticular disease in an indigenous African community. Author(s): Archampong EQ, Christian F, Badoe EA. Source: Annals of the Royal College of Surgeons of England. 1978 November; 60(6): 46470. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=718074&dopt=Abstract
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Diverticular disease of the colon and constipation. 3. High fibre diet with added bran. Author(s): Painter NS. Source: Nurs Times. 1972 May 18; 68(20): 620-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5027869&dopt=Abstract
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Diverticular disease of the colon. The first of the Western diseases shown to be due to a deficiency of dietary fibre. Author(s): Painter NS. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1982 June 26; 61(26): 1016-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6283684&dopt=Abstract
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Diverticular disease. Author(s): Waye JD. Source: Primary Care. 1976 March; 3(1): 91-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1085003&dopt=Abstract
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Diverticular disease: threee studies. Part II - Treatment with bran. Author(s): Brodribb AJ, Humphreys DM. Source: British Medical Journal. 1976 February 21; 1(6007): 425-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=766894&dopt=Abstract
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Diverticular disease-associated chronic colitis. Author(s): Makapugay LM, Dean PJ. Source: The American Journal of Surgical Pathology. 1996 January; 20(1): 94-102. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8540614&dopt=Abstract
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Does a high fibre diet prevent the complications of diverticular disease? Author(s): Hyland JM, Taylor I. Source: The British Journal of Surgery. 1980 February; 67(2): 77-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6244871&dopt=Abstract
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Does ispaghula husk stimulate the entire colon in diverticular disease? Author(s): Thorburn HA, Carter KB, Goldberg JA, Finlay IG. Source: Gut. 1992 March; 33(3): 352-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1568654&dopt=Abstract
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Efficacy of rifaximin on symptoms of uncomplicated diverticular disease of the colon. A pilot multicentre open trial. Diverticular Disease Study Group. Author(s): Papi C, Ciaco A, Koch M, Capurso L. Source: Ital J Gastroenterol. 1992 October; 24(8): 452-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1330083&dopt=Abstract
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Fecal beta-sitosterol in patients with diverticular disease of the colon and in vegetarians. Author(s): Miettinen TA, Tarpila S. Source: Scandinavian Journal of Gastroenterology. 1978; 13(5): 573-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=705252&dopt=Abstract
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Fibre and bowel transit times. Author(s): Gear JS, Brodribb AJ, Ware A, Mann JI. Source: The British Journal of Nutrition. 1981 January; 45(1): 77-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6258626&dopt=Abstract
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Food for thought. Author(s): Searle S. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2001 June 13-19; 15(39): 27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12206085&dopt=Abstract
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Gastric secretion of hydrochloric acid and electrolytes before and after large doses of histamine injected subcutaneously in man. Author(s): SEMB LS, MYREN J. Source: Scandinavian Journal of Clinical and Laboratory Investigation. 1964; 16: 253-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14164776&dopt=Abstract
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Giant colonic diverticulae presenting as painless abdominal lump. Author(s): Agarwal DK, Choudhuri G, Dhiman RK, Kapoor VK. Source: Indian J Gastroenterol. 1992 April; 11(2): 90. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1428041&dopt=Abstract
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High fibre diet in symptomatic diverticular disease of the colon. Author(s): Leahy AL, Ellis RM, Quill DS, Peel AL.
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Source: Annals of the Royal College of Surgeons of England. 1985 May; 67(3): 173-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2988400&dopt=Abstract •
How to manage constipation with high-fiber diet. Author(s): Burkitt DP, Meisner P. Source: Geriatrics. 1979 February; 34(2): 33-5, 38-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=104901&dopt=Abstract
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Influence on symptoms and transit-time of Vi-SiblinR in diverticular disease. Author(s): Ewerth S, Ahlberg J, Holmstrom B, Persson U, Uden R. Source: Acta Chir Scand Suppl. 1980; 500: 49-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7013392&dopt=Abstract
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Irritable bowel syndrome and dietary fiber. Author(s): Achord JL. Source: Journal of the American Dietetic Association. 1979 October; 75(4): 452-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=113444&dopt=Abstract
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L N S C3: a proposed classification system for female urethral diverticula. Author(s): Leach GE, Sirls LT, Ganabathi K, Zimmern PE. Source: Neurourology and Urodynamics. 1993; 12(6): 523-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8312937&dopt=Abstract
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Lactulose in the treatment of symptomatic diverticular disease: a comparative study with high-fibre diet. Author(s): Smits BJ, Whitehead AM, Prescott P. Source: Br J Clin Pract. 1990 August; 44(8): 314-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2169839&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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WebMDHealth: 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 diverticulosis; 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 Diverticular Disease Source: Healthnotes, Inc.; www.healthnotes.com Diverticular Disease Source: Integrative Medicine Communications; www.drkoop.com
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Herbs and Supplements Aloe Alternative names: Aloe vera, Aloe barbadensis, Aloe ferox , Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com Aloe Vera Source: Integrative Medicine Communications; www.drkoop.com Collinsonia Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Fiber Source: Integrative Medicine Communications; www.drkoop.com Peppermint Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,812,00.html Valerian Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10064,00.html
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General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. BOOKS ON DIVERTICULOSIS Overview This chapter provides bibliographic book references relating to diverticulosis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on diverticulosis 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 “diverticulosis” (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 diverticulosis: •
Gastroenterology and Hepatology: The Comprehensive Visual Reference. Volume 2: Colon, Rectum, and Anus Source: Philadelphia, PA: Current Medicine. 1996. [200 p.]. Contact: Available from Current Medicine. 400 Market Street, Suite 700, Philadelphia, PA 19106. (800) 427-1796 or (215) 574-2266. Fax (215) 574-2270. E-mail:
[email protected]. Website: current-medicine.com. PRICE: $125.00 plus shipping and handling. ISBN: 1878132792. Summary: This atlas is one in an 8-volume collection of images that pictorially displays the gastrointestinal tract, liver, biliary tree, and pancreas in health and disease, both in children and adults. This volume includes 11 chapters on the colon, rectum, and anus. The chapters on anatomy and physiology, endoscopy, radiology, and pathology provide a framework for understanding the structure and function of normal and diseased colon. An understanding of the principles of colorectal anatomy and intestinal
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physiology is essential for a proper interpretation of the symptoms and complications of dysmotility, diverticulosis, and gastrointestinal bleeding. The diagnosis and management of colorectal neoplasia and inflammatory bowel disease (IBD) depend on proper interpretations of visual imagery derived from radiologic, pathologic, and endoscopic disciplines. These chapters cover a broad range of disease. Illustrative radiographs and images of key pathologic lesions are provided. The chapter on colon and rectal surgery offers illustrations of some of the new operative procedures available for the treatment of colorectal disease. The format of the atlas is visual images supported by relatively brief text. Tables, charts, diagrams, and photomicrographs are used extensively. •
Digestive Diseases and Disorders Sourcebook Source: Detroit, MI: Omnigraphics. 2000. 300 p. Contact: Available from Omnigraphics, Inc. 615 Griswold, Detroit, MI 48226. (800) 2341340. Fax (800) 875-1340. PRICE: $48.00 plus shipping and handling. ISBN: 0780803272. Summary: This sourcebook provides basic information for the layperson about common disorders of the upper and lower digestive tract. The sourcebook also includes information about medications and recommendations for maintaining a healthy digestive tract. The book's 40 chapters are arranged in three major parts. The first section, Maintaining a Healthy Digestive Tract, offers basic information about the digestive system and digestive diseases, information about tests and treatments, and recommendations for maintaining a healthy digestive system. The second section, Digestive Diseases and Functional Disorders, describes nearly 40 different diseases and disorders affecting the digestive system. These include appendicitis, bleeding in the digestive tract, celiac disease, colostomy, constipation, constipation in children, Crohn's disease, cyclic vomiting syndrome, diarrhea, diverticulosis and diverticulitis, gallstones, gas in the digestive tract, heartburn (gastroesophageal reflux disease), hemorrhoids, hernias, Hirschsprung's disease, ileostomy, indigestion (dyspepsia), intestinal pseudoobstruction, irritable bowel syndrome (IBS), IBS in children, lactose intolerance, Menetrier's disease, rapid gastric emptying, short bowel syndrome, ulcerative colitis, ulcers, Whipple's disease, and Zollinger Ellison syndrome. The final section offers a glossary of terms, a subject index and a directory of digestive diseases organizations (which includes website and email addresses as available). Material in the book was collected from a wide range of government agencies, nonprofit organizations, and periodicals.
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 “diverticulosis” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “diverticulosis” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “diverticulosis” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com):
Books
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Irritable Bowel Syndrome and Diverticulosis: A Self-Help Plan by Shirley Trickett, Belinda Dawes; ISBN: 0722538618; http://www.amazon.com/exec/obidos/ASIN/0722538618/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 “diverticulosis” (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:5 •
Diverticulitis and diverticulosis of the right colon. Author: Fitzgibbons, Robert Joseph,; Year: 1983; [Minneapolis] 1947
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Diverticulosis and diverticulitis. Author: Welch, Claude E. (Claude Emerson), 1906-; Year: 1958
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Diverticulosis of the colon; a clinical and histological study. Author: Havia, Tapani.; Year: 1971; Turku, 1971
Chapters on Diverticulosis In order to find chapters that specifically relate to diverticulosis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and diverticulosis 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 “diverticulosis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on diverticulosis: •
Diverticula, Diverticulosis, and Diverticulitis Source: in Janowitz, H.D. Good Food for Bad Stomachs. New York, NY: Oxford University Press. 1997. p. 128-134. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $12.95 plus shipping and handling. ISBN: 0195126556. Summary: This chapter on diverticula, diverticulosis, and diverticulitis is from a book that presents a detailed look at present knowledge about the role of eating habits in
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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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preventing, causing, and treating the many disorders that plague the gastrointestinal tract and its associated digestive glands, the liver, the gallbladder, and the pancreas. The author addresses the role of diet in preventing and treating the intestinal pouches called diverticula. Topics include the incidence of diverticulosis, including risk factors; the part of the colon most likely to be involved; ways dietary fiber affects diverticula; complications of diverticulosis of the colon; a high fiber diet; and the relationship between irritable bowel syndrome (IBS) and colonic diverticula. The current evidence is far from complete, but it suggests that people raised on a diet high in fiber seem to have a much better chance of avoiding diverticula and their complications than people who consume a low fiber diet.
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CHAPTER 5. MULTIMEDIA ON DIVERTICULOSIS Overview In this chapter, we show you how to keep current on multimedia sources of information on diverticulosis. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on diverticulosis is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “diverticulosis” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “diverticulosis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on diverticulosis: •
Diverticular Disease and the Older Adult Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1995. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 091395B. Summary: Diverticular disease, including diverticulosis and diverticulitis, occurs when pouches (diverticula) form in the intestines. This videotape on coping with diverticular disease is one in a series of health promotion programs called 'Picture of Health,' produced by the University of Wisconsin. In this program, moderated by Mary Lee and featuring gastroenterologist John Wyman, the common etiology (causes), symptoms, diagnosis, and management of diverticular disease are covered. Dr. Wyman focuses on the role of diet as the major culprit in diverticular disease and also reviews why the
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condition can be difficult to diagnose. Dr. Wyman stresses the preferred term of 'diverticular disease' to connote a degenerative disease process, rather than a finite problem with a simple treatment. Diverticulosis is herniation of the colon lining, resulting in pouch like abnormalities; diverticulitis is what happens when these pouches become inflamed or infected (complications can include hemorrhage and abscess). Although 90 percent of people with diverticular disease have no symptoms, people with symptoms can experience pain (in the left lower abdomen) and chronic inflammation. Dr. Wyman reviews irritable bowel syndrome (IBS) and how it differs from diverticular disease, primarily in the symptoms of diarrhea, constipation, and other disorder bowel habits. A high fiber diet results in bulkier stools, more active and stable colonic bacteria, and an increase in bowel diameter (which reduces overall pressure through the colon). Dr. Wyman reiterates the importance of eating high fiber foods, which are on the bottom of the food pyramid and considers whether diet can actually prevent diverticular disease (probably, but it is not yet proven). The program briefly discusses the diagnostic tests used to confirm complications and treatment of diverticular disease. The program includes simple drawings of the intestines and other pictures used to explain the subject matter under discussion. The program concludes by referring viewers to the National Digestive Diseases Information Clearinghouse (NDDIC). •
Upper GI and Hepatobiliary Disorders Source: in Schwartz, R.S., ed. Aging and the Elderly: A Review Course of Geriatric Medicine. Seattle, WA: University of Washington School of Medicine. 1992. Tape Number 9, Section 32. Contact: Available from CME Conference Video, Inc. 2000 Crawford Place, Suite 100, Mount Laurel, NJ 08054. (800) 284-8433. PRICE: $549; plus $18.25 shipping and handling; Group Practice Package $150 plus $5.25 shipping and handling. Program Number 053. Summary: This videotape presentation is part of the 16th Annual Symposium on Aging and the Elderly, a continuing medical education (CME) program offered through the University of Washington School of Medicine. The program reviews upper gastrointestinal and hepatobiliary disorders. Topics include disorders of the oropharynx, esophagus, stomach and duodenum, pancreas, gallbladder and biliary tract, liver, and small intestine and colon. Specific disorders reviewed in the latter section include idiopathic inflammatory bowel disease, appendicitis, diverticulosis, constipation, and vascular ectasias. The videotape also includes the question-andanswer period conducted after the section. The proceedings include a reprint of this author's article in the New England Journal of Medicine on the same topics.
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CHAPTER 6. PERIODICALS AND NEWS ON DIVERTICULOSIS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover diverticulosis.
News Services and Press Releases One of the simplest ways of tracking press releases on diverticulosis 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 “diverticulosis” (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 diverticulosis. 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 “diverticulosis” (or synonyms). 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
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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 “diverticulosis” (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 “diverticulosis” (or synonyms). If you know the name of a company that is relevant to diverticulosis, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “diverticulosis” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “diverticulosis” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on diverticulosis:
Periodicals and News
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Diverticular Disease (Diverticulosis and Diverticulitis) Source: Intestinal Fortitude. 9(4): 1-3. 1999. Contact: Available from Intestinal Disease Foundation. 1323 Forbes Avenue, Suite 200, Pittsburgh, PA 15219. (412) 261-5888. Summary: This patient education article reviews diverticular disease (diverticulosis and diverticulitis) and its management. Diverticulosis is a condition in which pouches of intestinal lining balloon out through weak areas of the wall of the large intestine (colon). If the diverticula become infected, the condition is called diverticulitis, which can lead to serious complications. Diverticulosis is very common in North America, where diets tend to be low in fiber. Once formed, diverticula are permanent and cannot be reversed. The goal of management is to keep new diverticula from forming and to prevent complications. Patients with diverticulosis should follow the same advice given to people with constipation: eat regular meals that are high in fiber, drink plenty of fluids, exercise daily, respond right away to the urge to move the bowels, and avoid laxatives. High fiber diets are recommended because they help to create heavier, softer stools which move through the lower part of the gastrointestinal tract more easily than do small, hard stools. The goal is to consume 25 to 40 grams of dietary fiber per day. The article offers suggestions for increasing the amount of dietary fiber, noting that it is a good idea to increase fiber intake slowly (too much fiber too quickly can cause gas and bloating). Symptoms of diverticulitis may include fever and chills, abdominal pain (particularly on the lower left side), disruption of normal bowel activity, and abdominal tenderness. Infection can lead to complications such as rupturing of the diverticula, abscesses, bowel blockage, or leaks through the bowel wall. The article concludes by discussing the treatment options for diverticulitis, including surgical techniques that may be used.
Academic Periodicals covering Diverticulosis Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to diverticulosis. In addition to these sources, you can search for articles covering diverticulosis 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
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute6: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
6
These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 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:8 •
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/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
7
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). 8 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “diverticulosis” using the “Detailed Search” option. Go directly to the following hyperlink: 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 the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “diverticulosis” (or synonyms) into the “For these words:” box. The following is a sample result: •
Diverticular Disease (Diverticulosis; Diverticulitis) Source: in Griffith, H.W. Instructions for Patients. 5th ed. Philadelphia, PA: W.B. Saunders Company. 1994. p. 130. Contact: Available from W.B. Saunders Company. Book Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522. Fax (800) 874-6418. PRICE: $49.95. ISBN: 0721649300 (English); 0721669972 (Spanish). Summary: This fact sheet provides basic information on frequent signs and symptoms, causes, risk factors, preventive measures, etc.; treatment, medication, and diet; and when to contact one's health care provider. The fact sheet is designed to be photocopied and distributed to patients as a reinforcement of oral instructions and as a teaching tool. The book in which the fact sheet appears is available in English or Spanish.
The NLM Gateway9 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.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “diverticulosis” (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.
9
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
10
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).
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Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 10403 87 25 2 1 10518
HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 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.13 Simply search by “diverticulosis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists14 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.15 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.16 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/.
11
Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.
12
The HSTAT URL is http://hstat.nlm.nih.gov/.
13
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. 14 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 15
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. 16 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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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/.
The Genome Project and Diverticulosis In the following section, we will discuss databases and references which relate to the Genome Project and diverticulosis. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).17 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “diverticulosis” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for diverticulosis: •
Diverticulosis of Bowel, Hernia, and Retinal Detachment Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?223330
•
Diverticulosis, Small-intestinal Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?223320 Genes and Disease (NCBI - Map)
The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may 17 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.
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wish to revisit it from time to time. The following systems and associated disorders are addressed: •
Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html
•
Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html
•
Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html
•
Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html
•
Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html
•
Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html
•
Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez
Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases:
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3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books
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Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome
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NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/
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Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide
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OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM
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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset
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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo
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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein
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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
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Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure
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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy
To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “diverticulosis” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database18 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. 18
Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html.
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The Genome Database19 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “diverticulosis” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).
19
Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.
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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 diverticulosis 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 diverticulosis. 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 diverticulosis. 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 “diverticulosis”:
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Guides on diverticulosis Diverticulosis http://www.nlm.nih.gov/medlineplus/tutorials/diverticulosisloader.html Diverticulosis and Diverticulitis http://www.nlm.nih.gov/medlineplus/diverticulosisanddiverticulitis.html
•
Other guides Bladder Diseases http://www.nlm.nih.gov/medlineplus/bladderdiseases.html Colonic Diseases http://www.nlm.nih.gov/medlineplus/colonicdiseases.html Digestive Diseases http://www.nlm.nih.gov/medlineplus/digestivediseases.html
Within the health topic page dedicated to diverticulosis, the following was listed: •
General/Overviews Diverticulitis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00070 Diverticulosis http://www.nlm.nih.gov/medlineplus/tutorials/diverticulosisloader.html
•
Diagnosis/Symptoms Abdominal Pain, Acute: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/527.html Abdominal Pain, Chronic: Self-Care Flowcharts Source: American Academy of Family Physicians http://familydoctor.org/flowcharts/528.html Colonoscopy http://www.nlm.nih.gov/medlineplus/tutorials/colonoscopyloader.html Colonoscopy Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/colonoscopy/index.htm Flexible Sigmoidoscopy Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/sigmoidoscopy/index.htm Lower GI Series Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/lowergi/index.htm
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Virtual Colonoscopy Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/virtualcolonoscopy/index.htm •
Treatment Laparoscopic Intestinal Surgery: A Guide for Patients Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/health/healthinfo/docs/0900/0962.asp?index=4356
•
Specific Conditions/Aspects Meckel's Diverticulum Source: American Academy of Family Physicians http://familydoctor.org/handouts/547.html
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Organizations American Gastroenterological Association http://www.gastro.org/ National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/
•
Prevention/Screening Fiber Supplements: OK to Use Long Term? Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00130 Roughing It: Fitting More Fiber into Your Diet Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=NU00033
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 diverticulosis. 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:
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Diverticulosis and Diverticulitis Source: Bethesda, MD: National Diabetes Information Clearinghouse (NDDIC), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health. 1996. 5 p. Contact: Available from National Digestive Diseases Information Clearinghouse (NDDIC). 2 Information Way, Bethesda, MD 20892-3570. (800) 891-5389 or (301) 6543810. Fax (301) 634-0716. E-mail:
[email protected]. Website: www.niddk.nih.gov. PRICE: Single copy free. Summary: This fact sheet describes diverticulosis and diverticulitis. Most people have small pouches in their colons that bulge outward through weak spots; each pouch is called a diverticulum. The condition of having diverticula is called diverticulosis; when the pouches become infected or inflamed, the condition is called diverticulitis. The fact sheet reviews the causes of diverticular disease, the symptoms of diverticulosis and diverticulitis, possible complications (bleeding, abscess, perforation, peritonitis, fistula, intestinal obstruction), how diverticular disease is diagnosed, and treatment options. The most common symptom of diverticulitis is abdominal pain. If infection is the cause, fever, nausea, vomiting, chills, cramping, and constipation may occur as well. A high fiber diet and occasionally, mild pain medications will help relieve symptoms in most cases. Sometimes an attack of diverticulitis is serious enough to require a hospital stay and possibly surgery. The fact sheet lists common high fiber foods in the categories of fruits, vegetables, starchy vegetables, and grains. One sidebar summarizes the important points covered in the fact sheet. The fact sheet concludes with a brief description of the activities of the National Digestive Diseases Information Clearinghouse (NDDIC). 1 figure. 1 table. 3 references. 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: •
Diverticulosis and Diverticulitis Summary: This online document discusses diverticular disease -- causes, symptoms, diagnosis and treatment. Includes also recommended reading and other related sources. Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2000 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 diverticulosis. 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
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rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. NORD (The National Organization of Rare Disorders, Inc.) NORD provides an invaluable service to the public by publishing short yet comprehensive guidelines on over 1,000 diseases. NORD primarily focuses on rare diseases that might not be covered by the previously listed sources. NORD’s Web address is http://www.rarediseases.org/. A complete guide on diverticulosis can be purchased from NORD for a nominal fee. 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
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: 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 diverticulosis. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with diverticulosis. 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 diverticulosis. 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
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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 “diverticulosis” (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 “diverticulosis”. 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 “diverticulosis” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “diverticulosis” (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)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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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
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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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.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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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
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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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
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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/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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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
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).
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
75
DIVERTICULOSIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Ablation: The removal of an organ by surgery. [NIH] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] 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] Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU]
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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] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesics: Compounds capable of relieving pain without the loss of consciousness or without producing anesthesia. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angiodysplasia: Degenerative, acquired lesions consisting of distorted, dilated, thin-walled vessels lined by vascular endothelium. This pathological state is seen especially in the gastrointestinal tract and is frequently a cause of upper and lower gastrointestinal hemorrhage in the elderly. [NIH] Angiography: Radiography of blood vessels after injection of a contrast medium. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
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]
Dictionary 77
Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arterial embolization: The blocking of an artery by a clot of foreign material. This can be done as treatment to block the flow of blood to a tumor. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriography: A procedure to x-ray arteries. The arteries can be seen because of an injection of a dye that outlines the vessels on an x-ray. [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Ascites: Accumulation or retention of free fluid within the peritoneal cavity. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atresia: Lack of a normal opening from the esophagus, intestines, or anus. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Autopsy: Postmortem examination of the body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance
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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] Bed Rest: Confinement of an individual to bed for therapeutic or experimental reasons. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [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] Blind Loop Syndrome: Malabsorption, especially of vitamin B12 or folic acid, due to metabolic competition by bacteria proliferating in a segment of small intestine excluded from normal peristaltic movement; it may occur as a postoperative complication of side-toside anastomosis of intestine, as a result of intestinal diverticula, fistula, etc. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is
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most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchiectasis: Persistent abnormal dilatation of the bronchi. [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] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Cecum: The beginning of the large intestine. The cecum is connected to the lower part of the small intestine, called the ileum. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH]
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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] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Cholelithiasis: Presence or formation of gallstones. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [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] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colectomy: An operation to remove the colon. An open colectomy is the removal of the colon through a surgical incision made in the wall of the abdomen. Laparoscopic-assisted colectomy uses a thin, lighted tube attached to a video camera. It allows the surgeon to remove the colon without a large incision. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH]
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Colostomy: An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine.
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Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclic Vomiting Syndrome: Sudden, repeated attacks of severe vomiting (especially in children), nausea, and physical exhaustion with no apparent cause. Can last from a few hours to 10 days. The episodes begin and end suddenly. Loss of fluids in the body and changes in chemicals in the body can require immediate medical attention. Also called abdominal migraine. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] 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] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH]
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Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Dietary Fiber: The remnants of plant cell walls that are resistant to digestion by the alimentary enzymes of man. It comprises various polysaccharides and lignins. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] 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] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]
Duodenum: The first part of the small intestine. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH]
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Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Ectopic: Pertaining to or characterized by ectopia. [EU] Ectopic Pregnancy: The pregnancy occurring elsewhere than in the cavity of the uterus. [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] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrolytes: Substances that break up into ions (electrically charged particles) when they are dissolved in body fluids or water. Some examples are sodium, potassium, chloride, and calcium. Electrolytes are primarily responsible for the movement of nutrients into cells, and the movement of wastes out of cells. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Enteric Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [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]
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Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Perforation: A dilated vessel in the lower end of the esophagus that result from portal hypertension. [NIH] Esophageal Varices: Stretched veins in the esophagus that occur when the liver is not working properly. If the veins burst, the bleeding can cause death. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estrogen: One of the two female sex hormones. [NIH] Evacuation: An emptying, as of the bowels. [EU] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] 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] Fat: Total lipids including phospholipids. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Fecal occult blood test: A test to check for blood in stool. (Fecal refers to stool; occult means hidden.) [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH]
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Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] 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] Forearm: The part between the elbow and the wrist. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]
Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastritis: Inflammation of the stomach. [EU] Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system. [NIH] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal Hemorrhage: Bleeding in the gastrointestinal tract. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Geriatric: Pertaining to the treatment of the aged. [EU] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia
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lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Government Agencies: Administrative units of government responsible for policy making and management of governmental activities in the U.S. and abroad. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]
Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Haematoma: A localized collection of blood, usually clotted, in an organ, space, or tissue, due to a break in the wall of a blood vessel. [EU] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] 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] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH]
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Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatobiliary: Pertaining to the liver and the bile or the biliary ducts. [EU] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogenic: Derived from a different source or species. Also called heterogenous. [NIH] Heterogenous: Derived from a different source or species. Also called heterogenic. [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hydration: Combining with water. [NIH] Hydrochloric Acid: A strong corrosive acid that is commonly used as a laboratory reagent. It is formed by dissolving hydrogen chloride in water. Gastric acid is the hydrochloric acid component of gastric juice. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH]
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Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Ileus: Obstruction of the intestines. [EU] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
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Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Inguinal Hernia: A small part of the large or small intestine or bladder that pushes into the groin. May cause pain and feelings of pressure or burning in the groin. Often requires surgery. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestinal Obstruction: Any impairment, arrest, or reversal of the normal flow of intestinal contents toward the anus. [NIH] Intestinal Pseudo-Obstruction: Obstruction of the intestines that is functional, not mechanical. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravenous: IV. Into a vein. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] 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] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles
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in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischemic Colitis: Decreased blood flow to the colon. Causes fever, pain, and bloody diarrhea. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [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] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Lacerations: Torn, ragged, mangled wounds. [NIH] Lactose Intolerance: The disease state resulting from the absence of lactase enzyme in the musocal cells of the gastrointestinal tract, and therefore an inability to break down the disaccharide lactose in milk for absorption from the gastrointestinal tract. It is manifested by indigestion of a mild nature to severe diarrhea. It may be due to inborn defect genetically conditioned or may be acquired. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Lipid: Fat. [NIH] Lipomatosis: A disorder consisting of the accumulation of abnormal localized, or tumor-like fat in the tissues. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH]
Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]
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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] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [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] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]
Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Mesentery: A layer of the peritoneum which attaches the abdominal viscera to the abdominal wall and conveys their blood vessels and nerves. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [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] Microscopy: The application of microscope magnification to the study of materials that
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cannot be properly seen by the unaided eye. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] 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] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] 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]
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Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [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] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] 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] Nuclear Medicine: A specialty field of radiology concerned with diagnostic, therapeutic, and investigative use of radioactive compounds in a pharmaceutical form. [NIH] Nucleus: 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] Occult: Obscure; concealed from observation, difficult to understand. [EU] Occult Blood: Chemical, spectroscopic, or microscopic detection of extremely small amounts of blood. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Operating Rooms: Facilities equipped for performing surgery. [NIH] Oropharynx: Oral part of the pharynx. [NIH] 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] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH]
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Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [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] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Pelvic: Pertaining to the pelvis. [EU] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptic Ulcer Hemorrhage: Bleeding from a peptic ulcer. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Petechiae: Pinpoint, unraised, round red spots under the skin caused by bleeding. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH]
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Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physician Assistants: Persons academically trained, licensed, or credentialed to provide medical care under the supervision of a physician. The concept does not include nurses, but does include orthopedic assistants, surgeon's assistants, and assistants to other specialists. [NIH]
Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Plague: An acute infectious disease caused by Yersinia pestis that affects humans, wild rodents, and their ectoparasites. This condition persists due to its firm entrenchment in sylvatic rodent-flea ecosystems throughout the world. Bubonic plague is the most common form. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Policy Making: The decision process by which individuals, groups or institutions establish policies pertaining to plans, programs or procedures. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together
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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] Postoperative: After surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] 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] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [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] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prone: Having the front portion of the body downwards. [NIH] 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] 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] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU]
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Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pyoderma: Any purulent skin disease (Dorland, 27th ed). [NIH] Pyoderma Gangrenosum: An idiopathic, rapidly evolving, and severely debilitating disease occurring most commonly in association with chronic ulcerative colitis. It is characterized by the presence of boggy, purplish ulcers with undermined borders, appearing mostly on the legs. The majority of cases are in people between 40 and 60 years old. Its etiology is unknown. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioactivity: The quality of emitting or the emission of corpuscular or electromagnetic radiations consequent to nuclear disintegration, a natural property of all chemical elements of atomic number above 83, and possible of induction in all other known elements. [EU] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiologist: A doctor who specializes in creating and interpreting pictures of areas inside the body. The pictures are produced with x-rays, sound waves, or other types of energy. [NIH]
Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH]
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Radionuclide scanning: A test that produces pictures (scans) of internal parts of the body. The person is given an injection or swallows a small amount of radioactive material; a machine called a scanner then measures the radioactivity in certain organs. [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] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] 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] Resection: Removal of tissue or part or all of an organ by surgery. [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] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retrospective: Looking back at events that have already taken place. [NIH]
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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] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Roentgenography: Production of an image of an object on film, or other kind of sensitized plate, usually by means of X-radiation or gamma radiation, the contrast between different areas of the image being the result of differential interaction of the radiation in the object. [NIH]
Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [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] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Sclerotherapy: Treatment of varicose veins, hemorrhoids, gastric and esophageal varices, and peptic ulcer hemorrhage by injection or infusion of chemical agents which cause localized thrombosis and eventual fibrosis and obliteration of the vessels. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in
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successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Sigmoid: 1. Shaped like the letter S or the letter C. 2. The sigmoid colon. [EU] Sigmoid Colon: The lower part of the colon that empties into the rectum. [NIH] Sigmoidoscope: A thin, lighted tube used to view the inside of the colon. [NIH] Sigmoidoscopy: Endoscopic examination, therapy or surgery of the sigmoid flexure. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] 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] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH]
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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] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincters: Any annular muscle closing an orifice. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sprue: A non febrile tropical disease of uncertain origin. [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]
Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] 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] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH]
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Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] 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] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [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] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy,
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effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] 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]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [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] 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] Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH]
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Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] 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]
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INDEX A Abdomen, 44, 75, 78, 79, 80, 85, 87, 90, 91, 94, 95, 102, 103 Abdominal, 3, 6, 9, 11, 12, 26, 35, 47, 62, 64, 75, 82, 83, 91, 92, 94, 95, 104 Abdominal Pain, 3, 9, 47, 62, 64, 75, 91, 92, 95, 104 Ablation, 13, 75 Abscess, 4, 6, 8, 44, 64, 75 Acuity, 9, 75 Adenocarcinoma, 75, 88 Adjustment, 14, 75 Adrenal Medulla, 75, 85 Adrenergic, 75, 85, 102 Adverse Effect, 75, 101 Age of Onset, 75, 104 Algorithms, 75, 78 Alimentary, 75, 83, 95 Alkaline, 75, 77, 79 Alternative medicine, 46, 75 Amebiasis, 75, 92 Amine, 75, 88 Amino Acids, 13, 76, 96, 97 Ampulla, 76, 84 Anal, 76, 85 Analgesics, 11, 76 Anastomosis, 76, 78 Anatomical, 76, 77, 89, 100 Anemia, 5, 9, 57, 76, 86 Anesthesia, 76 Anesthetics, 76, 85 Angiodysplasia, 9, 76 Angiography, 6, 9, 76 Animal model, 28, 76 Antibacterial, 76, 102 Antibiotic, 11, 12, 76, 102 Antibody, 76, 81, 89, 90, 93, 98, 99, 105 Antigen, 76, 81, 89 Anti-inflammatory, 6, 77 Anti-Inflammatory Agents, 77 Anus, 5, 39, 76, 77, 79, 84, 86, 90, 99 Aorta, 77, 104 Appendicitis, 7, 11, 14, 40, 44, 77 Arterial, 9, 77, 89, 97, 103 Arterial embolization, 9, 77 Arteries, 77, 78, 82, 92, 93 Arteriography, 5, 13, 77 Arteriovenous, 5, 77
Ascites, 12, 77 Aspirin, 17, 77 Asymptomatic, 4, 7, 33, 75, 77 Ataxia, 57, 77, 103 Atresia, 18, 77 Atrium, 77, 104 Atrophy, 57, 77 Autopsy, 25, 77 B Bacteria, 44, 76, 77, 78, 84, 85, 86, 102 Barium, 5, 9, 13, 16, 23, 28, 77 Basal Ganglia, 77 Basal Ganglia Diseases, 77 Base, 77, 91 Bed Rest, 8, 78 Benign, 4, 78, 93, 99 Benzene, 78 Benzodiazepines, 5, 78 Bile, 78, 86, 88, 91, 102 Bile Acids, 78, 86, 102 Bile Ducts, 78, 86 Biliary, 39, 44, 78, 88 Biliary Tract, 44, 78 Bilirubin, 78, 86 Biotechnology, 15, 41, 46, 53, 56, 57, 58, 78 Bladder, 62, 78, 89, 90, 97, 99, 104 Blind Loop Syndrome, 12, 78 Bloating, 47, 78, 89, 91, 92 Blood Coagulation, 78, 79 Blood pressure, 9, 13, 78, 89, 93, 101 Blood transfusion, 5, 10, 78 Blood vessel, 76, 78, 79, 84, 87, 91, 92, 101, 103, 104 Body Fluids, 78, 84, 101 Bone Density, 12, 78 Bone scan, 79, 100 Bowel Movement, 79, 83, 102 Brachytherapy, 79, 90, 98, 105 Branch, 71, 79, 95, 101, 103 Breakdown, 79, 83, 86 Bronchi, 79, 85 Bronchial, 79, 88 Bronchiectasis, 16, 79 C Calcium, 9, 12, 79, 81, 84 Carcinogen, 79, 92 Carcinogenic, 78, 79, 102 Carcinoma, 11, 23, 79
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Cardiac, 79, 85, 86, 93, 99, 102 Case report, 17, 19, 21, 23, 32, 79 Case series, 23, 79 Cecum, 79, 91 Celiac Disease, 40, 79 Cell, 57, 77, 78, 79, 81, 83, 90, 93, 94, 96, 99, 103, 105 Cell Division, 57, 77, 79, 96 Cellobiose, 79, 80 Cellulose, 16, 28, 79, 80, 96 Cerebellar, 77, 80, 99 Cerebral, 77, 80, 85, 101 Cerebrum, 80, 104 Character, 80, 83, 87 Chest Pain, 14, 80 Cholelithiasis, 7, 13, 80 Cholesterol, 11, 13, 78, 80, 82, 86, 88, 102 Chromosomal, 24, 80 Chronic, 7, 8, 12, 13, 34, 44, 57, 62, 75, 80, 83, 84, 85, 89, 91, 96, 98, 102, 104 Chronic renal, 80, 96 Clinical trial, 14, 53, 80 Cloning, 78, 80 Cofactor, 80, 97 Colectomy, 6, 80 Colitis, 5, 10, 18, 25, 33, 34, 80, 91 Collagen, 18, 28, 80, 97 Colonoscopy, 4, 5, 6, 9, 62, 63, 80 Colorectal, 4, 5, 8, 9, 11, 25, 33, 34, 39, 80 Colorectal Cancer, 4, 5, 8, 11, 80 Colostomy, 18, 40, 81 Complement, 81 Complementary and alternative medicine, 31, 38, 81 Complementary medicine, 31, 81 Computational Biology, 53, 56, 81 Computed tomography, 79, 81, 82, 100 Computerized axial tomography, 81, 82, 100 Computerized tomography, 6, 81 Concomitant, 13, 82 Connective Tissue, 80, 82, 85, 86, 100 Consciousness, 76, 82, 99 Constipation, 9, 10, 11, 12, 13, 15, 22, 34, 36, 40, 44, 47, 64, 82, 91, 95 Consumption, 7, 32, 82, 83, 99 Contraindications, ii, 82 Coronary, 33, 82, 92, 93 Coronary heart disease, 33, 82 Coronary Thrombosis, 82, 92, 93 Cortex, 77, 82, 97, 99 Corticosteroids, 6, 82
Curative, 82, 103 Cyclic, 40, 82 Cyclic Vomiting Syndrome, 40, 82 Cyst, 20, 82 D Dairy Products, 9, 82 Databases, Bibliographic, 53, 82 Decarboxylation, 82, 88 Defecation, 15, 83 Degenerative, 44, 76, 83, 88 Developed Countries, 4, 83 Diabetes Mellitus, 11, 12, 83, 87, 90 Diagnostic procedure, 46, 83 Diaphragm, 83, 88 Diarrhea, 10, 11, 12, 40, 44, 75, 83, 91, 92 Diastolic, 83, 89 Dietary Fiber, 4, 8, 10, 11, 28, 32, 36, 42, 47, 83 Digestion, 75, 78, 79, 83, 89, 90, 91, 95, 102 Digestive system, 40, 83, 86 Digestive tract, 4, 10, 40, 83, 101 Dilatation, 79, 83 Direct, iii, 4, 8, 9, 83, 87, 99 Disease Progression, 13, 83 Distal, 5, 83, 86, 97 Distention, 11, 83 Diverticula, 3, 7, 11, 32, 33, 36, 41, 43, 47, 64, 78, 83 Diverticulitis, 4, 6, 7, 11, 18, 19, 25, 40, 41, 43, 47, 54, 62, 64, 83 Diverticulum, 4, 31, 32, 63, 64, 83 Drug Interactions, 83 Duodenal Ulcer, 7, 83 Duodenum, 44, 78, 83, 84, 86, 95, 102 Dyspepsia, 40, 83, 89 Dysphagia, 19, 24, 83 Dysplasia, 57, 83 Dystrophy, 57, 84 E Ectopic, 14, 84 Ectopic Pregnancy, 14, 84 Efficacy, 35, 84, 103 Elastin, 80, 84 Elective, 5, 6, 8, 84 Electrolytes, 35, 78, 84 Emboli, 6, 84 Embolization, 6, 84 Endocrine Glands, 84 Endoscope, 84 Endoscopic, 5, 6, 8, 9, 40, 80, 84, 101 Endoscopy, 4, 5, 6, 11, 17, 18, 20, 21, 22, 23, 24, 32, 39, 84
Index 109
Endothelium, 76, 84 End-stage renal, 80, 84, 96 Enema, 6, 11, 16, 28, 84 Enteric Nervous System, 8, 84 Enteritis, 7, 84 Enterocolitis, 84 Environmental Exposure, 84, 94 Environmental Health, 52, 54, 84 Enzymatic, 79, 81, 84, 88 Enzyme, 84, 85, 91, 95, 105 Epigastric, 85, 94 Epinephrine, 6, 75, 85 Erythrocytes, 76, 85 Esophageal, 5, 7, 19, 20, 21, 22, 23, 24, 26, 85, 86, 100 Esophageal Perforation, 20, 85 Esophageal Varices, 5, 85, 100 Esophagitis, 85, 86 Esophagus, 20, 21, 23, 44, 77, 83, 85, 86, 87, 91, 96, 99, 102 Essential Tremor, 57, 85 Estrogen, 10, 85 Evacuation, 82, 85, 86 Exhaustion, 82, 85 Exocrine, 85, 94 Exogenous, 85, 104 External-beam radiation, 85, 90, 98, 105 F Family Planning, 53, 85 Fat, 4, 7, 11, 13, 82, 84, 85, 91, 100 Febrile, 85, 102 Fecal Incontinence, 12, 15, 85, 89 Fecal occult blood test, 16, 85 Feces, 82, 85, 102 Fibrin, 78, 85, 95 Fibrosis, 19, 57, 85, 100 Fistula, 6, 8, 17, 64, 78, 85 Flatulence, 11, 86 Flatus, 85, 86 Fold, 86, 92 Folic Acid, 78, 86 Forearm, 78, 86 G Gallbladder, 7, 12, 42, 44, 75, 78, 83, 86 Gallstones, 7, 8, 40, 80, 86 Ganglia, 77, 84, 86, 94 Gas, 10, 12, 40, 47, 86, 88, 89, 91, 92 Gastric, 5, 35, 40, 86, 87, 88, 95, 100 Gastric Emptying, 40, 86 Gastric Juices, 86, 95 Gastric Mucosa, 86, 95 Gastritis, 5, 86
Gastroenterologist, 5, 43, 86 Gastroesophageal Reflux, 7, 10, 40, 86 Gastroesophageal Reflux Disease, 7, 40, 86 Gastrointestinal Hemorrhage, 9, 76, 86 Gastrointestinal tract, 11, 39, 42, 47, 76, 86, 91 Gene, 41, 58, 59, 78, 86, 94 Geriatric, 33, 44, 86 Giardiasis, 86, 92 Gland, 75, 87, 94, 97, 100 Glucose, 57, 79, 80, 83, 87, 90, 100 Glucose Intolerance, 83, 87 Gluten, 79, 87 Goats, 82, 87 Gonadal, 87, 102 Governing Board, 87, 97 Government Agencies, 40, 87, 97 Groin, 87, 90 Growth, 57, 76, 87, 92, 93, 94, 96, 104 H Haematoma, 87 Haemorrhage, 16, 17, 87 Health Education, 12, 87 Health Promotion, 43, 87 Heartburn, 10, 11, 40, 87, 88, 89 Hemoglobin, 76, 85, 87, 88 Hemoglobinuria, 57, 88 Hemorrhage, 4, 6, 7, 8, 9, 44, 88, 98 Hemorrhoids, 4, 5, 10, 11, 40, 88, 100 Hepatitis, 12, 88 Hepatobiliary, 44, 88 Hepatocellular, 12, 88 Hepatocellular carcinoma, 12, 88 Hepatocytes, 88 Hereditary, 88, 99 Heredity, 86, 88 Heterogenic, 88 Heterogenous, 8, 88 Hiatal Hernia, 11, 88 Histamine, 35, 88 Histidine, 88 Hormonal, 77, 88 Hormone, 82, 85, 88, 90, 97, 100 Hydration, 8, 88 Hydrochloric Acid, 35, 88 Hydrogen, 75, 78, 88, 94, 95 Hydroxylysine, 80, 88 Hydroxyproline, 80, 88 Hypercholesterolemia, 8, 88 Hyperlipidemia, 11, 13, 88 Hypersensitivity, 89, 100 Hypertension, 10, 85, 89
110 Diverticulosis
Hypertrophy, 18, 89 I Id, 29, 36, 62, 63, 65, 70, 72, 89 Idiopathic, 44, 89, 98 Ileostomy, 40, 89 Ileum, 79, 89 Ileus, 19, 20, 24, 89 Immune system, 89, 105 Immunocompromised, 4, 18, 89 Immunodeficiency, 57, 89 Impairment, 77, 89, 90 Implant radiation, 89, 90, 98, 105 In vitro, 15, 89 In vivo, 15, 89 Incision, 80, 89 Incompetence, 86, 89 Incontinence, 12, 89 Indicative, 40, 89, 95, 104 Indigestion, 40, 89, 91 Infancy, 13, 89 Infarction, 89 Infection, 12, 15, 47, 64, 75, 86, 89, 92, 94, 100, 102, 104, 105 Inflammation, 3, 7, 11, 15, 44, 77, 80, 83, 84, 85, 86, 88, 90, 95, 100, 104 Inflammatory bowel disease, 6, 7, 8, 10, 40, 44, 90 Infusion, 6, 9, 90, 100, 103 Inguinal, 7, 90 Inguinal Hernia, 7, 90 Inorganic, 90, 93 Insulin, 90, 104 Intermittent, 6, 90 Internal radiation, 90, 98, 105 Interstitial, 79, 90, 105 Intestinal, 3, 8, 12, 13, 14, 16, 18, 23, 24, 39, 40, 42, 47, 56, 63, 64, 78, 79, 84, 90, 92 Intestinal Obstruction, 8, 14, 64, 90 Intestinal Pseudo-Obstruction, 8, 40, 90 Intestine, 7, 78, 79, 80, 84, 90, 91 Intoxication, 90, 105 Intracellular, 89, 90, 97 Intravenous, 90 Involuntary, 77, 85, 90, 93 Ions, 77, 84, 88, 90 Irradiation, 21, 90, 105 Irritable Bowel Syndrome, 7, 8, 10, 11, 12, 22, 40, 41, 42, 44, 90 Ischemia, 77, 91 Ischemic Colitis, 6, 9, 10, 11, 91 K Kb, 52, 91
Kidney Disease, 24, 52, 57, 63, 64, 91 Kidney stone, 13, 91 Kidney Transplantation, 24, 91 L Lacerations, 5, 91 Lactose Intolerance, 10, 40, 91 Large Intestine, 47, 79, 80, 83, 90, 91, 99, 101 Leukemia, 57, 91 Library Services, 70, 91 Ligament, 91, 97 Lipid, 13, 90, 91 Lipomatosis, 18, 24, 91 Liver, 7, 12, 24, 39, 42, 44, 75, 78, 83, 85, 86, 88, 91, 100 Liver cancer, 12, 91 Liver scan, 91, 100 Localized, 87, 89, 91, 96, 100, 104 Lower Esophageal Sphincter, 86, 91 Lymphatic, 84, 89, 92 Lymphoid, 82, 92 Lymphoma, 57, 92 M Magnetic Resonance Imaging, 92, 100 Malabsorption, 57, 78, 79, 92, 101 Malabsorption syndrome, 92, 101 Malignancy, 9, 92 Malignant, 57, 75, 91, 92, 93, 99 Malnutrition, 12, 77, 92, 93 Manifest, 4, 92 Meat, 4, 9, 92 Medical Records, 14, 92 MEDLINE, 53, 56, 57, 92 Melanocytes, 92 Melanoma, 57, 92 Membrane, 7, 81, 92, 93, 96 Mesenteric, 6, 92 Mesentery, 92, 95 Metronidazole, 12, 92 MI, 40, 73, 92 Microscopy, 26, 92 Milliliter, 78, 93 Molecular, 28, 53, 55, 56, 78, 81, 93 Monitor, 12, 93, 94 Monoclonal, 90, 93, 98, 105 Morphological, 8, 92, 93 Motility, 4, 12, 23, 93 Motion Sickness, 93 Motor Activity, 10, 93 Mucosa, 5, 11, 79, 84, 86, 93 Mucus, 7, 93, 104 Muscle Fibers, 93
Index 111
Muscular Atrophy, 57, 93 Muscular Dystrophies, 84, 93 Myocardial infarction, 14, 82, 92, 93 Myocardium, 92, 93 Myotonic Dystrophy, 57, 93 N Nasogastric, 5, 93 Nausea, 11, 64, 82, 89, 93 Necrosis, 89, 92, 93 Need, 3, 5, 8, 9, 11, 39, 41, 43, 46, 54, 66, 80, 93 Neoplasia, 40, 57, 93, 94 Neoplasm, 6, 93, 94 Neoplastic, 92, 94 Nephropathy, 91, 94 Nephrosis, 94 Nephrotic, 13, 94 Nerve, 12, 75, 76, 77, 84, 94, 100 Nervous System, 8, 57, 78, 86, 94, 102 Neuromuscular, 8, 94 Neuropathy, 12, 94 Neutrons, 90, 94, 98 Nuclear, 5, 6, 77, 93, 94, 98 Nuclear Medicine, 5, 94 Nucleus, 77, 82, 94, 103 Nurse Practitioners, 5, 94 O Occult, 5, 13, 33, 85, 94 Occult Blood, 5, 94 Oncogene, 57, 94 Operating Rooms, 14, 94 Oropharynx, 44, 94 Outpatient, 5, 94 P Palliative, 94, 103 Pancreas, 39, 42, 44, 75, 83, 90, 94, 95 Pancreatic, 57, 86, 94, 95 Pancreatic cancer, 57, 94 Pancreatic Juice, 86, 95 Paroxysmal, 57, 95 Pathogenesis, 28, 95 Pathologic, 5, 8, 40, 82, 89, 95, 104 Pathologies, 4, 95 Pathophysiology, 4, 10, 22, 95 Patient Education, 47, 63, 68, 70, 73, 95 Pelvic, 95, 97 Pepsin, 95 Pepsin A, 95 Peptic, 5, 7, 10, 11, 95, 100 Peptic Ulcer, 5, 7, 10, 11, 95, 100 Peptic Ulcer Hemorrhage, 95, 100 Perforation, 6, 8, 24, 64, 95
Peritoneal, 24, 77, 95 Peritoneal Cavity, 77, 95 Peritoneum, 92, 95 Peritonitis, 6, 64, 95 Petechiae, 87, 95 PH, 79, 95 Pharmaceutical Preparations, 80, 95 Pharmacologic, 76, 96, 103 Pharynx, 86, 94, 96 Phospholipids, 85, 96 Phosphorus, 79, 96 Physical Examination, 5, 96 Physician Assistants, 5, 96 Physiologic, 8, 96 Physiology, 8, 10, 39, 96 Pigment, 78, 92, 96 Plague, 42, 96 Plants, 87, 96, 100, 103 Plasma, 13, 87, 96, 101 Poisoning, 90, 93, 96 Policy Making, 87, 96 Polycystic, 24, 57, 96 Polypeptide, 80, 95, 96 Polyposis, 24, 80, 96 Polysaccharide, 76, 80, 96 Posterior, 76, 77, 94, 97 Postoperative, 78, 97 Potassium, 84, 97 Practicability, 97, 104 Practice Guidelines, 55, 97 Prevalence, 4, 7, 23, 24, 25, 28, 97 Progesterone, 97, 102 Progression, 76, 97 Progressive, 80, 87, 93, 97 Proline, 80, 88, 97 Prone, 12, 97 Prospective study, 31, 97 Prostate, 57, 97 Protein S, 41, 57, 58, 78, 97 Proteins, 76, 80, 81, 95, 96, 97, 101, 103 Proteinuria, 13, 97 Proximal, 83, 97 Public Policy, 53, 98 Publishing, 6, 9, 65, 98 Pulmonary, 78, 82, 98, 104 Pulmonary Artery, 78, 98, 104 Pulse, 93, 98 Purpura, 87, 98 Purulent, 75, 98 Pyoderma, 6, 98 Pyoderma Gangrenosum, 6, 98
112 Diverticulosis
R Radiation, 84, 85, 90, 92, 98, 99, 100, 105 Radiation therapy, 85, 90, 98, 105 Radioactive, 79, 88, 89, 90, 91, 94, 98, 99, 100, 105 Radioactivity, 98, 99 Radiography, 9, 76, 98 Radiolabeled, 90, 98, 105 Radiological, 6, 98 Radiologist, 13, 98 Radiology, 17, 22, 24, 28, 33, 39, 94, 98 Radionuclide scanning, 9, 99 Radiotherapy, 79, 90, 98, 99, 105 Reagent, 88, 99 Rectal, 9, 40, 99 Rectum, 5, 12, 17, 18, 24, 25, 28, 39, 77, 79, 80, 83, 86, 89, 90, 91, 97, 99, 101 Recurrence, 5, 99 Red Nucleus, 77, 99 Refer, 1, 81, 94, 99 Reflux, 86, 99 Refraction, 99, 102 Regurgitation, 86, 87, 99 Remission, 99 Renal pelvis, 91, 99 Resection, 4, 6, 99, 101 Respiration, 93, 99 Restoration, 99 Resuscitation, 6, 99 Retinoblastoma, 57, 99 Retrograde, 25, 26, 99 Retrospective, 25, 99 Rheumatism, 100 Rheumatoid, 19, 100 Rheumatoid arthritis, 19, 100 Risk factor, 6, 42, 54, 97, 100 Roentgenography, 11, 100 S Salivary, 83, 94, 100 Salivary glands, 83, 100 Saponins, 100, 102 Scans, 13, 99, 100 Schizoid, 100, 105 Schizophrenia, 100, 105 Schizotypal Personality Disorder, 100, 105 Sclerosis, 16, 57, 100 Sclerotherapy, 6, 100 Screening, 4, 5, 80, 100 Secretion, 35, 88, 93, 100, 101 Segmental, 6, 25, 100 Segmentation, 101 Seizures, 95, 101
Semen, 97, 101 Serum, 11, 81, 95, 101 Sex Determination, 57, 101 Shock, 101, 103 Short Bowel Syndrome, 40, 101 Side effect, 11, 12, 75, 101, 103 Sigmoid, 5, 16, 17, 18, 22, 26, 28, 101 Sigmoid Colon, 5, 26, 101 Sigmoidoscope, 5, 101 Sigmoidoscopy, 4, 5, 16, 62, 101 Signs and Symptoms, 8, 54, 99, 101 Small intestine, 6, 12, 44, 78, 79, 83, 84, 86, 88, 89, 90, 93, 101 Smooth muscle, 8, 88, 101, 102 Sodium, 84, 101 Sound wave, 98, 101 Spastic, 91, 101 Specialist, 65, 101 Species, 85, 88, 93, 102, 104, 105 Spectrum, 7, 102 Sphincters, 85, 102 Spinal cord, 10, 80, 84, 94, 102 Sporadic, 99, 102 Sprue, 7, 102 Staging, 100, 102 Steroid, 10, 100, 102 Stimulant, 88, 102 Stomach, 5, 7, 44, 75, 83, 85, 86, 88, 91, 93, 95, 96, 99, 101, 102 Stool, 9, 10, 33, 85, 89, 91, 102 Stress, 91, 93, 100, 102 Subacute, 89, 102 Subclinical, 89, 101, 102 Substance P, 100, 102 Sympathomimetic, 85, 102 Symphysis, 97, 102 Symptomatic, 7, 31, 35, 36, 102 Systemic, 10, 16, 77, 78, 85, 89, 90, 98, 103, 105 Systemic disease, 10, 103 Systolic, 89, 103 T Telangiectasia, 57, 103 Thalamic, 77, 103 Thalamic Diseases, 77, 103 Therapeutics, 103 Thorax, 75, 103 Threshold, 89, 103 Thrombosis, 97, 100, 103 Tissue, 76, 77, 78, 82, 84, 87, 90, 91, 92, 93, 94, 95, 96, 99, 101, 102, 103 Tomography, 32, 103
Index 113
Toxic, iv, 78, 84, 94, 103 Toxicity, 83, 103 Toxicology, 54, 103 Toxins, 76, 89, 103 Trace element, 13, 103 Transfection, 78, 103 Transfusion, 103 Trauma, 14, 26, 77, 85, 93, 103 Treatment Outcome, 4, 103 Trichomoniasis, 26, 92, 104 Tryptophan, 80, 104 Tuberculosis, 22, 82, 104 Tuberous Sclerosis, 57, 104 Type 2 diabetes, 9, 104 U Ulcer, 83, 95, 104 Ulcerative colitis, 7, 10, 40, 90, 98, 104 Ultrasonography, 6, 11, 104 Unconscious, 76, 89, 104 Ureters, 91, 104 Urethra, 97, 104 Urinary, 11, 89, 104 Urine, 78, 88, 89, 91, 97, 99, 104
Uterus, 84, 97, 104 V Varicose, 100, 104 Varicose vein, 100, 104 Vascular, 6, 10, 13, 16, 44, 76, 84, 89, 104 Vasoconstriction, 85, 104 Vasodilator, 88, 104 Vein, 77, 90, 94, 104 Venous, 77, 88, 97, 104 Ventricle, 31, 98, 103, 104 Vertebrae, 102, 105 Veterinary Medicine, 53, 105 Villous, 79, 105 Visceral, 8, 95, 105 Vitro, 105 Vivo, 105 W White blood cell, 76, 92, 93, 105 Withdrawal, 5, 105 X Xenograft, 76, 105 X-ray, 77, 79, 81, 90, 94, 98, 99, 100, 105 X-ray therapy, 90, 105
114 Diverticulosis
Index 115
116 Diverticulosis
