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

ASPIRATION PNEUMONIA A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

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

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Aspiration Pneumonia: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00104-7 1. Aspiration Pneumonia-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on aspiration pneumonia. 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 ASPIRATION PNEUMONIA ........................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Aspiration Pneumonia .................................................................. 4 E-Journals: PubMed Central ......................................................................................................... 8 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. NUTRITION AND ASPIRATION PNEUMONIA .............................................................. 35 Overview...................................................................................................................................... 35 Finding Nutrition Studies on Aspiration Pneumonia................................................................. 35 Federal Resources on Nutrition ................................................................................................... 36 Additional Web Resources ........................................................................................................... 36 CHAPTER 3. ALTERNATIVE MEDICINE AND ASPIRATION PNEUMONIA ........................................ 39 Overview...................................................................................................................................... 39 National Center for Complementary and Alternative Medicine.................................................. 39 Additional Web Resources ........................................................................................................... 45 General References ....................................................................................................................... 45 CHAPTER 4. BOOKS ON ASPIRATION PNEUMONIA ........................................................................ 47 Overview...................................................................................................................................... 47 Book Summaries: Online Booksellers........................................................................................... 47 Chapters on Aspiration Pneumonia............................................................................................. 47 CHAPTER 5. PERIODICALS AND NEWS ON ASPIRATION PNEUMONIA ........................................... 51 Overview...................................................................................................................................... 51 News Services and Press Releases................................................................................................ 51 Newsletter Articles ...................................................................................................................... 53 Academic Periodicals covering Aspiration Pneumonia ............................................................... 53 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 57 Overview...................................................................................................................................... 57 NIH Guidelines............................................................................................................................ 57 NIH Databases............................................................................................................................. 59 Other Commercial Databases....................................................................................................... 61 APPENDIX B. PATIENT RESOURCES ................................................................................................. 63 Overview...................................................................................................................................... 63 Patient Guideline Sources............................................................................................................ 63 Finding Associations.................................................................................................................... 66 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 69 Overview...................................................................................................................................... 69 Preparation................................................................................................................................... 69 Finding a Local Medical Library.................................................................................................. 69 Medical Libraries in the U.S. and Canada ................................................................................... 69 ONLINE GLOSSARIES.................................................................................................................. 75 Online Dictionary Directories ..................................................................................................... 75 ASPIRATION PNEUMONIA DICTIONARY............................................................................ 77 INDEX .............................................................................................................................................. 103

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with aspiration pneumonia 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 aspiration pneumonia, 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 aspiration pneumonia, 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 aspiration pneumonia. 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 aspiration pneumonia, 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 aspiration pneumonia. 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 ASPIRATION PNEUMONIA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on aspiration pneumonia.

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

Impact of Oral Diseases on Systemic Health in the Elderly: Diabetes Mellitus and Aspiration Pneumonia Source: Journal of Public Health Dentistry. 60(4): 313-320. Fall 2000. Contact: Available from American Association of Public Health Dentistry. 3760 SW Lyle Court, Portland, OR 97221. (503) 242-0712. Fax (503) 242-0721. E-mail: [email protected]. Summary: Evidence is increasing that oral health has important impacts on systemic health. This article presents data from the third National Health and Nutrition Examination Survey (NHANES III) describing the prevalence of dental caries and periodontal diseases in the older adult population. The authors then evaluate published

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reports and present data from clinical and epidemiological studies on relationships among oral health status, chronic oral infections (including caries and periodontitis), and certain systemic diseases, specifically focusing on type 2 diabetes and aspiration pneumonia. Both of these diseases increase in occurrence and impact in older age groups. The NHANES III data demonstrate that dental caries (cavities) and periodontal diseases occur with substantial frequency and represent a burden of unmet treatment need in older adults. The authors found clinical and epidemiological evidence to support considering periodontal infection a risk factor for poor glycemic control in type 2 diabetes; however, there is limited representation of older adults in reports of this relationship. For aspiration pneumonia, several lines of evidence support oral health status as an important etiologic factors. Additional clinical studies designed specifically to evaluate the effects of treating periodontal infection on glycemic control and improving oral health status in reducing the risk of aspiration pneumonia are needed. Although the associations are complicated, there is evidence to support recommending oral care regimens in protocols for managing type 2 diabetes and preventing aspiration pneumonia. 8 tables. 71 references.

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

Project Title: COORDINATION OF RESPIRATION AND DEGLUTITION Principal Investigator & Institution: Perlman, Adrienne L.; Professor; Speech and Hearing Science; University of Illinois Urbana-Champaign Henry Administration Bldg Champaign, Il 61820 Timing: Fiscal Year 2002; Project Start 15-JAN-2000; Project End 31-DEC-2003 Summary: The close proximity of the larynx to the entrance of the esophagus, and the common pathway through the pharynx that both air and a swallowed bolus must traverse, require that swallowing and respiration be well coordinated. Discoordination can result in the aspiration of food, liquid, or oral secretions consequent risk of severe respiratory complications. Despite its critical function, the coordination of respiration

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

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with swallowing is not well-understood either in healthy individuals or in persons, such as stroke patients, who are known to be at high risk for developing aspiration pneumonia. Using respirodeglutometry, this research will characterize the joint timing of respiration with the swallow and simultaneously record respiratory airflow, submental surface electromyography, and swallow-associated acoustic signals. Two hundred forty normal subjects (120 male, 120 female) in five groups ranging from 3 to 85 years-of-age, and sixty medically stable stroke patients, will be studied. Respirodeglutometric (RDT) output will be digitized at 1000 samples/sec/channel while subjects swallow pre-measured 5, 10, and 15 ml volumes of water and pudding. For all subjects and for each swallow, the direction of respiration preceding and following the swallow, the duration of deglutition apnea, and five additional RDT temporal measures will be obtained. All stroke patients will also be seen for videofluoroscopic assessment within 24 hours of the RDT evaluation in order to directly assess the oral and pharyngeal stages of their swallow and to identify various indicators of dysphagia, including the presence/absence of laryngeal penetration and aspiration. Analysis will address i) effects of size and viscosity of swallowed material on timing of RDT measured events within the swallow, ii) changes in the coordination of respiration with swallowing in healthy subjects across the lifespan, iii) age and gender adjusted effects of stroke on such coordination, iv) adaptations of coordination by healthy subjects and stroke patients to feeding by a caregiver relative to self-feeding, and v) the relationship in stroke patients of videofluoroscopically- observed oropharyngeal dysphasia and aspiration to aberrant respiratory-swallowing patterns. Findings from this research can have a profound effect on patient evaluation procedures as well as on behavioral management techniques, clinical outcome goals, and medical costs for stroke patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: LINGUAL MECHANICAL FUNCTION DURING SWALLOWING Principal Investigator & Institution: Gilbert, Richard J.; Mechanical Engineering; Massachusetts Institute of Technology Room E19-750 Cambridge, Ma 02139 Timing: Fiscal Year 2003; Project Start 12-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): The human tongue is an intricately configured muscular organ that plays a vital role during the physiological act of swallowing. During normal deglutition, the tongue first configures, then propels the ingested bolus from the oral cavity retrograde to the pharynx. From a clinical perspective, disorders of lingual function are exceedingly common in the elderly, in association with common neurological diseases, such as stroke, Parkinson's disease, and dementia, and are responsible for impaired nutrition and increased risk of aspiration pneumonia in these patient populations. Notwithstanding, there is minimal understanding of the way in which lingual muscular structure contributes to physiological function. The study of lingual mechanics has long been hampered by the complex myoarchitecture of the tissue and its material properties. As a result, mechanical function cannot be determined solely from global changes of shape, but necessitates the study of intramural dynamics. Our overall hypothesis is that the tongue functions as a muscular hydrostat, a unique structure in the human body, with the ability to both create motion and to provide the skeletal support for that motion. In order to test this hypothesis in the setting of human swallowing, we have considered the tongue from the perspective of a material continuum, and have thus depicted the tissue in terms of local fiber organization and strain. This project will study the quantitative relationship between three-dimensional myoarchitecture and regional mechanics during human swallowing. Our experimental

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approach uses non-invasive nuclear magnetic resonance imaging techniques to discern patterns of myoarchitecture and regional mechanics in vivo. In Specific Aim 1, the threedimensional myoarchitecture of the tongue will be studied through the depiction of the local second order diffusion tensor derived from magnetic resonance imaging. In Specific Aim 2, the quantitative relationship between muscle fiber architecture and regional strain in association with swallowing will be determined by linkage of the structural measures with tagged magnetization. In Specific Aim 3, the regional mechanical adaptation to varying bolus volume and viscosity will be studied through combined diffusion tensor and tagged magnetization imaging under varying load conditions. This project should result in an improved understanding of structurefunction relationships for the human tongue, and related human muscular hydrostats. It is anticipated that this understanding will result in novel hypotheses of pathological lingual function for patients with oropharyngeal dysphagia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLEARANCE

MECHANISM

OF

GASTROESOPHAGEAL

REFLUX

AND

Principal Investigator & Institution: Massey, Benson T.; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532260509 Timing: Fiscal Year 2002 Summary: The gastroesophageal junction is the first portal through which noxious gastric contents must pass if they are to cause injury to the upper aerodigestive tract. When reflux occurs excessively and clearance of reflux is impaired, patients can develop esophagitis, ulcers, stricture, adenocarcinoma, laryngitis, and aspiration pneumonia. Unfortunately, the mechanisms for initiating and suppressing reflux and the factors contributing to the altered clearance of the refluxate are poorly understood. The specific objectives of this subproject are to explore the following hypotheses: 1). Intragastric pressure is a major determination of whether reflux occurs, with reflux patients having lower threshold pressures for triggering reflux. 2). Afferent sensory pathways in the cardia of the stomach are important in triggering GERD. Agents can be delivered endoscopically to block these pathways and inhibit GER. 3). Esophageal longitudinal muscles play an active role in the reflux event. 4). Esophageal acidification alters the function of longitudinal esophageal muscles, so as to contribute to forming a hiatal hernia. 5). Longitudinal esophageal muscle function during primary and secondary peristalsis is abnormal in patients with reflux disease, and these abnormalities contribute to disturbances in esophageal bolus clearance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREDICTING HOSPITALIZATION

PEDIATRIC

RISK

OF

DEATH

AFTER

Principal Investigator & Institution: Feudtner, John C.; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 191044399 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006 Summary: (provided by applicant): The prospective identification of dying children is an essential task that must be accomplished in order to improve the beneficial impact of palliative, end-of-life, and bereavement (P-EOL-B) services on dying children and their families, since this prospective identification is essential if effective individual-level interventions are to be employed in a timely manner. We hypothesize that using administrative health service utilization data, one can prospectively identify with

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reasonable accuracy a substantial proportion of children who die from complex chronic conditions, and that proactive identification can improve the delivery of P-EOL-B care to these children and their families. We therefore aim to: 1. Develop a method of prognostication that would use administrative health utilization data to triage patients into low, medium-low, medium-high, and high risk groups for subsequent 1-year mortality. 2. Develop collaborative relationships and plan a larger replication study using data from other contexts, in order to validate techniques that would enable the recreation of this prognostication algorithm in the context of local and evolving systems of pediatric health care services. The algorithm will be developed using logistic regression and recursive partitioning, which will model the probability of dying 365 days after hospitalization among children age. We will utilize administrative hospital discharge data contained in the Pennsylvania Health Care Cost Commission database, linked to vital statistics records. With this innovative mortality risk prediction system in hand, we postulate that P-EOL-B and pastoral care teams in hospitals and health care programs would be able to identify individual patients or classes of patients (eg, those with cerebral palsy and the first or second hospitalization for an aspiration pneumonia) suitable for quality of care assessment and improvement, with targeted intensive care coordination to introduce P-EOL-B care earlier into these patients' and families' comprehensive package of care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STATEWIDE EFFORTS TO IMPROVE CARE IN INTENSIVE CARE UNIT Principal Investigator & Institution: Pronovost, Peter J.; Anesthesiology/Crit Care Med; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 29-SEP-2005 Summary: (Provided by the Applicant) Over 5 million people who suffer preventable morbidity and mortality are admitted annually in the U.S.; consuming about 30 percent of acute care costs ($180 billion annually). Previous studies suggest that nearly every ICU patient suffers a potentially life threatening adverse event. To reduce this, we must learn what is broken and fix it. We hypothesize that we can improve patient safety; improve safety culture; and reduce ICU mortality, blood stream infections, aspiration pneumonia and ICU length of stay. To accomplish this, we will partner with the Michigan Hospital Association, whose has over 130 Michigan hospitals, to implement a safety program and other interventions in a cohort of hospitals. The specific aims of this project are to implement and evaluate the: (1) impact of the Comprehensive Unit-based Safety Program that includes the ICU Safety Reporting System; (2) effect of an intervention to improve communication and staffing in ICUs; (3) effect of an intervention to reduce/eliminate catheter related blood stream infections in ICU s; (4) effect of an intervention to improve the care of ventilated IC patients; and (5) effect of an intervention to reduce ICU mortality. To implement these aims, we will develop interventions for MHA who will then interact with Michigan hospitals to implement these interventions. Hospitals must commit a team--including a senior executive (vicepresident or above), an ICU director or ICU physician, ICU nurse or nurse manager, and a department administrator--to collecting required data and attending 2 meetings and 2 conference calls/year. All teams will work on specific aim 1 and then choose one of the other specific aims every 6 months. By the end of the two year project, each team will have implemented all 5 specific aims and able to coach each other. Successful completion of this project will lead to significant improvements in patient safety across a state.

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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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

Clindamycin in Treatment of Aspiration Pneumonia in Children. by Brook I.; 1979 Mar; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=352662

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with aspiration pneumonia, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “aspiration pneumonia” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for aspiration pneumonia (hyperlinks lead to article summaries): •

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A clinical approach to the choice of antimicrobial agents, case number 7: aspiration pneumonia. Author(s): Raff MJ, Melo JC. Source: J Ky Med Assoc. 1979 July; 77(7): 343-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=458256 Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

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

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A national inpatient cost estimate of percutaneous endoscopic gastrostomy (PEG)associated aspiration pneumonia. Author(s): Siddique R, Neslusan CA, Crown WH, Crystal-Peters J, Sloan S, Farup C. Source: Am J Manag Care. 2000 April; 6(4): 490-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10977455

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A novel diagnostic test for the risk of aspiration pneumonia in the elderly. Author(s): Teramoto S, Yamamoto H, Yamaguchi Y, Ouchi Y, Matsuse T. Source: Chest. 2004 February; 125(2): 801-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14769774

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A randomized controlled trial of penicillin vs clindamycin for the treatment of aspiration pneumonia in children. Author(s): Jacobson SJ, Griffiths K, Diamond S, Winders P, Sgro M, Feldman W, Macarthur C. Source: Archives of Pediatrics & Adolescent Medicine. 1997 July; 151(7): 701-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9232045

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A retrospective survey of treatment and mortality in aspiration pneumonia. Author(s): Hickling KG, Howard R. Source: Intensive Care Medicine. 1988; 14(6): 617-22. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3053842

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ACE inhibitors and prevention of aspiration pneumonia in elderly hypertensives. Author(s): Teramoto S, Ouchi Y. Source: Lancet. 1999 March 6; 353(9155): 843. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10459988

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Actionstat. Aspiration pneumonia. Author(s): Calianno C. Source: Nursing. 1996 October; 26(10): 47. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8975192

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Acute stroke predisposes to oral gram-negative bacilli -- a cause of aspiration pneumonia? Author(s): Millns B, Gosney M, Jack CI, Martin MV, Wright AE. Source: Gerontology. 2003 May-June; 49(3): 173-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12679608

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•

Adult aspiration pneumonia. Author(s): Kross DE. Source: American Family Physician. 1980 July; 22(1): 73-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7386355

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Aeromonas hydrophila and aspiration pneumonia: a diverse presentation. Author(s): Mukhopadhyay C, Bhargava A, Ayyagari A. Source: Yonsei Medical Journal. 2003 December 30; 44(6): 1087-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14703621

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Ampicillin + sulbactam vs clindamycin +/- cephalosporin for the treatment of aspiration pneumonia and primary lung abscess. Author(s): Allewelt M, Schuler P, Bolcskei PL, Mauch H, Lode H; Study Group on Aspiration Pneumonia. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2004 February; 10(2): 163-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14759242

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Anaerobic thoracic empyema complicated by bronchopleural fistula and aspiration pneumonia. Author(s): Bjelland JC, Freundlich IM. Source: Ariz Med. 1976 April; 33(4): 307-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1275759

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Antibiotics for the treatment of aspiration pneumonia. Author(s): Joseph PR. Source: Archives of Pediatrics & Adolescent Medicine. 1998 February; 152(2): 207-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9491053

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Aspiration pneumonia after anesthesia in a patient with a Zenker diverticulum. Author(s): Aouad MT, Berzina CE, Baraka AS. Source: Anesthesiology. 2000 June; 92(6): 1837-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10839940

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Aspiration pneumonia after brain surgery. Author(s): Reiff T. Source: Hosp Pract (Off Ed). 1981 October; 16(10): 44H, 44L-44M, 44P. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6800924

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Aspiration pneumonia after cardiac arrest and resuscitation. Author(s): Greenberg HB. Source: Journal of the American Geriatrics Society. 1967 February; 15(2): 148-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6017291

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Aspiration pneumonia and altered dental status. Author(s): Finucane TE. Source: Journal of the American Geriatrics Society. 2002 March; 50(3): 589; Author Reply 589-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11943064

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Aspiration pneumonia and anaerobic lung infections. Author(s): Tuazon CU. Source: Primary Care. 1978 September; 5(3): 487-501. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=251325

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Aspiration pneumonia and coma--an unusual presentation of dystrophic myotonia. Author(s): Hannon VM, Cunningham AJ, Hutchinson M, McNicholas W. Source: Can Anaesth Soc J. 1986 November; 33(6): 803-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3779503

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Aspiration pneumonia and complications of inhalation of smoke and toxic gases. Author(s): Tams TR. Source: The Veterinary Clinics of North America. Small Animal Practice. 1985 September; 15(5): 971-89. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3878028

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Aspiration pneumonia and dysphagia after technically successful repair of oesophageal atresia. Author(s): Chrispin AR, Friedland GW, Waterston DJ. Source: Thorax. 1966 March; 21(2): 104-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5935835

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Aspiration pneumonia and dysphagia in the elderly. Author(s): Marik PE, Kaplan D. Source: Chest. 2003 July; 124(1): 328-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12853541

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Aspiration pneumonia and insular hypoperfusion in patients with cerebrovascular disease. Author(s): Okamura N, Maruyama M, Ebihara T, Matsui T, Nemoto M, Arai H, Sasaki H, Yanai K. Source: Journal of the American Geriatrics Society. 2004 April; 52(4): 645-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15066090

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Aspiration pneumonia and the laryngeal mask airway. Author(s): Pearce AW, Heath ML. Source: Anaesthesia. 1991 July; 46(7): 592. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1741829

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Aspiration pneumonia and the laryngeal mask airway. Author(s): Griffin RM, Hatcher IS. Source: Anaesthesia. 1990 December; 45(12): 1039-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2132310

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Aspiration pneumonia as a cause of death. Author(s): Haleem MA. Source: Br J Clin Pract. 1990 October; 44(10): 398-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2268516

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Aspiration pneumonia as a complication of severe mania. Author(s): Jain S, Gibson RH, Guedet PJ, Lehrmann JA, Tsao CI. Source: General Hospital Psychiatry. 2003 March-April; 25(2): 136-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12676428

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Aspiration pneumonia associated with a giant epiglottic cyst after cardiac surgery. Author(s): So M, Sobue K, Arima H, Morishima T, Fukumoto M, Tanaka S, Ando H, Katsuya H. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 JuneJuly; 50(6): 622-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12826565

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Aspiration pneumonia caused by Mycobacterium smegmatis. Author(s): Newton JA Jr, Weiss PJ. Source: Mayo Clinic Proceedings. 1994 March; 69(3): 296. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8133672

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Aspiration pneumonia complicating small bowel biopsy. Author(s): Noskin G, Craig RM. Source: The American Journal of Gastroenterology. 1989 May; 84(5): 557-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2719013

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Aspiration pneumonia due to diffuse cervical hyperostosis. Author(s): Warnick C, Sherman MS, Lesser RW. Source: Chest. 1990 September; 98(3): 763-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2394159

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Aspiration pneumonia due to teeth--950 AD and 1973 AD. Author(s): Allison MJ, Pezzia A, Gerszten E, Giffler RF, Mendoza D. Source: Southern Medical Journal. 1974 April; 67(4): 479-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4593905

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Aspiration pneumonia following diesel oil siphonage--analysis of 12 cases. Author(s): Lee CH, Chiang YC, Lan RS, Tsai YH, Wang WJ. Source: Changgeng Yi Xue Za Zhi. 1988 September 20; 11(3): 180-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3233548

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Aspiration pneumonia following gavage feeding. Author(s): Pecora DV. Source: Chest. 1979 December; 76(6): 714. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=116805

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Aspiration pneumonia following intravenous administration of alcohol during labor. Author(s): Greenhouse BS, Hook R, Hehre FW. Source: Jama : the Journal of the American Medical Association. 1969 December 29; 210(13): 2393-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4902527

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Aspiration pneumonia following severe self-poisoning. Author(s): Liisanantti J, Kaukoranta P, Martikainen M, Ala-Kokko T. Source: Resuscitation. 2003 January; 56(1): 49-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12505738

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Aspiration pneumonia following surgically placed feeding tubes. Author(s): Fox KA, Mularski RA, Sarfati MR, Brooks ME, Warneke JA, Hunter GC, Rappaport WD. Source: American Journal of Surgery. 1995 December; 170(6): 564-6; Discussion 566-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7492001

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Aspiration pneumonia from povidone-iodine (Betadine): report of case. Author(s): Howe DJ. Source: J Oral Surg. 1981 March; 39(3): 224-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6936546

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Aspiration pneumonia in a mentally handicapped patient due to a foreign body impacted in the pharynx: a near fatal outcome. Author(s): Asgarali S, Nandapalan V, Phillips D, Osunuga O. Source: Journal of Accident & Emergency Medicine. 1996 July; 13(4): 291. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8832357

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Aspiration pneumonia in an infant with pharyngonasal reflux and left-sided vocal cord paralysis. Author(s): Fischer WW, Beckerman RC, Reed HT. Source: Southern Medical Journal. 1987 January; 80(1): 93-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3798192

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Aspiration pneumonia in association with oral vitamin K. Author(s): Bhandari V, Tin NO, Ahmed SR. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2002 November; 87(3): F232. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12391003

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Aspiration pneumonia in institutionalized children. A retrospective comparison of treatment with penicillin G, clindamycin and carbenicillin. Author(s): Brook I. Source: Clinical Pediatrics. 1981 February; 20(2): 117-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7460462

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Aspiration pneumonia in nursing home patients fed via gastrostomy tubes. Author(s): Cogen R, Weinryb J. Source: The American Journal of Gastroenterology. 1989 December; 84(12): 1509-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2512808

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Aspiration pneumonia in patients fed through nasoenteral tubes. Author(s): Metheny NA, Eisenberg P, Spies M. Source: Heart & Lung : the Journal of Critical Care. 1986 May; 15(3): 256-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3084401

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Aspiration pneumonia in patients with enteral feeding tube. Author(s): Woo K. Source: Perspectives. 1999 Fall; 23(3): 2-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12026409

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Aspiration pneumonia in pediatric age group: etiology, predisposing factors and clinical outcome. Author(s): Karim RM, Momin IA, Lalani II, Merchant SS, Sewani AA, Hassan BS, Mahmood N. Source: J Pak Med Assoc. 1999 April; 49(4): 105-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10540543

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Aspiration pneumonia in stroke. Author(s): Johnson ER, McKenzie SW, Sievers A. Source: Archives of Physical Medicine and Rehabilitation. 1993 September; 74(9): 973-6. Erratum In: Arch Phys Med Rehabil 1994 June; 75(6): 665. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8379846

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Aspiration pneumonia in the intensive care unit. Author(s): Bryan-Brown CW, Adler DC. Source: International Anesthesiology Clinics. 1977 Spring; 15(1): 71-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=844910

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Aspiration pneumonia possibly secondary to clozapine-induced sialorrhea. Author(s): Hinkes R, Quesada TV, Currier MB, Gonzalez-Blanco M. Source: Journal of Clinical Psychopharmacology. 1996 December; 16(6): 462-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8959476

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Aspiration pneumonia prophylaxis. Author(s): Coombs DW. Source: Anesthesia and Analgesia. 1983 December; 62(12): 1055-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6650888

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Aspiration pneumonia secondary to giant cervical osteophyte formation (diffuse idiopathic skeletal hyperostosis or Forrestier's disease): a case report. Author(s): Babores M, Finnerty JP. Source: Chest. 1998 November; 114(5): 1481-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9824035

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Aspiration pneumonia, anaerobic infections, and lung abscess. Author(s): Johanson WG Jr, Harris GD. Source: The Medical Clinics of North America. 1980 May; 64(3): 385-94. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6993806

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Aspiration pneumonia, necrotizing pneumonia, and lung abscess. Author(s): Pennza PT. Source: Emergency Medicine Clinics of North America. 1989 May; 7(2): 279-307. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2653801

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Aspiration pneumonia. Author(s): Cambell-Taylor I. Source: The New England Journal of Medicine. 2001 June 14; 344(24): 1869; Author Reply 1869-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11407358

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Aspiration pneumonia. Author(s): Finucane TE, Christmas C. Source: The New England Journal of Medicine. 2001 June 14; 344(24): 1869; Author Reply 1869-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11407357

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Aspiration pneumonia. Author(s): Dreyfuss D, Mier L. Source: The New England Journal of Medicine. 2001 June 14; 344(24): 1868-9; Author Reply 1869-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11407356

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Aspiration pneumonia. Author(s): Broe PJ, Toung TJ, Cameron JL. Source: The Surgical Clinics of North America. 1980 December; 60(6): 1551-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7006127

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Aspiration pneumonia. Author(s): Bartlett JG. Source: Clin Notes Respir Dis. 1980 Spring; 18(4): 3-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7363523

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Aspiration pneumonia. Author(s): Laforet EG. Source: Jama : the Journal of the American Medical Association. 1972 July 17; 221(3): 301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5067798

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Aspiration pneumonia. Author(s): Perry A, Shannon J, Fowler MR, Baethge BA. Source: J La State Med Soc. 1992 July; 144(7): 307-11. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1431490

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Aspiration pneumonia. Author(s): Finegold SM. Source: Reviews of Infectious Diseases. 1991 July-August; 13 Suppl 9: S737-42. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1925318

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Aspiration pneumonia. Author(s): DePaso WJ. Source: Clinics in Chest Medicine. 1991 June; 12(2): 269-84. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1855371

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Aspiration pneumonia. A clinical and experimental review. Author(s): Cameron JL, Anderson RP, Zuidema GD. Source: The Journal of Surgical Research. 1967 January; 7(1): 44-53. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5333798

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Aspiration pneumonia. A threat when deglutition is compromised. Author(s): Khawaja IT, Buffa SD, Brandstetter RD. Source: Postgraduate Medicine. 1992 July; 92(1): 165-8, 173-7, 181. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1614930

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Aspiration pneumonia. Clinical outcome following documented aspiration. Author(s): Cameron JL, Mitchell WH, Zuidema GD. Source: Archives of Surgery (Chicago, Ill. : 1960). 1973 January; 106(1): 49-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4565234

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Aspiration pneumonia. Magnitude and frequency of the problem. Author(s): Cameron JL, Zuidema GD. Source: Jama : the Journal of the American Medical Association. 1972 February 28; 219(9): 1194-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5066871

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Aspiration pneumonia. Medical management. Author(s): Kirsch CM, Sanders A. Source: Otolaryngologic Clinics of North America. 1988 November; 21(4): 677-89. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3054720

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Aspiration pneumonia. Prevention of aspiration in patients with tracheostomies. Author(s): Bone DK, Davis JL, Zuidema GD, Cameron JL. Source: The Annals of Thoracic Surgery. 1974 July; 18(1): 30-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4834725

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Aspiration pneumonia. Recognizing and managing a potentially growing disorder. Author(s): Johnson JL, Hirsch CS. Source: Postgraduate Medicine. 2003 March; 113(3): 99-102, 105-6, 111-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12647477

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Aspiration pneumonia. Strategies for early recognition and prevention. Author(s): Lomotan JR, George SS, Brandstetter RD. Source: Postgraduate Medicine. 1997 August; 102(2): 225-6, 229-31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9270712

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Aspiration pneumonia: a medical emergency. Author(s): Massey DG, Lumeng J. Source: Hawaii Med J. 1983 February; 42(2): 48-50. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6341312

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Aspiration pneumonia: a misnomer. Author(s): Jurado RL, Franco-Paredes C. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2001 November 1; 33(9): 1612-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11588707

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Aspiration pneumonia: a review. Author(s): Chokshi SK, Asper RF, Khandheria BK. Source: American Family Physician. 1986 March; 33(3): 195-202. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3513497

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Aspiration pneumonia: a ten-year review. Author(s): LeFrock JL, Clark TS, Davies B, Klainer AS. Source: The American Surgeon. 1979 May; 45(5): 305-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=453716

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Aspiration pneumonia: dental and oral risk factors in an older veteran population. Author(s): Terpenning MS, Taylor GW, Lopatin DE, Kerr CK, Dominguez BL, Loesche WJ. Source: Journal of the American Geriatrics Society. 2001 May; 49(5): 557-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11380747

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Aspiration pneumonia: incidence, mortality, and at-risk populations. Author(s): DeLegge MH. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 2002 November-December; 26(6 Suppl): S19-24; Discussion S24-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12405619

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Aspiration pneumonia: pathophysiology and treatment. Author(s): Vazquez V, Gorbea HF, Ramirez-Ronda CH. Source: Bol Asoc Med P R. 1983 June; 75(6): 272-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6577874

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Aspiration pneumonia; incidence of aspiration with endotracheal tubes. Author(s): Spray SB, Zuidema GD, Cameron JL. Source: American Journal of Surgery. 1976 June; 131(6): 701-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=937649

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Aspiration pneumonia--Mendelson syndrome; a review. Author(s): Cunningham AJ, Slazenger M. Source: Ir Med J. 1984 August; 77(8): 252-5. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6384133

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Aspiration pneumonitis and aspiration pneumonia. Author(s): Marik PE. Source: The New England Journal of Medicine. 2001 March 1; 344(9): 665-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11228282

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Atypical legionellosis: isolation of Legionella pneumophila serogroup 1 from a patient with aspiration pneumonia. Author(s): Wright JB, Athar MA, van Olm TM, Wootliff JS, Costerton JW. Source: The Journal of Hospital Infection. 1989 February; 13(2): 187-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2567312

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Bacteriology of aspiration pneumonia in children. Author(s): Brook I, Finegold SM. Source: Pediatrics. 1980 June; 65(6): 1115-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6990374

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Bacteriology of aspiration pneumonia. A prospective study of community- and hospital-acquired cases. Author(s): Lorber B, Swenson RM. Source: Annals of Internal Medicine. 1974 September; 81(3): 329-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4850729

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Bilateral vocal cord teflon injection. An ineffective treatment for recurrent aspiration pneumonia. Author(s): Lewis WS, Wikholm RP, Passy V. Source: Archives of Otolaryngology--Head & Neck Surgery. 1991 April; 117(4): 427-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2007015

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Carotid artery aneurysm as a rare cause for aspiration pneumonia. A case report. Author(s): Decrinis M, Aschauer M, Lafer M, Stark G. Source: Vasa. Zeitschrift Fur Gefasskrankheiten. Journal for Vascular Diseases. 1996; 25(4): 362-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8956552

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Cerebellar hemangioblastoma presenting as secondary erythrocytosis and aspiration pneumonia. Author(s): Farrukh HM. Source: The Western Journal of Medicine. 1996 February; 164(2): 169-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8775737

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Changes of venous admixture with inspired oxygen in hyaline membrane disease and foetal aspiration pneumonia. Author(s): Corbet AJ, Burnard ED. Source: Aust Paediatr J. 1973 February; 9(1): 25-30. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4736055

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Child with repeated aspiration pneumonia and peculiar face. Author(s): Koffler T. Source: European Journal of Pediatrics. 1998 February; 157(2): 161-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9504793

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Clindamycin in treatment of aspiration pneumonia in children. Author(s): Brook I. Source: Antimicrobial Agents and Chemotherapy. 1979 March; 15(3): 342-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=380459

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Clinical outcome of laryngotracheal separation for intractable aspiration pneumonia. Author(s): Yamana T, Kitano H, Hanamitsu M, Kitajima K. Source: Orl; Journal for Oto-Rhino-Laryngology and Its Related Specialties. 2001 September-October; 63(5): 321-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11528278

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Clostridium paraputrificum bacteremia associated with aspiration pneumonia. Author(s): Nachamkin I, DeBlois GE, Dalton HP. Source: Southern Medical Journal. 1982 August; 75(8): 1023-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7112187

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Clostridium tertium bacteremia in a patient with aspiration pneumonia: an elusive diagnosis. Author(s): Johnson JR, Tenover FC. Source: The Journal of Infectious Diseases. 1988 April; 157(4): 854-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3346578

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Community-acquired aspiration pneumonia in intensive care units. Epidemiological and prognosis data. Author(s): Leroy O, Vandenbussche C, Coffinier C, Bosquet C, Georges H, Guery B, Thevenin D, Beaucaire G. Source: American Journal of Respiratory and Critical Care Medicine. 1997 December; 156(6): 1922-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9412576

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Difficulty in swallowing, with aspiration pneumonia in infancy. Author(s): Matsaniotis N, Karpouzas J, Gregoriou M. Source: Archives of Disease in Childhood. 1967 June; 42(223): 308-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6025372

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Diffuse idiopathic skeletal hyperostosis resulting in dysphagia and aspiration pneumonia. Author(s): Giddings CE, Caulfield HM, Dorward NL. Source: British Journal of Neurosurgery. 2003 October; 17(5): 467-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14635756

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Does gastrostomy and fundoplication prevent aspiration pneumonia in mentally retarded persons? Author(s): Bui HD, Dang CV, Chaney RH, Vergara LM. Source: Am J Ment Retard. 1989 July; 94(1): 16-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2502160

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Dysphagia and aspiration pneumonia in patients with Alzheimer's disease. Author(s): Kalia M. Source: Metabolism: Clinical and Experimental. 2003 October; 52(10 Suppl 2): 36-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14577062

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Effect of ventilation with positive end-expiratory pressure on the development of lung damage in experimental acid aspiration pneumonia in the rabbit. Author(s): Sohma A, Brampton WJ, Dunnill MS, Sykes MK. Source: Intensive Care Medicine. 1992; 18(2): 112-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1613190

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Enteral feeding associated gastroesophageal reflux and aspiration pneumonia: a review. Author(s): Kazi N, Mobarhan S. Source: Nutrition Reviews. 1996 October; 54(10): 324-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9063023

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Epidemiology and impact of aspiration pneumonia in patients undergoing surgery in Maryland, 1999-2000. Author(s): Kozlow JH, Berenholtz SM, Garrett E, Dorman T, Pronovost PJ. Source: Critical Care Medicine. 2003 July; 31(7): 1930-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12847385

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Fatal aspiration pneumonia caused by an esophageal foreign body. Author(s): Mittelman M, Perek J, Kolkov Z, Lewinski U, Djaldetti M. Source: Annals of Emergency Medicine. 1985 April; 14(4): 365-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3985452

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Fatal aspiration pneumonia during transition from donepezil to rivastigmine. Author(s): Taylor AM, Hoehns JD, Anderson DM, Tobert DG. Source: The Annals of Pharmacotherapy. 2002 October; 36(10): 1550-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12243604

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Fever, cough, and bilateral lung infiltrates. Achalasia associated with aspiration pneumonia. Author(s): Akritidis N, Gousis C, Dimos G, Paparounas K. Source: Chest. 2003 February; 123(2): 608-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12576387

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Fine needle aspiration diagnosis of aspiration pneumonia (phytopneumonitis). Author(s): Covell JL, Feldman PS. Source: Acta Cytol. 1984 January-February; 28(1): 77-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6582741

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Further experiences with the arytenoid-epiglottic flap for chronic aspiration pneumonia. Author(s): Vecchione TR, Habal MB, Murray JE. Source: Plastic and Reconstructive Surgery. 1975 March; 55(3): 318-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1118491

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Future considerations in aspiration pneumonia in the critically ill patient: what is not known, areas for future research, and experimental methods. Author(s): DiSario JA. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 2002 November-December; 26(6 Suppl): S75-8; Discussion S79. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12405627

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Gastrografin-induced aspiration pneumonia: a lethal complication of computed tomography. Author(s): Trulzsch DV, Penmetsa A, Karim A, Evans DA. Source: Southern Medical Journal. 1992 December; 85(12): 1255-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1470976

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Guarding against aspiration pneumonia. Author(s): Handerhan B. Source: Nursing. 1992 October; 22(10): 96-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1436803

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How to protect your patients against aspiration pneumonia. Author(s): Coyle N, Arbit E. Source: Nursing. 1978 October; 8(10): 50-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=250665

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Impact of oral diseases on systemic health in the elderly: diabetes mellitus and aspiration pneumonia. Author(s): Taylor GW, Loesche WJ, Terpenning MS. Source: J Public Health Dent. 2000 Fall; 60(4): 313-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11243053

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Incidence of aspiration pneumonia in intubated patients receiving activated charcoal. Author(s): Moll J, Kerns W 2nd, Tomaszewski C, Rose R. Source: The Journal of Emergency Medicine. 1999 March-April; 17(2): 279-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10195487

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Incidence of pneumothorax and pneumomediastinum in patients with aspiration pneumonia requiring ventilatory support. Author(s): de Latorre FJ, Tomasa A, Klamburg J, Leon C, Soler M, Rius J. Source: Chest. 1977 August; 72(2): 141-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=884974

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Inefficiency of antacid in prevention of aspiration pneumonia. Author(s): Toung T, Cameron JL. Source: British Journal of Anaesthesia. 1980 February; 52(2): 241-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7362726

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Interventions to prevent aspiration pneumonia in older adults: a systematic review. Author(s): Loeb MB, Becker M, Eady A, Walker-Dilks C. Source: Journal of the American Geriatrics Society. 2003 July; 51(7): 1018-22. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12834525

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Introduction of simple swallowing ability test for prevention of aspiration pneumonia in the elderly and investigation of factors of swallowing disorders. Author(s): Miyazaki Y, Arakawa M, Kizu J. Source: Yakugaku Zasshi. Journal of the Pharmaceutical Society of Japan. 2002 January; 122(1): 97-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11828754

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Is penicillin G an adequate initial treatment for aspiration pneumonia? A prospective evaluation using a protected specimen brush and quantitative cultures. Author(s): Mier L, Dreyfuss D, Darchy B, Lanore JJ, Djedaini K, Weber P, Brun P, Coste F. Source: Intensive Care Medicine. 1993; 19(5): 279-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8408937

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Isolation of Mycobacterium chelonei from a patient with recurrent aspiration pneumonia. Author(s): Levy H, Lewis M, Myburgh DP. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1984 February 11; 65(6): 217-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6695286

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Jejunostomy and aspiration pneumonia. Author(s): Smythe WR, Morris JB, Mullen JL. Source: The American Journal of Gastroenterology. 1992 July; 87(7): 928-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1530728

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Lack of cough reflex in aspiration pneumonia. Author(s): Sekizawa K, Ujiie Y, Itabashi S, Sasaki H, Takishima T. Source: Lancet. 1990 May 19; 335(8699): 1228-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1971077

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Laryngopharyngeal sensory testing with modified barium swallow as predictors of aspiration pneumonia after stroke. Author(s): Aviv JE, Sacco RL, Mohr JP, Thompson JL, Levin B, Sunshine S, Thomson J, Close LG. Source: The Laryngoscope. 1997 September; 107(9): 1254-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9292613

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Laryngotracheal separation for intractable aspiration pneumonia in neurologically impaired children: experience with 11 cases. Author(s): Takamizawa S, Tsugawa C, Nishijima E, Muraji T, Satoh S. Source: Journal of Pediatric Surgery. 2003 June; 38(6): 975-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12778406

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Letter: Aspiration pneumonia. Author(s): Solan GM. Source: W V Med J. 1976 January; 72(1): 18. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1108455

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Lipid aspiration pneumonia due to gastroesophageal reflux. A complication of nasogastric lipid feedings. Author(s): Wolfson BJ, Allen JL, Panitch HB, Karmazin N. Source: Pediatric Radiology. 1989; 19(8): 545-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2797940

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Lipid-laden alveolar macrophages as an indicator of aspiration pneumonia. Author(s): Langston C, Pappin A. Source: Archives of Pathology & Laboratory Medicine. 1996 April; 120(4): 326-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8619741

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Lipid-laden alveolar macrophages may indicate either aspiration pneumonia or sickle cell acute chest syndrome associated with pulmonary fat embolism. Author(s): Williams RA. Source: Archives of Pathology & Laboratory Medicine. 1995 September; 119(9): 772. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7668931

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Lower esophageal sphincter dysfunction in esophageal atresia: nocturnal regurgitation and aspiration pneumonia. Author(s): Shermeta DW, Whitington PF, Seto DS, Haller JA. Source: Journal of Pediatric Surgery. 1977 December; 12(6): 871-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=592067

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Methods for decreasing risk of aspiration pneumonia in critically ill patients. Author(s): Scolapio JS. Source: Jpen. Journal of Parenteral and Enteral Nutrition. 2002 November-December; 26(6 Suppl): S58-61; Discussion S61. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12405624

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Microbiological and clinical aspects of aspiration pneumonia. Author(s): Lode H. Source: The Journal of Antimicrobial Chemotherapy. 1988 April; 21 Suppl C: 83-90. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3290185

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Microbiology of severe aspiration pneumonia in institutionalized elderly. Author(s): El-Solh AA, Pietrantoni C, Bhat A, Aquilina AT, Okada M, Grover V, Gifford N. Source: American Journal of Respiratory and Critical Care Medicine. 2003 June 15; 167(12): 1650-4. Epub 2003 April 10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12689848

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Necrotizing aspiration pneumonia. Author(s): Disler D, Deluca SA. Source: American Family Physician. 1991 November; 44(5): 1719-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1950968

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Neonatal milk aspiration pneumonia--a possible additional use for continuous positive airway pressure. Author(s): Newth CJ, Reilly BJ, Swyer PR. Source: Critical Care Medicine. 1973 May-June; 1(3): 145-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4585443

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New strategies for aspiration pneumonia. Author(s): Sasaki H, Sekizawa K, Yanai M, Arai H, Yamaya M, Ohrui T. Source: Intern Med. 1997 December; 36(12): 851-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9475237

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No elimination of aspiration pneumonia in neurologically disabled patients with feeding gastrostomy. Author(s): Hassett JM, Sunby C, Flint LM. Source: Surg Gynecol Obstet. 1988 November; 167(5): 383-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3140401

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Olive oil aspiration pneumonia (lipoid) in children. Author(s): Annobil SH, el Tahir M, Kameswaran M, Morad N. Source: Tropical Medicine & International Health : Tm & Ih. 1997 April; 2(4): 383-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9171848

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Opitz oculo-genito-laryngeal syndrome: a rare cause of recurrent aspiration pneumonia in an adult. Author(s): de Silva D, Osborne A, Simpson SA, Dean JC, Seaton A. Source: Thorax. 1998 February; 53(2): 149-50; Discussion 148. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9624301

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Our approach to aspiration pneumonia and respiratory burns. Author(s): Gongaware T. Source: Med Times. 1976 August; 104(8): 51-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=940451

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Outcome of acid ingestion related aspiration pneumonia. Author(s): Tseng YL, Wu MH, Lin MY, Lai WW. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2002 April; 21(4): 638-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11932160

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Percutaneous transtracheal aspiration in the diagnosis and treatment of aspiration pneumonia in children. Author(s): Brook I. Source: The Journal of Pediatrics. 1980 June; 96(6): 1000-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6989969

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Peripartum general anasthesia without tracheal intubation: incidence of aspiration pneumonia. Author(s): Ezri T, Szmuk P, Stein A, Konichezky S, Hagai T, Geva D. Source: Anaesthesia. 2000 May; 55(5): 421-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10792131

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Polystyrene sulphonates and aspiration pneumonia: a histochemical study. Author(s): Chaplin AJ, Kemp P. Source: Histopathology. 1984 March; 8(2): 331-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6724534

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Postgastrectomy aspiration pneumonia. Author(s): Marumo K, Homma S, Fukuchi Y. Source: Chest. 1995 February; 107(2): 453-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7842777

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Postoperative aspiration pneumonia. Author(s): Tinstman TC, Dines DE, Arms RA. Source: The Surgical Clinics of North America. 1973 August; 53(4): 859-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4717254

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Postpartum perioperative risk of aspiration pneumonia. Author(s): James CF, Gibbs CP, Banner T. Source: Anesthesiology. 1984 December; 61(6): 756-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6507928

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Preanaesthetic H2 antagonists for acid aspiration pneumonia prophylaxis. Is there evidence of tolerance? Author(s): Timmins A. Source: British Journal of Anaesthesia. 2003 September; 91(3): 446; Author Reply 446-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12925493

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Preanaesthetic H2 antagonists for acid aspiration pneumonia prophylaxis. Is there evidence of tolerance? Author(s): Hirota K, Kushikata T. Source: British Journal of Anaesthesia. 2003 May; 90(5): 576-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12697583

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Predictors of aspiration pneumonia in nursing home residents. Author(s): Langmore SE, Skarupski KA, Park PS, Fries BE. Source: Dysphagia. 2002 Fall; 17(4): 298-307. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12355145

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Predictors of aspiration pneumonia: how important is dysphagia? Author(s): Langmore SE, Terpenning MS, Schork A, Chen Y, Murray JT, Lopatin D, Loesche WJ. Source: Dysphagia. 1998 Spring; 13(2): 69-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9513300

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Prevention of aspiration pneumonia by continuous esophageal aspiration during esophagogastric tamponade and gastric cooling. Author(s): Edlich RF, Lande AJ, Goodale RL, Wangensteen OH. Source: Surgery. 1968 August; 64(2): 405-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5302564

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Prevention of aspiration pneumonia during long-term feeding by percutaneous endoscopic gastrostomy: might cisapride play any role? An open pilot study. Author(s): Sartori S, Trevisani L, Tassinari D, Nielsen I, Gilli G, Donati D, Malacarne P. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 1994 May; 2(3): 188-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8032705

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Prevention of aspiration pneumonia: a research-based protocol. Author(s): Metheny N, Reed-Smith L. Source: Dimensions of Critical Care Nursing : Dccn. 1996 September-October; 15(5): 263. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8949211

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Prevention of aspiration pneumonia: a research-based protocol. Author(s): Goodwin RS. Source: Dimensions of Critical Care Nursing : Dccn. 1996 March-April; 15(2): 58-71; Quiz 72. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8697946

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Pulmonary complication of heroin intoxication. Aspiration pneumonia and diffuse bronchiectasis. Author(s): Warnock ML, Ghahremani GG, Rattenborg C, Ginsberg M, Valenzuela J. Source: Jama : the Journal of the American Medical Association. 1972 February 21; 219(8): 1051-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5066762

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Pulmonary effects of aspiration pneumonia. Author(s): Shimada Y, Yoshiya I, Tanaka K, Ishida T, Kumon K, Yamazaki T, Sone S, Higashihara T. Source: Med J Osaka Univ. 1978 September; 29(1-2): 139-50. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=752747

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Radiological case of the month. Brain-stem astrocytoma presenting with aspiration pneumonia. Author(s): Oades P, Buchdal R, Wood BP. Source: Am J Dis Child. 1992 February; 146(2): 251-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1733158

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Relation between Glasgow Coma Scale and aspiration pneumonia. Author(s): Adnet F, Baud F. Source: Lancet. 1996 July 13; 348(9020): 123-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8676684

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Relation of body position at the time of discovery with suspected aspiration pneumonia in poisoned comatose patients. Author(s): Adnet F, Borron SW, Finot MA, Minadeo J, Baud FJ. Source: Critical Care Medicine. 1999 April; 27(4): 745-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10321664

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Review of current concepts in aspiration pneumonia. Author(s): Karetzky MS, Khan AU. Source: Heart & Lung : the Journal of Critical Care. 1977 March-April; 6(2): 321-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=584722

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Right middle lobe aspiration pneumonia following gasoline siphonage. Author(s): Carlson DH. Source: Chest. 1981 August; 80(2): 246-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7249782

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Risk and outcome of aspiration pneumonia in a city hospital. Author(s): Jones J. Source: Journal of the National Medical Association. 1993 July; 85(7): 533-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8350375

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Risk factors of aspiration pneumonia in Alzheimer's disease patients. Author(s): Wada H, Nakajoh K, Satoh-Nakagawa T, Suzuki T, Ohrui T, Arai H, Sasaki H. Source: Gerontology. 2001 September-October; 47(5): 271-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11490146

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Risk of aspiration pneumonia in the elderly. Author(s): Nakazawa H, Sekizawa K, Ujiie Y, Sasaki H, Takishima T. Source: Chest. 1993 May; 103(5): 1636-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8486071

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Routine preoperative gastric emptying is seldom indicated. A study of 85,594 anaesthetics with special focus on aspiration pneumonia. Author(s): Mellin-Olsen J, Fasting S, Gisvold SE. Source: Acta Anaesthesiologica Scandinavica. 1996 November; 40(10): 1184-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8986180

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Severe aspiration pneumonia after surgery for reconstructed gastric tube cancer treated with extracorporeal life support. Author(s): Motoyama S, Kitamura M, Kamata S, Suzuki H, Sekine S, Ogawa J. Source: Jpn J Thorac Cardiovasc Surg. 1999 August; 47(8): 394-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10496064

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Short-term asynchronous ventilation and differential positive end-expiratory pressure in the treatment of aspiration pneumonia. A case report. Author(s): van Renen RG, Schoonbee CG. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1985 January 19; 67(3): 96-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3880932

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Simple two-step swallowing provocation test for elderly patients with aspiration pneumonia. Author(s): Teramoto S, Matsuse T, Fukuchi Y, Ouchi Y. Source: Lancet. 1999 April 10; 353(9160): 1243. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10217091

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Sputum substance P in aspiration pneumonia. Author(s): Nakagawa T, Ohrui T, Sekizawa K, Sasaki H. Source: Lancet. 1995 June 3; 345(8962): 1447. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7539090

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Surgical treatment of life-endangering chronic aspiration pneumonia. Use of an epiglottic flap to the arytenoids. Author(s): Habal MB, Murray JE. Source: Plastic and Reconstructive Surgery. 1972 March; 49(3): 305-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5060322

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•

Technetium tin colloid test detecting symptomless dysphagia and ACE inhibitor prevented occurrence of aspiration pneumonia. Author(s): Arai T, Yasuda Y, Takaya T, Ito Y, Hayakawa K, Toshima S, Shibuya C, Suematsu F, Shibayama M, Yoshimi N, Kashiki Y. Source: International Journal of Molecular Medicine. 2000 June; 5(6): 609-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10812009

•

The association of swallowing dysfunction and aspiration pneumonia. Author(s): Martin BJ, Corlew MM, Wood H, Olson D, Golopol LA, Wingo M, Kirmani N. Source: Dysphagia. 1994 Winter; 9(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8131418

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The bacteriology of aspiration pneumonia. Author(s): Bartlett JG, Gorbach SL, Finegold SM. Source: The American Journal of Medicine. 1974 February; 56(2): 202-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4812076

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The causes of aspiration pneumonia in mechanically ventilated patients; a possible pathological link with upper airway bacterial colonization. Author(s): Teramoto S. Source: British Journal of Anaesthesia. 2000 May; 84(5): 694. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10844851

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The cytologic evaluation of lipid-laden alveolar macrophages as an indicator of aspiration pneumonia in young children. Author(s): Collins KA, Geisinger KR, Wagner PH, Blackburn KS, Washburn LK, Block SM. Source: Archives of Pathology & Laboratory Medicine. 1995 March; 119(3): 229-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7887776

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The nasogastric feeding tube as a risk factor for aspiration and aspiration pneumonia. Author(s): Gomes GF, Pisani JC, Macedo ED, Campos AC. Source: Current Opinion in Clinical Nutrition and Metabolic Care. 2003 May; 6(3): 32733. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12690267

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The role of anaerobes in patients with ventilator-associated pneumonia and aspiration pneumonia: a prospective study. Author(s): Marik PE, Careau P. Source: Chest. 1999 January; 115(1): 178-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9925081

Studies

33

•

The threat of aspiration pneumonia in the aged. Author(s): Zavala DC. Source: Geriatrics. 1977 March; 32(3): 46-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=844688

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The triple threat of aspiration pneumonia. Author(s): Bartlett JG, Gorbach SL. Source: Chest. 1975 October; 68(4): 560-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1175415

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The value of the lipid-laden macrophage index in the assessment of aspiration pneumonia. Author(s): Adams R, Ruffin R, Campbell D. Source: Aust N Z J Med. 1997 October; 27(5): 550-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9404586

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The view box. Pharyngeal (Zenker's) diverticulum and aspiration pneumonia. Author(s): Augustin GJ. Source: Med Ann Dist Columbia. 1972 October; 41(10): 648 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4627662

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Tracheoesophageal anastomosis for intractable aspiration pneumonia. Author(s): Nakasaki H, Sugihara T, Tajima T, Mitomi T, Osamura Y, Onoda N, Fujii K. Source: The Annals of Thoracic Surgery. 1991 January; 51(1): 23-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1985569

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Tracheoesophageal fistula secondary to esophageal carcinoma presenting with aspiration pneumonia. Author(s): Adler L, Kabnick EM, Patel M, Azueta V, Helfgott A, Alexander LL, Tafreshi M. Source: Journal of the National Medical Association. 1985 May; 77(5): 401-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3999155

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Treatment of aspiration pneumonia and primary lung abscess. Penicillin G vs clindamycin. Author(s): Bartlett JG, Gorbach SL. Source: Jama : the Journal of the American Medical Association. 1975 December 1; 234(9): 935-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1041750

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Treatment of nosocomial aspiration pneumonia and soft-tissue infections in diabetic patients. Author(s): Venezio FR. Source: Clinical Therapeutics. 1987; 10 Suppl A: 66-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3319174

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Treatment of recurrent aspiration pneumonia in end-stage dementia: preferences and choices of a group of elderly nursing home residents. Author(s): Low JA, Chan DK, Hung WT, Chye R. Source: Internal Medicine Journal. 2003 August; 33(8): 345-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12895164

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Use of tube feeding to prevent aspiration pneumonia. Author(s): Finucane TE, Bynum JP. Source: Lancet. 1996 November 23; 348(9039): 1421-4. Review. Erratum In: Lancet 1997 February 1; 349(9048): 364. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8937283

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Value of C-reactive protein in the detection of bacterial contamination at the time of presentation in drug-induced aspiration pneumonia. Author(s): Adnet F, Borron SW, Vicaut E, Giraudeaux V, Lapostolle F, Bekka R, Baud FJ. Source: Chest. 1997 August; 112(2): 466-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9266885

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CHAPTER 2. NUTRITION AND ASPIRATION PNEUMONIA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and aspiration pneumonia.

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

7

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

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

Effects of qing fei tang (TJ-90) on aspiration pneumonia in mice. Author(s): Department of Geriatric Medicine, School of Medicine, Tohuku University, Sendai, Japan. [email protected] Source: Iwasaki, K Wang, Q Satoh, N Yoshida, S Akaike, T Sekizawa, K Maeda, H Sasaki, H Phytomedicine. 1999 May; 6(2): 95-101 0944-7113

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

•

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

•

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

•

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

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

•

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

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

Nutrition

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

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

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39

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

“Silent” regurgitation and aspiration during general anesthesia. Author(s): Blitt CD, Gutman HL, Cohen DD, Weisman H, Dillon JB. Source: Anesthesia and Analgesia. 1970 September-October; 49(5): 707-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5534428

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A case of adrenocortical carcinoma associated with recurrence after laparoscopic surgery. Author(s): Iino K, Oki Y, Sasano H. Source: Clinical Endocrinology. 2000 August; 53(2): 243-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10931107

•

A traditional Chinese herbal medicine, banxia houpo tang, improves cough reflex of patients with aspiration pneumonia.

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Author(s): Iwasaki K, Cyong JC, Kitada S, Kitamura H, Ozeki J, Satoh Y, Suzuki T, Sasaki H. Source: Journal of the American Geriatrics Society. 2002 October; 50(10): 1751-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12366640 •

Accidental, intravenous infusion of a peanut oil-based medication. Author(s): Seifert SA, Dart RC, Kaplan EH. Source: Journal of Toxicology. Clinical Toxicology. 1998; 36(7): 733-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9865244

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Acid instillation enhances the inflammatory response to subsequent lipopolysaccharide challenge in rats. Author(s): Yamada H, Miyazaki H, Kikuchi T, Fujimoto J, Kudoh I. Source: American Journal of Respiratory and Critical Care Medicine. 2000 October; 162(4 Pt 1): 1366-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11029346

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Allogeneic marrow transplantation in the treatment of MOPP-resistant Hodgkin's disease. Author(s): Appelbaum FR, Sullivan KM, Thomas ED, Buckner CD, Clift RA, Deeg HJ, Neiman PE, Sanders JE, Stewart P, Storb R. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1985 November; 3(11): 1490-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2414410

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An infant with respiratory distress. Author(s): Requena-Kassarjian Y, Flores G. Source: Clinical Pediatrics. 2001 September; 40(9): 507-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11583050

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Aspiration pneumonia. Author(s): Arms RA, Dines DE, Tinstman TC. Source: Chest. 1974 February; 65(2): 136-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4810670

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Chest radiographic findings in childhood lipoid pneumonia following aspiration of animal fat. Author(s): Annobil SH, Ogunbiyi AO, Benjamin B. Source: European Journal of Radiology. 1993 April; 16(3): 217-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8508840

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Childhood febrile seizures (Benin City experience). Author(s): Obi JO, Ejeheri NA, Alakija W.

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Source: Annals of Tropical Paediatrics. 1994; 14(3): 211-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7825994 •

Copper sulfate. Not a harmless chemical. Author(s): Lamont DL, Duflou JA. Source: The American Journal of Forensic Medicine and Pathology : Official Publication of the National Association of Medical Examiners. 1988 September; 9(3): 226-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3177352

•

Does 360 ml of apple juice ingested before elective surgery worsen gastric volume and acidity in patients given acid aspiration prophylaxis? Author(s): Vincent RD Jr, McNeil TJ, Spaid CL, MacMahon FR, Maxwell SJ, Brenner JS, Schryer VL. Source: Journal of Clinical Anesthesia. 1991 July-August; 3(4): 285-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1910795

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Dysphagia among nursing home residents. Author(s): Kayser-Jones J, Pengilly K. Source: Geriatric Nursing (New York, N.Y.). 1999 March-April; 20(2): 77-82; Quiz 84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10382421

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Effect of Seihai-to, a Kampo medicine, in relapsing aspiration pneumonia--an openlabel pilot study. Author(s): Mantani N, Kasahara Y, Kamata T, Sekiya N, Shimada Y, Usuda K, Sakakibara I, Hattori N, Terasawa K. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2002 April; 9(3): 195-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12046858

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Effects of qing fei tang (TJ-90) on aspiration pneumonia in mice. Author(s): Iwasaki K, Wang Q, Satoh N, Yoshida S, Akaike T, Sekizawa K, Maeda H, Sasaki H. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 1999 May; 6(2): 95-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10374247

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Efficacy, duration, and absorption of a paediatric oral liquid preparation of ranitidine hydrochloride. Author(s): Goresky GV, Finley GA, Bissonnette B, Shaffer EA. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1992 October; 39(8): 791-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1288904

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Emergency treatment of petroleum distillate and turpentine ingestion. Author(s): Ng RC, Darwish H, Stewart DA. Source: Can Med Assoc J. 1974 September 21; 111(6): 537-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4153346

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Endogenous lipoid pneumonia associated with undifferentiated connective tissue disease (UCTD). Author(s): Barta Z, Szabo GG, Bruckner G, Szegedi G. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2001 January-February; 7(1): 134-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11208509

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Enteral feeding. Author(s): Jeejeebhoy KN. Source: Current Opinion in Clinical Nutrition and Metabolic Care. 2002 November; 5(6): 695-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12394646

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Evaluation and management of oropharyngeal Dysphagia in head and neck cancer. Author(s): Gaziano JE. Source: Cancer Control : Journal of the Moffitt Cancer Center. 2002 September-October; 9(5): 400-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12410179

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Exogenous lipid pneumonia related to smoking weed oil following cadaveric renal transplantation. Author(s): Vethanayagam D, Pugsley S, Dunn EJ, Russell D, Kay JM, Allen C. Source: Can Respir J. 2000 July-August; 7(4): 338-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10980460

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Folate deficiency and risk of pneumonia in older people. Author(s): Sato E, Ohrui T, Matsui T, Arai H, Sasaki H. Source: Journal of the American Geriatrics Society. 2001 December; 49(12): 1739-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11844017

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Hydrocarbon pneumonitis--a hazard in fire-eaters. Author(s): Agrawal PK, Srivastava DK. Source: J Assoc Physicians India. 1986 October; 34(10): 752. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3818532

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Hyperbaric oxygen therapy for chemical pneumonitis. Experimental and clinical observations. Author(s): Gorman JF, Glow DE, Rejent M, Stansell G, Rosenberg JC.

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Source: Surgery. 1968 December; 64(6): 1027-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5700084 •

Inhibitory effect of disodium edetate on gastric secretion. Author(s): Cardan E, Dragoi G, Pascu O. Source: Arzneimittel-Forschung. 1986 April; 36(4): 756-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3087372

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Lentil aspiration pneumonia. Author(s): Ros PR. Source: Jama : the Journal of the American Medical Association. 1984 March 9; 251(10): 1277-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6700019

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Lentil aspiration pneumonia: radiographic and CT findings. Author(s): Marom EM, McAdams HP, Sporn TA, Goodman PC. Source: Journal of Computer Assisted Tomography. 1998 July-August; 22(4): 598-600. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9676451

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Lipoid pneumonia caused by an Oriental folk medicine. Author(s): Jenkins DW, Quinn DL. Source: Southern Medical Journal. 1984 January; 77(1): 93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6695232

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Lipoid pneumonia in children following aspiration of animal fat (ghee). Author(s): Annobil SH, Benjamin B, Kameswaran M, Khan AR. Source: Annals of Tropical Paediatrics. 1991; 11(1): 87-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1714701

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Lipoid pneumonia in infants and children in South India. Author(s): Balakrishnan S. Source: British Medical Journal. 1973 November 10; 4(5888): 329-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4758425

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Lipoid pneumonia with Cryptococcus neoformans colonisation. Author(s): Subramanian S, Kherdekar SS, Babu PG, Christianson CS. Source: Thorax. 1982 April; 37(4): 319-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7112467

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Management of oil of citronella poisoning. Author(s): Temple WA, Smith NA, Beasley M.

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Source: Journal of Toxicology. Clinical Toxicology. 1991; 29(2): 257-62; Discussion 263. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1675696 •

Nasal or oral oil application on infants: a possible risk factor for adult bronchiectasis. Author(s): Dossing M, Khan JH. Source: European Journal of Epidemiology. 1995 April; 11(2): 141-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7672066

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Neonatal pneumonia associated with medium-chain triglyceride feeding supplement. Author(s): Smith RM, Brumley GW, Stannard MW. Source: The Journal of Pediatrics. 1978 May; 92(5): 801-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=641632

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Neurotoxic envenoming by the Sri Lankan krait (Bungarus ceylonicus) complicated by traditional treatment and a reaction to antivenom. Author(s): de Silva A, Mendis S, Warrell DA. Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 1993 November-December; 87(6): 682-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8296376

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Phase I/II trial of accutane as a potentiator of carboplatin and paclitaxel in squamous cell carcinomas. Author(s): Wieder R, Pavlick AC, Bryan M, Hameed M, Baredes S, Pliner L, Saunders T, Korah R. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 2002 October; 25(5): 447-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12393981

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Phase II study of tolerance and efficacy of hyperfractionated radiotherapy and 5fluorouracil, cisplatin, and paclitaxel (Taxol) in stage III and IV inoperable and/or unresectable head-and-neck squamous cell carcinoma: A-2 protocol. Author(s): Abitbol A, Abdel-Wahab M, Lewin A, Troner M, Rodrigues MA, HamiltonNelson KL, Markoe A. Source: International Journal of Radiation Oncology, Biology, Physics. 2002 July 15; 53(4): 942-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12095561

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Pneumatoceles as a complication of chemical pneumonia after hydrocarbon ingestion. Author(s): Harris VJ, Brown R. Source: Am J Roentgenol Radium Ther Nucl Med. 1975 November; 125(3): 531-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1239197

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Pneumatoceles following aspiration of hydrocarbons. Author(s): Neuhauser EB. Source: Postgraduate Medicine. 1971 January; 49(1): 57-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5539680

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/

•

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

•

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/

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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 ASPIRATION PNEUMONIA Overview This chapter provides bibliographic book references relating to aspiration pneumonia. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on aspiration pneumonia include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Mechanism - Treatment - Prevention of Aspiration Pneumonia (Theodor Billroth) by Karel B. Absolon, J. Lee Sedwitz; ISBN: 0930329708; http://www.amazon.com/exec/obidos/ASIN/0930329708/icongroupinterna

Chapters on Aspiration Pneumonia In order to find chapters that specifically relate to aspiration pneumonia, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and aspiration pneumonia 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

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“aspiration pneumonia” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on aspiration pneumonia: •

Dental Disease and Systemic Infections Source: in Montgomery, M.T.; Redding, S.W., eds. Oral-Facial Emergencies: Diagnosis and Management. Portland, OR: JBK Publishing, Inc. 1994. p. 89-102. Contact: Available from Special Care Dentistry. 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2660. Fax (312) 440-2824. PRICE: $27.00 (member) or $30.00 (nonmember), plus shipping and handling; institutional prices and bulk orders available. ISBN: 0945892055. Summary: This chapter on dental disease and systemic infections is from an emergency room handbook that addresses a variety of orofacial injuries that are likely to be encountered in an acute care setting. The author notes that diseases of the orofacial complex are not always localized and can play a role in causing or exacerbating certain systemic disorders. Conversely, systemic disease is frequently manifested in the oral cavity. The purpose of this chapter is to examine the relationship of orofacial disease to certain systemic illnesses. Topics include fevers of unknown origin, aspiration pneumonia, immunosuppression, and diabetic ketoacidosis. For each, the author presents detailed information on diagnosis and clinical presentation and treatment recommendations. The author does not provide a comprehensive discussion of oral manifestations of systemic disease. 1 figure. 7 tables. 27 references. (AA-M).

•

Enteral Nutrition Source: in Whitney, E.N., Cataldo, C.B., and Rolfes, S.R. Understanding Normal and Clinical Nutrition. 4th ed. St. Paul, MN: West Publishing Company. 1994. p. 723-751. Contact: Available from West Publishing. 620 Opperman Drive, St. Paul, MN 55164. (800) 340-9378 or (612) 687-7000. PRICE: $67.00. ISBN: 0314041788. Summary: This chapter on enteral nutrition is from an introductory medical textbook on nutrition. Topics include feeding strategies such as supplemental nutrition, tube feedings, feeding-tube placement, and feeding tubes; formula characteristics, including the types of formulas, nutrient composition, and formula selection; tube-feeding techniques including formula preparation, formula administration, and methods of delivery; tube feedings for infants, young children, and teenagers; prevention of tubefeeding complications, including inappropriate formula delivery, diarrhea, dehydration and electrolyte imbalance, aspiration pneumonia, and other gastrointestinal problems; record-keeping and charting considerations; drug administration through feeding tubes; and the transition from tube feedings to table foods. The chapter concludes with study questions, clinical application questions, and a 'highlight' section addressing the medical marketplace of enteral formulas. 3 figures. 5 tables. 35 references. (AA-M).

•

Complications Source: in Du Bois, D. Enteral Feedings in the Nursing Home. La Grange, TX: M and H Publishing Company, Inc. 1990. p. 53-58. Contact: Available from M and H Publishing Company, Inc. P.O. Box 268, La Grange, TX 78945-0268. (409) 968-9508. PRICE: $10.95 plus $2.50 shipping and handling. ISBN: 1877735205.

Books

49

Summary: This chapter, from a nursing guidebook about enteral feedings in the nursing home population, discusses potential complications arising from tube feedings. Topics include complications of insertion; mechanical complications; complications of administration, including aspiration, diarrhea, nausea, vomiting, constipation, and dehydration; metabolic complications, including dehydration, fluid overload, hyperglycemic hyperosmolar nonketosis, simple hyperglycemia, electrolyte abnormalities, and hyponatremia; and infectious complications, including aspiration pneumonia. 15 references.

51

CHAPTER 5. PERIODICALS AND NEWS ON ASPIRATION PNEUMONIA Overview In this chapter, we suggest a number of news sources and present various periodicals that cover aspiration pneumonia.

News Services and Press Releases One of the simplest ways of tracking press releases on aspiration pneumonia 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 “aspiration pneumonia” (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 aspiration pneumonia. 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 “aspiration pneumonia” (or synonyms).

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

Periodicals and News

53

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 “aspiration pneumonia” (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 aspiration pneumonia: •

What Else Can We Attribute to GERD? Source: Digestive Health Matters. 3(4): 1-2. Fall 2001. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. Website: www.iffgd.org. Summary: This health newsletter article reviews some seldom discussed complications of gastroesophageal reflux disease (GERD). GERD is characterized by the return (reflux) of gastric (stomach) acid backwards into the esophagus. The common symptoms of GERD include heartburn, unexplained chest pain, and inflammation and scarring of the lower esophagus (esophageal stricture) leading to swallowing difficulty. In this article, the author discusses other symptoms associated with GERD which may be common and can cause great distress. These symptoms are sore throat and cough, nocturnal choking, aspiration pneumonia, asthma, acid laryngitis, dental erosions, and reflux dyspareunia (heartburn during sexual intercourse). The author also considers problems with misdiagnosis and treatment options for these lesser-known complications of GERD. Treatment is focused on the rigorous prevention of reflux (drug therapy, lifestyle and dietary changes). 3 references.

Academic Periodicals covering Aspiration Pneumonia Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to aspiration pneumonia. In addition to these sources, you can search for articles covering aspiration pneumonia 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.”

55

APPENDICES

57

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

8

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

9

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

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•

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

•

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

The NLM Gateway11 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.12 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “aspiration pneumonia” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 4637 13 932 13 45 5640

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

11

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

12

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

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

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

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

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

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

•

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

16 Adapted 17

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

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

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

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

Dysphagia Source: Bethesda, MD: National Institute on Deafness and Other Communication Disorders (NIDCD). October 1998. [3 p.]. Contact: Available from NIDCD Information Clearinghouse. 1 Communication Avenue, Bethesda, MD 20892-3456. Voice (800) 241-1044. TTY (800) 241-1055. Fax (301) 907-8830. E-mail: [email protected]. Website: www.nidcd.nih.gov. PRICE: Single copy free. NIH Publication Number 99-4307. Summary: People with dysphagia have difficulty swallowing and may also experience pain while swallowing. This fact sheet describes dysphagia, including the complexity of the swallowing process, how dysphagia occurs, some problems caused by dysphagia (including malnutrition and aspiration pneumonia), the causes of dysphagia, treatment options, and current research studying dysphagia. The fact sheet notes that any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. There are different treatments for various types of dysphagia, therefore an accurate diagnosis is crucial. Once the cause of the dysphagia is found, surgery or medication may help. The physician may refer the patient to a speech language pathologist who is trained in testing and treating swallowing disorders. The fact sheet concludes with the addresses and telephone numbers of various organizations through which readers can get more information about swallowing disorders.

Patient Resources

•

65

Glossary of Terms Source: Chicago, IL: EA/TEF Child and Family Support Connection. 1997. 2 p. Contact: Available from EA/TEF Child and Family Support Connection. 111 West Jackson Boulevard, Suite 1145, Chicago, IL 60604-3502. (312) 987-9085. Fax: (312) 9879086. Email: [email protected]. Website: www.eatef.org. PRICE: Single copy free; full-text available online at no charge. Summary: This fact sheet provides a glossary of terms related to children with esophageal atresia (EA) or tracheoesophageal fistula (TEF). EA is a congenital birth defect of the esophagus (foodpipe) in which the esophagus is in two segments rather than a continuous connection to the stomach. TEF is a birth defect of the esophagus and the trachea (windpipe). In TEF, the esophagus is connected to the trachea in one or more places which makes eating very dangerous because food and saliva have a direct route to the lungs. These birth defects are present together 85 percent of the time. They require at least one major surgery for a baby to survive. The glossary briefly defines anastomotic leak, anastomosis, aspiration pneumonia, bougie, cardiac, cephalad, cervical esophagostomy, ciliated, circular myotomy, distal esphagus, diverticulum, duodenum, endoderm, epithelium, gastrostomy, lateral, ligation and division, posterior, primitive foregut, proximal pouch, renal, retropleural, stratified squamous epithelium, thoracotomy, vagus nerve, and ventral. 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 aspiration pneumonia. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to aspiration pneumonia. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with aspiration pneumonia. 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 aspiration pneumonia. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “aspiration pneumonia” (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 “aspiration pneumonia”. 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 “aspiration pneumonia” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “aspiration pneumonia” (or a synonym) into the search box, and click “Submit Query.”

69

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

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

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

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

19

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

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

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

20

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

Finding Medical Libraries

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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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

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

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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73

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

75

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

77

ASPIRATION PNEUMONIA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Aberrant: Wandering or deviating from the usual or normal course. [EU] Abscess: A localized, circumscribed collection of pus. [NIH] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Acoustic: Having to do with sound or hearing. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [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] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [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] Aged, 80 and Over: A person 80 years of age and older. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [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]

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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] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] 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] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and

Dictionary 79

dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspiration: The act of inhaling. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Astrocytoma: A tumor that begins in the brain or spinal cord in small, star-shaped cells called astrocytes. [NIH] Asynchronous: Pacing mode where only one timing interval exists, that between the stimuli. While the duration of this interval may be varied, it is not modified by any sensed event once set. As no sensing occurs, the upper and lower rate intervals are the same as the pacema. [NIH] Atresia: Lack of a normal opening from the esophagus, intestines, or anus. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [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]

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Barium swallow: A series of x-rays of the esophagus. The x-ray pictures are taken after the person drinks a solution that contains barium. The barium coats and outlines the esophagus on the x-ray. Also called an esophagram. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bereavement: Refers to the whole process of grieving and mourning and is associated with a deep sense of loss and sadness. [NIH] Beta-Lactamases: Enzymes found in many bacteria which catalyze the hydrolysis of the amide bond in the beta-lactam ring. Well known antibiotics destroyed by these enzymes are penicillins and cephalosporins. EC 3.5.2.6. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchiectasis: Persistent abnormal dilatation of the bronchi. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Carbenicillin: Broad-spectrum semisynthetic penicillin derivative used parenterally. It is

Dictionary 81

susceptible to gastric juice and penicillinase and may damage platelet function. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboplatin: An organoplatinum compound that possesses antineoplastic activity. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardia: That part of the stomach surrounded by the esophagogastric junction, characterized by the lack of acid-forming cells. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiac arrest: A sudden stop of heart function. [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] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or 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] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body

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between the neck and the abdomen. [NIH] Cholinesterase Inhibitors: Drugs that inhibit cholinesterases. The neurotransmitter acetylcholine is rapidly hydrolyzed, and thereby inactivated, by cholinesterases. When cholinesterases are inhibited, the action of endogenously released acetylcholine at cholinergic synapses is potentiated. Cholinesterase inhibitors are widely used clinically for their potentiation of cholinergic inputs to the gastrointestinal tract and urinary bladder, the eye, and skeletal muscles; they are also used for their effects on the heart and the central nervous system. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clindamycin: An antibacterial agent that is a semisynthetic analog of lincomycin. [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] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Comatose: Pertaining to or affected with coma. [EU] 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

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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. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]

Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or

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treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cricoid Cartilage: The small thick cartilage that forms the lower and posterior parts of the laryngeal wall. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cyanosis: A bluish or purplish discoloration of the skin and mucous membranes due to an increase in the amount of deoxygenated hemoglobin in the blood or a structural defect in the hemoglobin molecule. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Deglutition: The process or the act of swallowing. [NIH] Dehydration: The condition that results from excessive loss of body water. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diabetic Ketoacidosis: Complication of diabetes resulting from severe insulin deficiency coupled with an absolute or relative increase in glucagon concentration. The metabolic acidosis is caused by the breakdown of adipose stores and resulting increased levels of free fatty acids. Glucagon accelerates the oxidation of the free fatty acids producing excess ketone bodies (ketosis). [NIH] Diagnostic procedure: A method used to identify a disease. [NIH]

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Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] 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] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Donepezil: A drug used in the treatment of Alzheimer's disease. It belongs to the family of drugs called cholinesterase inhibitors. It is being studied as a treatment for side effects caused by radiation therapy to the brain. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyspareunia: Painful sexual intercourse. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dyspnea: Difficult or labored breathing. [NIH] Dystrophic: Pertaining to toxic habitats low in nutrients. [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] 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]

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Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empyema: Presence of pus in a hollow organ or body cavity. [NIH] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endoderm: The inner of the three germ layers of the embryo. [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] Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. [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] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. Also called squamous cell carcinoma. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophageal Atresia: Congenital failure of the full esophageal lumen to develop that commonly occurs with tracheoesophageal fistula. Symptoms include excessive salivation, gagging, cyanosis, and dyspnea. [NIH] Esophageal Stricture: A narrowing of the esophagus often caused by acid flowing back from the stomach. This condition may require surgery. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagostomy: Surgical formation of an external opening (stoma) into the esophagus. [NIH]

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Esophagram: A series of x-rays of the esophagus. The x-ray pictures are taken after the person drinks a solution that contains barium. The barium coats and outlines the esophagus on the x-ray. Also called a barium swallow. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Evacuation: An emptying, as of the bowels. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expander: Any of several colloidal substances of high molecular weight. used as a blood or plasma substitute in transfusion for increasing the volume of the circulating blood. called also extender. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracorporeal: Situated or occurring outside the body. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatal Outcome: Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from death, the physiological cessation of life and from mortality, an epidemiological or statistical concept. [NIH] Febrile: Pertaining to or characterized by fever. [EU] 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] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Foetal: Of or pertaining to a fetus; pertaining to in utero development after the embryonic period. [EU] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] 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] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gasoline: Volative flammable fuel (liquid hydrocarbons) derived from crude petroleum by processes such as distillation reforming, polymerization, etc. [NIH] Gastric: Having to do with the stomach. [NIH]

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Gastric Emptying: The evacuation of food from the stomach into the duodenum. [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] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [NIH] Gavage: Feeding by a tube passed into the stomach; called also tube feeding. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Germ Layers: The three layers of cells comprising the early embryo. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [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]

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Hoarseness: An unnaturally deep or rough quality of voice. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Hyaline membrane disease: A respiratory disease of newborns, especially premature infants, in which a membrane composed of proteins and dead cells forms and lines the alveoli making gas exchange difficult or impossible. [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] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperostosis: Increase in the mass of bone per unit volume. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppression: Deliberate prevention or diminution of the host's immune response. It may be nonspecific as in the administration of immunosuppressive agents (drugs or radiation) or by lymphocyte depletion or may be specific as in desensitization or the simultaneous administration of antigen and immunosuppressive drugs. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of suppressor T-cell populations or by inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [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] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus,

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or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Inoperable: Not suitable to be operated upon. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Instillation: . [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] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]

Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients. [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] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles,

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etc., having sufficient kinetic energy to produce ionization by collision. [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] Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [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] Keratolytic: An agent that promotes keratolysis. [EU] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Ketosis: A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis. [NIH] Laryngeal: Having to do with the larynx. [NIH] Laryngitis: Inflammation of the larynx. This condition presents itself with dryness and soreness of the throat, difficulty in swallowing, cough, and hoarseness. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Legionellosis: Infections with bacteria of the genus Legionella. [NIH] Length of Stay: The period of confinement of a patient to a hospital or other health facility. [NIH]

Lethal: Deadly, fatal. [EU] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Lincomycin: (2S-trans)-Methyl 6,8-dideoxy-6-(((1-methyl-4-propyl-2pyrrolidinyl)carbonyl)amino)-1-thio-D-erythro-alpha-D-galacto-octopyranoside. An antibiotic produced by Streptomyces lincolnensis var. lincolnensis. It has been used in the treatment of staphylococcal, streptococcal, and Bacteroides fragilis infections. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipoid: The most common nephrotic syndrome disease of childhood. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU]

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Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [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]

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

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphocyte Depletion: Immunosuppression by reduction of circulating lymphocytes or by T-cell depletion of bone marrow. The former may be accomplished in vivo by thoracic duct drainage or administration of antilymphocyte serum. The latter is performed ex vivo on bone marrow before its transplantation. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] 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] 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]

Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Mechanical ventilation: Use of a machine called a ventilator or respirator to improve the exchange of air between the lungs and the atmosphere. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning,

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(2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Metabolic acidosis: (met-ah-BOL-ik as-id-O-sis): A condition in which the blood is too acidic. It may be caused by severe illness or sepsis (bacteria in the bloodstream). [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] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] 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] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonia: Prolonged failure of muscle relaxation after contraction. This may occur after voluntary contractions, muscle percussion, or electrical stimulation of the muscle. Myotonia is a characteristic feature of myotonic disorders. [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] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU]

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Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Nosocomial: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection. [EU] 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 magnetic resonance imaging: NMRI. A procedure in which a magnet linked to a computer is used to create detailed pictures of areas inside the body. Also called magnetic resonance imaging (MRI). [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [NIH]

Orofacial: Of or relating to the mouth and face. [EU] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH]

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Pastoral Care: Counseling or comfort given by ministers, priests, rabbis, etc., to those in need of help with emotional problems or stressful situations. [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] Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope. [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]

Penicillin: An antibiotic drug used to treat infection. [NIH] Penicillin V: A broad-spectrum penicillin antibiotic used orally in the treatment of mild to moderate infections by susceptible gram-positive organisms. [NIH] Penicillinase: A beta-lactamase preferentially cleaving penicillins. (Dorland, 28th ed) EC 3.5.2.-. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] 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] Pilot study: The initial study examining a new method or treatment. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Pneumonia: Inflammation of the lungs. [NIH]

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Pneumonitis: A disease caused by inhaling a wide variety of substances such as dusts and molds. Also called "farmer's disease". [NIH] Pneumothorax: Accumulation of air or gas in the space between the lung and chest wall, resulting in partial or complete collapse of the lung. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Positive End-Expiratory Pressure: A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lung at the end of expiration, thus keeping the alveoli open and improving gas exchange. [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] Povidone: A polyvinyl polymer of variable molecular weight; used as suspending and dispersing agent and vehicle for pharmaceuticals; also used as blood volume expander. [NIH] Povidone-Iodine: An iodinated polyvinyl polymer used as topical antiseptic in surgery and for skin and mucous membrane infections, also as aerosol. The iodine may be radiolabeled for research purposes. [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] Preoperative: Preceding an operation. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prophylaxis: An attempt to prevent disease. [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] 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] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proto-Oncogene Proteins: Products of proto-oncogenes. Normally they do not have oncogenic or transforming properties, but are involved in the regulation or differentiation of cell growth. They often have protein kinase activity. [NIH] Proto-Oncogene Proteins c-mos: Cellular proteins encoded by the c-mos genes. They function in the cell cycle to maintain maturation promoting factor in the active state and

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have protein-serine/threonine kinase activity. Oncogenic transformation can take place when c-mos proteins are expressed at the wrong time. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] 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] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [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] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Ranitidine: A non-imidazole blocker of those histamine receptors that mediate gastric secretion (H2 receptors). It is used to treat gastrointestinal ulcers. [NIH] Ranitidine Hydrochloride: Drug used to eradicate Helicobacter pylori. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH]

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Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] 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] 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] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] 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] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Salivation: 1. The secretion of saliva. 2. Ptyalism (= excessive flow of saliva). [EU] 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] 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] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH]

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Sialorrhea: Increased salivary flow. [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] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] 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] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Squamous Epithelium: Tissue in an organ such as the esophagus. Consists of layers of flat, scaly cells. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH]

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Stoma: A surgically created opening from an area inside the body to the outside. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] 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]

Sulbactam: A beta-lactamase inhibitor with very weak antibacterial action. The compound prevents antibiotic destruction of beta-lactam antibiotics by inhibiting beta-lactamases, thus extending their spectrum activity. Combinations of sulbactam with beta-lactam antibiotics have been used successfully for the therapy of infections caused by organisms resistant to the antibiotic alone. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Tamponade: The inserting of a tampon; a dressing is inserted firmly into a wound or body cavity, as the nose, uterus or vagina, principally for stopping hemorrhage. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thoracic: Having to do with the chest. [NIH] Thoracotomy: Surgical incision into the chest wall. [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] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU]

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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] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Tracheoesophageal Fistula: Abnormal communication between the esophagus and the trachea, acquired or congenital, often associated with esophageal atresia. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Triage: The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Tube-feeding: Feeding by a tube passed into the stomach. [NIH] Turpentine: The concrete oleoresin obtained from Pinus palustris Mill. (Pinaceae) and other species of Pinus. It contains a volatile oil, to which its properties are due, and to which form it is generally used. (Dorland, 28th ed) Turpentine is used as a solvent and an experimental irritant in biomedical research. Turpentine toxicity is of medical interest. [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] Unresectable: Unable to be surgically removed. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic

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afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venter: Belly. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vital Statistics: Used for general articles concerning statistics of births, deaths, marriages, etc. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vocal cord: The vocal folds of the larynx. [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]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

103

INDEX A Aberrant, 5, 77 Abscess, 10, 16, 33, 77 Acidity, 41, 77 Acoustic, 5, 77 Adaptation, 6, 77 Adenocarcinoma, 6, 77 Adjustment, 77 Adverse Effect, 77, 82, 99 Aerosol, 77, 96 Affinity, 77, 79, 82 Age Groups, 4, 77 Age of Onset, 77, 101 Aged, 80 and Over, 77 Airway, 12, 26, 32, 77 Algorithms, 77, 80 Alimentary, 77, 86 Alkaline, 78, 79 Alternative medicine, 52, 78 Alveoli, 78, 89, 96, 102 Ampulla, 78, 86 Anaerobic, 10, 11, 16, 78 Analog, 78, 82, 87 Anastomosis, 33, 65, 78 Anesthesia, 10, 15, 39, 41, 77, 78 Aneurysm, 20, 78 Antagonism, 78, 82 Antibacterial, 78, 82, 99, 100 Antibiotic, 78, 80, 91, 95, 99, 100 Antibody, 77, 78, 82, 89, 90, 97 Antigen, 77, 78, 82, 89, 90 Antimetabolite, 78, 87 Antimicrobial, 8, 20, 26, 78 Antineoplastic, 78, 81, 87, 94 Antipsychotic, 78, 82, 94 Antiseptic, 79, 96 Anus, 79 Apnea, 5, 79 Arteries, 79, 80, 84, 93 Artery, 20, 78, 79, 84, 92 Astrocytes, 79 Astrocytoma, 30, 79 Asynchronous, 31, 79 Atresia, 11, 79 Atypical, 19, 79, 82 Auditory, 79, 92, 102 B Bacteremia, 21, 79

Bacteria, 78, 79, 80, 84, 86, 87, 88, 91, 93, 99, 101 Bacterial Physiology, 77, 79 Barium, 25, 79, 80, 87 Barium swallow, 25, 80, 87 Benign, 80, 93, 97 Bereavement, 6, 80 Beta-Lactamases, 80, 100 Bilateral, 20, 22, 80 Bile, 80, 88, 92 Bile Acids, 80, 88 Biological Transport, 80, 85 Biopsy, 13, 80, 95 Biotechnology, 8, 52, 59, 80 Blood vessel, 80, 81, 86, 100, 102 Blood Volume, 80, 96 Bolus, 4, 5, 6, 80 Bolus infusion, 80 Bowel, 13, 80, 90 Broad-spectrum, 80, 95 Bronchi, 80, 101 Bronchiectasis, 29, 44, 80 Bronchitis, 64, 80 Burns, 27, 80 Burns, Electric, 80 C Carbenicillin, 14, 80 Carbon Dioxide, 81, 87, 98 Carboplatin, 44, 81 Carcinoma, 33, 39, 81 Cardia, 6, 81 Cardiac, 11, 12, 65, 81, 93, 98 Cardiac arrest, 11, 81 Case report, 15, 20, 31, 81, 87 Catheter, 7, 81, 90 Catheterization, 81, 90 Caudal, 81, 96 Cause of Death, 12, 81 Cell, 26, 79, 80, 81, 82, 83, 84, 87, 88, 89, 90, 92, 93, 95, 96, 97, 98, 102 Cell Cycle, 81, 82, 96 Cell Respiration, 81, 98 Central Nervous System, 81, 82, 98 Cerebral, 7, 81 Cerebral Palsy, 7, 81 Cerebrovascular, 12, 81 Cerebrum, 81 Cervical, 13, 15, 65, 81

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Cervix, 81 Chest Pain, 53, 81 Chest wall, 81, 96, 100 Cholinesterase Inhibitors, 82, 85 Chromosome, 82, 91 Chronic, 4, 7, 23, 31, 82, 86, 90, 100 Cisplatin, 44, 82 Clindamycin, 8, 9, 10, 14, 20, 33, 82 Clinical trial, 4, 59, 82, 96, 97 Cloning, 80, 82 Clozapine, 15, 82 Collapse, 82, 96 Comatose, 30, 82 Complement, 82, 83 Complementary and alternative medicine, 39, 45, 83 Complementary medicine, 39, 83 Computational Biology, 59, 83 Computed tomography, 23, 83 Computerized axial tomography, 83 Computerized tomography, 83 Connective Tissue, 42, 83, 92 Connective Tissue Cells, 83 Consciousness, 83, 84, 98 Constipation, 49, 79, 83 Contamination, 34, 83 Continuum, 5, 83 Contraindications, ii, 83 Coordination, 4, 7, 84 Coronary, 84, 93 Coronary Thrombosis, 84, 93 Cortical, 84, 98 Cranial, 84, 101 Cricoid Cartilage, 84, 102 Curative, 84, 100 Cyanosis, 84, 86 Cyst, 12, 84 Cytotoxic, 84, 89, 97 Cytotoxicity, 82, 84 D Deglutition, 5, 17, 84 Dehydration, 48, 49, 84 Dementia, 5, 34, 79, 84 Dental Caries, 3, 84 Desensitization, 84, 89 Diabetes Mellitus, 3, 23, 84, 88, 90 Diabetic Ketoacidosis, 48, 84 Diagnostic procedure, 52, 84 Diaphragm, 85, 88 Diarrhea, 48, 49, 85 Diffusion, 6, 80, 85 Digestion, 77, 80, 85, 90, 92, 100

Digestive tract, 85, 99 Direct, iii, 65, 85, 97 Distal, 65, 85, 88 Diverticulum, 10, 33, 65, 85 Donepezil, 22, 85 Dopamine, 79, 82, 85 Dorsal, 85, 96 Drug Interactions, 85 Drug Tolerance, 85, 100 Duodenum, 65, 80, 85, 86, 88, 94, 100 Dyspareunia, 53, 85 Dysphagia, 5, 6, 11, 21, 22, 28, 29, 32, 41, 42, 64, 85 Dyspnea, 85, 86 Dystrophic, 11, 85 E Efficacy, 41, 44, 85 Elective, 41, 85 Electrolyte, 48, 49, 86, 94 Electromyography, 5, 86 Electrons, 86, 90, 91, 94, 97 Embolism, 26, 86 Embryo, 86, 88 Empyema, 10, 86 Enamel, 84, 86 Endoderm, 65, 86 Endoscope, 86 Endoscopic, 9, 29, 86 Enteral Nutrition, 19, 23, 26, 48, 86 Environmental Health, 58, 60, 86 Enzymatic, 83, 84, 86, 88 Epidemiological, 4, 21, 86, 87 Epidermoid carcinoma, 86, 99 Epithelial, 77, 80, 86 Epithelial Cells, 86 Epithelium, 65, 86 Esophageal, 6, 22, 26, 29, 33, 53, 65, 86, 88, 101 Esophageal Atresia, 26, 65, 86, 101 Esophageal Stricture, 53, 86 Esophagitis, 6, 86, 88 Esophagostomy, 65, 86 Esophagram, 80, 87 Esophagus, 4, 53, 65, 79, 80, 85, 86, 87, 88, 92, 95, 98, 99, 100, 101 Evacuation, 83, 87, 88 Exogenous, 42, 87, 101 Expander, 87, 96 Expiration, 87, 96, 98 Extracellular, 79, 83, 87 Extracellular Matrix, 83, 87 Extracorporeal, 31, 87

105

F Family Planning, 59, 87 Fat, 26, 40, 43, 87, 91, 101 Fatal Outcome, 14, 87 Febrile, 40, 87 Feces, 83, 87 Fetus, 87, 101 Fistula, 10, 33, 87 Fluorouracil, 44, 87 Foetal, 20, 87 G Gamma Rays, 87, 97 Gas, 81, 85, 87, 89, 96, 102 Gas exchange, 87, 89, 96, 102 Gasoline, 30, 87 Gastric, 6, 29, 31, 41, 43, 53, 81, 87, 88, 97 Gastric Emptying, 31, 88 Gastroesophageal Reflux, 22, 25, 53, 88 Gastroesophageal Reflux Disease, 53, 88 Gastrointestinal, 48, 53, 82, 86, 88, 97, 98, 100 Gastrostomy, 9, 14, 21, 27, 29, 65, 86, 88 Gavage, 13, 88 Gene, 80, 88 Germ Layers, 86, 88 Gland, 88, 92, 98, 99 Glucose, 84, 88, 90 Glucose Intolerance, 84, 88 Governing Board, 88, 96 Gram-negative, 9, 88 Gram-positive, 88, 95 H Health Status, 4, 88 Heartburn, 53, 88 Hemorrhage, 88, 100 Hiatal Hernia, 6, 88 Histamine, 79, 88, 97 Hoarseness, 89, 91 Homogeneous, 83, 89 Hyaline membrane disease, 20, 89 Hydrogen, 77, 89, 93, 94 Hydrolysis, 80, 82, 89 Hyperglycemia, 49, 89 Hyperostosis, 13, 15, 21, 89 I Idiopathic, 15, 21, 89 Imidazole, 88, 89, 97 Immune response, 78, 89, 100 Immune system, 89, 92, 102 Immunologic, 89, 97 Immunosuppressant, 87, 89 Immunosuppression, 48, 89, 92

Immunosuppressive, 89 Immunosuppressive Agents, 89 In vitro, 89 In vivo, 6, 89, 92 Incision, 89, 90, 100 Incompetence, 88, 89 Infancy, 21, 89 Infant, Newborn, 77, 89 Infarction, 84, 89, 93 Infection, 4, 10, 19, 90, 92, 94, 95, 100, 102 Inflammation, 53, 80, 86, 90, 91, 95 Infusion, 40, 90 Ingestion, 27, 42, 44, 90, 96 Inhalation, 11, 77, 90, 96 Inoperable, 44, 90 Inorganic, 82, 90 Instillation, 40, 90 Insulin, 84, 90, 91, 101 Intensive Care, 7, 9, 15, 21, 22, 24, 90 Intensive Care Units, 21, 90 Intestine, 80, 90, 95, 99 Intoxication, 29, 90 Intracellular, 90 Intravenous, 13, 40, 90 Intubation, 28, 81, 90 Invasive, 6, 90, 92 Involuntary, 90, 93, 98 Iodine, 90, 96 Ionizing, 90, 97 Ions, 77, 86, 89, 91 J Jejunostomy, 25, 86, 91 K Kb, 58, 91 Keratolytic, 84, 91 Ketone Bodies, 84, 91 Ketosis, 84, 91 L Laryngeal, 5, 12, 27, 84, 91 Laryngitis, 6, 53, 91 Larynx, 4, 91, 101, 102 Legionellosis, 19, 91 Length of Stay, 7, 91 Lethal, 23, 91 Ligation, 65, 91 Lincomycin, 82, 91 Linkage, 6, 91 Lipid, 25, 26, 32, 33, 42, 90, 91, 101 Lipoid, 27, 40, 42, 43, 91 Lipopolysaccharide, 40, 88, 91 Lipoprotein, 88, 91 Liver, 80, 87, 92

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Lobe, 30, 92 Localized, 48, 77, 84, 90, 92 Lower Esophageal Sphincter, 88, 92 Lubricants, 92, 95 Lymph, 81, 92 Lymph node, 81, 92 Lymphatic, 90, 92 Lymphocyte, 78, 89, 92 Lymphocyte Depletion, 89, 92 M Macrophage, 33, 92 Magnetic Resonance Imaging, 6, 92, 94 Malignant, 77, 78, 92, 93, 97 Malnutrition, 64, 92 Mania, 12, 92 Meatus, 92, 102 Mechanical ventilation, 92, 96 Mediate, 85, 92, 97 MEDLINE, 59, 92 Membrane, 79, 83, 87, 88, 89, 91, 92, 95, 96 Memory, 84, 92 Mental, iv, 4, 58, 60, 84, 89, 92, 93, 97 Metabolic acidosis, 84, 93 MI, 75, 93 Microbiology, 10, 26, 77, 79, 93 Micro-organism, 84, 93 Microtubules, 93, 94 Molecular, 32, 59, 61, 78, 80, 83, 87, 93, 96, 101 Molecule, 78, 82, 84, 89, 93, 94, 97 Monitor, 42, 93, 94 Motion Sickness, 93 Mucins, 93, 98 Muscle Relaxation, 93 Myocardium, 93 Myotonia, 11, 93 N Nasogastric, 25, 32, 86, 93 Nausea, 49, 79, 91, 93 Necrosis, 89, 93 Neoplasms, 78, 93, 97 Nephrotic, 91, 93, 94 Nephrotic Syndrome, 91, 94 Nerve, 78, 94, 99, 101 Neuroleptic, 78, 82, 94 Nosocomial, 34, 94 Nuclear, 6, 86, 87, 93, 94 Nuclear magnetic resonance imaging, 6, 94 Nuclei, 86, 92, 94 Nutritional Support, 88, 94

O Oral Health, 3, 94 Oral Manifestations, 48, 94 Orofacial, 48, 94 Oxidation, 84, 94 Oxygen Consumption, 94, 98 P Paclitaxel, 44, 94 Paediatric, 41, 94 Palliative, 6, 94, 100 Pancreatic, 88, 94 Pancreatic Juice, 88, 94 Paralysis, 14, 94 Pastoral Care, 7, 95 Pathologic, 80, 84, 95 Pathologist, 64, 95 Pathophysiology, 19, 95 Patient Education, 64, 70, 72, 75, 95 Penicillin, 9, 14, 24, 33, 78, 80, 95 Penicillin V, 9, 95 Penicillinase, 81, 95 Percutaneous, 9, 27, 29, 95 Periodontal disease, 3, 95 Periodontitis, 4, 95 Perioperative, 28, 95 Peristalsis, 6, 95 Petroleum, 42, 87, 95 Pharmacologic, 78, 95, 101 Pharynx, 4, 5, 14, 88, 95, 102 Phospholipids, 87, 91, 95 Pilot study, 29, 41, 95 Platinum, 82, 95 Pneumonitis, 19, 42, 96 Pneumothorax, 24, 96 Poisoning, 13, 43, 90, 93, 96 Positive End-Expiratory Pressure, 22, 31, 96 Posterior, 65, 84, 85, 96 Povidone, 14, 96 Povidone-Iodine, 14, 96 Practice Guidelines, 60, 96 Preoperative, 31, 96 Prevalence, 3, 96 Progressive, 84, 85, 93, 96 Prophylaxis, 15, 28, 41, 96 Prospective study, 20, 32, 96 Protein S, 80, 96 Proteins, 78, 82, 89, 93, 96 Protocol, 29, 44, 96 Proto-Oncogene Proteins, 94, 96 Proto-Oncogene Proteins c-mos, 94, 96 Psychiatry, 12, 97, 102

107

Psychic, 93, 97, 98 Public Policy, 59, 97 Publishing, 8, 48, 97 Pulmonary, 26, 29, 97, 102 R Radiation, 44, 85, 87, 89, 90, 97, 102 Radiation therapy, 85, 97 Radioactive, 89, 94, 97 Radioimmunotherapy, 97 Radiolabeled, 96, 97 Radiological, 30, 95, 97 Radiotherapy, 44, 97 Randomized, 9, 85, 97 Ranitidine, 41, 97 Ranitidine Hydrochloride, 41, 97 Receptor, 77, 78, 82, 85, 97, 98 Recurrence, 39, 97 Refer, 1, 64, 82, 94, 97, 101 Reflex, 25, 39, 98 Reflux, 6, 14, 53, 88, 98 Regimen, 85, 98 Regurgitation, 26, 39, 88, 98 Remission, 97, 98 Respiration, 4, 79, 81, 93, 98 Respiratory Physiology, 98, 102 Resuscitation, 11, 13, 98 Retrograde, 5, 98 Retrospective, 9, 14, 98 Risk factor, 4, 18, 30, 32, 44, 96, 98 S Saliva, 65, 98 Salivary, 98, 99 Salivary glands, 98 Salivation, 86, 98 Screening, 82, 98 Secretion, 43, 88, 93, 97, 98 Seizures, 40, 98 Semisynthetic, 80, 82, 98 Serotonin, 79, 82, 98 Sialorrhea, 15, 99 Side effect, 77, 79, 85, 99, 101 Skeletal, 5, 15, 21, 82, 99 Skeleton, 99 Skull, 99, 100 Small intestine, 85, 90, 93, 99 Solvent, 99, 101 Somatic, 99, 101 Specialist, 66, 99 Species, 99, 101 Spectrum, 99, 100 Sphincter, 26, 91, 99 Spinal cord, 79, 81, 98, 99

Squamous, 44, 65, 86, 99 Squamous cell carcinoma, 44, 86, 99 Squamous cells, 99 Squamous Epithelium, 65, 99 Stenosis, 99, 100 Stimulus, 98, 99, 100 Stoma, 86, 100 Stomach, 6, 53, 65, 81, 85, 86, 87, 88, 91, 92, 93, 95, 98, 99, 100, 101 Stress, 93, 100 Stricture, 6, 99, 100 Stroke, 5, 9, 15, 25, 58, 100 Subacute, 90, 100 Subclinical, 90, 98, 100 Substance P, 98, 100 Sulbactam, 10, 100 Systemic, 3, 23, 48, 90, 97, 100 Systemic disease, 4, 48, 100 T Tachycardia, 79, 100 Tachypnea, 79, 100 Tamponade, 29, 100 Temporal, 5, 92, 100 Therapeutics, 34, 100 Thoracic, 10, 18, 27, 33, 85, 92, 100, 102 Thoracotomy, 65, 100 Thorax, 11, 27, 43, 100, 102 Threshold, 6, 100 Thrombosis, 96, 100 Tissue, 5, 34, 78, 80, 83, 85, 92, 93, 94, 95, 98, 99, 100, 101 Tolerance, 28, 44, 88, 100 Tomography, 43, 101 Tooth Preparation, 77, 101 Topical, 96, 101 Toxic, iv, 11, 84, 85, 101 Toxicity, 85, 101 Toxicology, 40, 44, 60, 101 Toxin, 100, 101 Trachea, 65, 80, 91, 95, 101 Tracheoesophageal Fistula, 65, 86, 101 Transfection, 80, 101 Transplantation, 40, 42, 92, 101 Trauma, 86, 93, 101 Triage, 7, 101 Triglyceride, 44, 101 Tube-feeding, 48, 101 Turpentine, 42, 101 Type 2 diabetes, 4, 101 U Unresectable, 44, 101 Uterus, 81, 100, 101

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V Vagina, 81, 100, 101 Vagus Nerve, 65, 101 Vascular, 20, 90, 102 Vein, 78, 90, 94, 102 Venous, 20, 96, 102 Venter, 102 Ventilation, 22, 31, 102 Ventral, 65, 102 Veterinary Medicine, 59, 102 Visceral, 102

Visceral Afferents, 102 Viscosity, 5, 6, 102 Vital Statistics, 7, 102 Vivo, 92, 102 Vocal cord, 14, 20, 102 W White blood cell, 78, 92, 102 Windpipe, 65, 95, 102 X X-ray, 80, 83, 87, 94, 97, 102