FATIGUE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2003 by ICON Group International, Inc. Copyright ©2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Fatigue: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83906-9 1. Fatigue-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on fatigue. 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 FATIGUE .................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Fatigue .......................................................................................... 7 E-Journals: PubMed Central ....................................................................................................... 67 The National Library of Medicine: PubMed ................................................................................ 69 CHAPTER 2. NUTRITION AND FATIGUE ........................................................................................ 115 Overview.................................................................................................................................... 115 Finding Nutrition Studies on Fatigue ....................................................................................... 115 Federal Resources on Nutrition ................................................................................................. 123 Additional Web Resources ......................................................................................................... 123 CHAPTER 3. ALTERNATIVE MEDICINE AND FATIGUE .................................................................. 129 Overview.................................................................................................................................... 129 National Center for Complementary and Alternative Medicine................................................ 129 Additional Web Resources ......................................................................................................... 139 General References ..................................................................................................................... 157 CHAPTER 4. DISSERTATIONS ON FATIGUE .................................................................................... 159 Overview.................................................................................................................................... 159 Dissertations on Fatigue ............................................................................................................ 159 Keeping Current ........................................................................................................................ 175 CHAPTER 5. CLINICAL TRIALS AND FATIGUE............................................................................... 177 Overview.................................................................................................................................... 177 Recent Trials on Fatigue ............................................................................................................ 177 Keeping Current on Clinical Trials ........................................................................................... 186 CHAPTER 6. PATENTS ON FATIGUE............................................................................................... 189 Overview.................................................................................................................................... 189 Patents on Fatigue ..................................................................................................................... 189 Patent Applications on Fatigue.................................................................................................. 202 Keeping Current ........................................................................................................................ 227 CHAPTER 7. BOOKS ON FATIGUE .................................................................................................. 229 Overview.................................................................................................................................... 229 Book Summaries: Federal Agencies............................................................................................ 229 Book Summaries: Online Booksellers......................................................................................... 231 The National Library of Medicine Book Index ........................................................................... 238 Chapters on Fatigue ................................................................................................................... 239 CHAPTER 8. MULTIMEDIA ON FATIGUE........................................................................................ 243 Overview.................................................................................................................................... 243 Video Recordings ....................................................................................................................... 243 Audio Recordings....................................................................................................................... 248 Bibliography: Multimedia on Fatigue........................................................................................ 249 CHAPTER 9. PERIODICALS AND NEWS ON FATIGUE..................................................................... 251 Overview.................................................................................................................................... 251 News Services and Press Releases.............................................................................................. 251 Newsletters on Fatigue .............................................................................................................. 253 Newsletter Articles .................................................................................................................... 255 Academic Periodicals covering Fatigue...................................................................................... 256 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 257 Overview.................................................................................................................................... 257 U.S. Pharmacopeia..................................................................................................................... 257 Commercial Databases ............................................................................................................... 258
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Researching Orphan Drugs ....................................................................................................... 259 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 263 Overview.................................................................................................................................... 263 NIH Guidelines.......................................................................................................................... 263 NIH Databases........................................................................................................................... 265 Other Commercial Databases..................................................................................................... 272 APPENDIX B. PATIENT RESOURCES ............................................................................................... 273 Overview.................................................................................................................................... 273 Patient Guideline Sources.......................................................................................................... 273 Associations and Fatigue ........................................................................................................... 282 Finding Associations.................................................................................................................. 283 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 285 Overview.................................................................................................................................... 285 Preparation................................................................................................................................. 285 Finding a Local Medical Library................................................................................................ 285 Medical Libraries in the U.S. and Canada ................................................................................. 285 ONLINE GLOSSARIES................................................................................................................ 291 Online Dictionary Directories ................................................................................................... 293 FATIGUE DICTIONARY ............................................................................................................. 295 INDEX .............................................................................................................................................. 381
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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 fatigue is indexed in search engines, such as www.google.com or others, a nonsystematic 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 fatigue, 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 fatigue, 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 fatigue. 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 fatigue, 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 fatigue. 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 FATIGUE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on fatigue.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and fatigue, 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 “fatigue” (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: •
Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain Syndrome Source: Current Opinion in Rheumatology. 13(2): 117-127. March 2001. Summary: This journal article highlights research on fibromyalgia (FM), chronic fatigue syndrome (CFS), and myofascial pain syndrome to provide health professionals with information on the prevalence, symptoms, etiology, diagnosis, and treatment of these conditions. The prevalence of chronic widespread pain in the general population in Israel was comparable with reports from the United States, United Kingdom, and Canada. Comorbidity with FM resulted in somatic hyperalgesia in patients with irritable bowel syndrome. One sixth of the subjects with chronic widespread pain in the general population were also found to have a mental disorder. Mechanisms involved in referred pain, temporal summation, muscle hyperalgesia, and muscle pain at rest were attenuated by the N-methyl-D-aspartate antagonist, ketamine, in FM patients. Delayed
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corticotropin release, after interleukin 6 administration, in FM was shown to be consistent with a defect in hypothalamic corticotropin releasing neural function. The basal autonomic state of FM patients was characterized by increased sympathetic and decreased parasympathetic systems tones. The severity of functional impairment as assessed by the Medical Outcome Survey Short Form discriminated between patients with widespread pain alone and FM patients. CFS occurred in about 0.42 percent of a random community based sample of 28,673 adults in Chicago, IL. A significant clinical overlap between CFS and FM was reported. Cytokine dysregulation was not found to be a singular or dominant factor in the pathogenesis of CFS. A favorable outcome of CFS in children was reported. Two thirds recovered and resumed normal activities. No major therapeutic trials in FM and CFS were reported between 2000 and 2001. Data indicate that ultrasound treatment and trigger point injections were equally effective when combined with neck stretching exercises for the treatment of myofascial pain. 83 references. (AA-M). •
Chronic Fatigue Syndrome: Evaluation and Treatment Source: American Family Physician. 65(6): 1083-1090. March 15, 2002. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail:
[email protected]. Website: www.aafp.org. Summary: This journal article provides health professionals with information on the etiology, clinical features, diagnosis, and treatment of chronic fatigue syndrome (CFS). Severe fatigue is a common complaint among patients. Often, the fatigue is transient or can be attributed to a definable organic illness. Some patients present with persistent and disabling fatigue, but show no abnormalities on physical examination or screening laboratory tests. In these cases, the diagnosis of CFS should be considered. CFS is characterized by debilitating fatigue with associated myalgias, tender lymph nodes, arthralgias, chills, feverish feelings, and postexertional malaise. Diagnosis of CFS is primarily by exclusion because of the lack of a definitive laboratory test or physical findings. The Centers for Disease Control and Prevention's criteria for diagnosis of CFS require patients to present with severe fatigue lasting for at least 6 consecutive months, to have no definable organic disease, and to experience associated physical symptoms. Medical research continues to examine the many possible etiologic agents for CFS, including infectious, immunologic, neurologic, and psychiatric, but the answer remains elusive. CFS is a heterogeneous disorder possibly involving an interaction of biologic systems. Similarities with fibromyalgia exist, and concomitant illnesses include irritable bowel syndrome, depression, and headaches. Therefore, treatment for CFS may be variable and should be tailored to each patient. Therapy should include exercise, diet, good sleep hygiene, antidepressants, and other medications, depending on the patient's presentation. 1 figure, 2 tables, and 39 references. (AA-M).
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Assessment of Fatigue and Psychologic Disturbances in Patients with Hepatitis C Virus Infection Source: Journal of Clinical Gastroenterology. 32(5): 413-417. May-June 2001. Contact: Available from Lippincott Williams and Wilkins, Inc. 12107 Insurance Way, Hagerstown, MD 21740. (800) 638-3030 or (301) 714-2300. Summary: It is a common clinical impression that fatigue is a frequent, and often debilitating, symptom in patients with chronic hepatitis C virus (HCV) infection. However, despite its obvious clinical importance, several aspects of fatigue, including its
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relationship with the underlying liver disease and the presence of psychological disturbances, have not been well examined. This article reports on a study carried out to assess these issues. The subjects (n = 149) were assigned to one of the following study groups: healthy controls (n = 31), chronic HCV infection (n = 24), combined HCV infection and chronic alcohol abuse (n = 32), alcoholic liver disease (n = 22), and chronic non liver diseases (n = 40). All subjects were administered investigator assisted questionnaires designed to analyze the presence of severity of fatigue and psychological abnormalities. The means fatigue scores in patients with chronic HCV infection, alcoholic liver disease, mixed liver disease, and chronic non liver diseases were significantly greater compared to healthy subjects. The total fatigue scores were higher in HCV infected subjects compared with the other patient groups, but the differences failed to reach statistical significance. Moreover, the fatigue experienced by patients with HCV did not improve with rest as effectively as in the other study groups. All patient groups had higher scores for psychological disturbances compared with health subjects. Patients with HCV infection were shown to be more depressed and harbor greater feelings of anger and hostility compared with those with non liver chronic diseases. The authors conclude that these observations are important because proper management of the psychological symptoms may have a favorable impact on the quality of life of patients with HCV infection. 3 tables. 30 references. •
How to Fight Fatigue Source: Diabetes Self-Management. 15(1): 6-8, 10-11. January-February 1998. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Summary: This article provides people who have diabetes with information about fatigue. With the exception of chronic fatigue syndrome, fatigue is usually a symptom of another problem or condition as opposed to a medical problem in and of itself. The author presents the primary causes of fatigue in three categories: lifestyle factors, medical conditions, and mood disorders. Lifestyle factors may include stress, nutrition, dehydration, exercise, and smoking. Among the medical conditions that may cause fatigue are high blood glucose, infection, hypothyroidism, heart disease, mitral valve prolapse, cancer, iron-deficiency anemia, iron overload, sleep disorders, and chronic fatigue syndrome. The author refers to depression and seasonal affective disorder as mood disorders which may cause fatigue. A health care professional should be consulted when fatigue is sudden or severe; is accompanied by symptoms such as fever, shortness of breath, or chest pain; or lasts more than two weeks without obvious cause. A sidebar provides nine tips for sleeping more peacefully. The article lists three organizations as sources of further information about fatigue. (AA-M).
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Fatigue After Work in Noise: An Epidemiological Survey Study and Three QuasiExperimental Field Studies Source: Noise and Health. Volume 1: 47-55. September-December 1998. Contact: Available from Noise and Health. Institute of Laryngology and Otology, University College London, 330 Gray's Inn Road, London WC1X 8EE, United Kingdom. +44 171 915 1575. Fax +44 171 278 8041. Summary: This article reports on four studies that investigated the contribution of noise exposure to fatigue at work: one survey study and three field studies were utilized. The survey study was based on a questionnaire covering symptoms and work place exposure, and was answered by 50,000 state employees. Noise exposure was also
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estimated from their type of job and self rated noise exposure. Fatigue and headache were found to be more common among the noise exposed groups, even after control for the effects of other critical variables. Study 2 compared reaction times before and after a week's work in high noise exposure and one in low noise exposure in a group of airplane mechanics. Reaction times were prolonged after work in the noise week, whereas an opposite trend was seen in the control week. Study 3 showed a gradual increase of reaction times during a week of noise exposure in a group of airplane technicians. Study 4 compared reaction times and subjective fatigue among naval crews on a day with low and a day with high noise exposure. In one of the studied boat types (hovercraft), the development of fatigue during the work day was accentuated on the day with high exposure. 6 figures. 1 table. 13 references. (AA-M). •
Fatigue: When You Don't Feel Like Fighting Source: Arthritis Today. 16(3): 60-64. May-June 2002. Summary: This journal article discusses fatigue that is associated with rheumatic disorders. Fatigue is subjective and affects patients in different ways. Illness-related fatigue may be due to many different factors including inflammatory disease activity, anemia, pain, poor sleep, lack of activity, hypothyroidism, depression, poor nutrition, fibromyalgia, and neurally mediated hypotension. Suggestions for coping with fatigue and increasing energy level include managing the disease properly, controlling pain, getting regular and enough sleep, increasing activity, seeking counseling, learning to relax, taking a break, reinterpreting symptoms, and joining a support group. New drugs are being tested to help combat fatigue.
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Evaluating and Treating Fatigue in Individuals With HIV Infection Source: STEP Perspective; Vol. 5, No. 3. Contact: Seattle Treatment Education Project, 1123 E John St, Seattle, WA, 98102, (206) 329-4857, http://www.thebody.com/step/steppage.html. Summary: This journal article discusses the possible causes of fatigue in HIV-infected individuals and cites the author's experience and anecdotal records as the basis for treatment recommendations when research material is unavailable. It summarizes the following as causes of fatigue: chronic viral infection, active infections or malignancies, endocrine disorders, malnutrition, drug toxicity, sleep disturbances, and chronic pain. The article suggests pharmacologic therapy after proper diagnosis or nonpharmacologic approaches like exercise and lifestyle changes such as improved diet. It also mentions nontraditional approaches for treating fatigue.
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Gender of Demented Patients and Specific Family Relationship of Caregiver to Patients Influence Mental Fatigue and Burdens on Relatives as Caregivers Source: International Journal of Geriatric Psychiatry. 14: 618-625. 1999. Summary: This journal article explores the burden and psychological problems of Japanese family caregivers for people with dementia. Sixty-two dementia patients and their caregivers were recruited from a university outpatient clinic and the day service system for the elderly in Kagoshima. The patients were rated on standardized measures of cognitive function, activities of daily living (ADL), and behavior. Caregivers completed a caregiver burden scale and a measure of mental fatigue. Higher levels of caregiver burden were associated with greater cognitive impairment, greater impairment in five areas of ADL performance, more severe behavioral disturbance, and
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greater mental fatigue. Behavioral disturbance, caregiver burden, and mental fatigue were significantly higher for males. Mental fatigue was significantly worse among spouses than among offspring, but these two groups of caregivers did not differ on caregiver burden except for the caregiver physical problems subscale. The authors conclude that caregiver burden may be affected by patient gender and the relationship of caregiver to patient. 1 figure, 3 tables, 23 references. •
Fibromyalgia, Chronic Fatigue, and Other Iatrogenic Diagnostic Algorithms Source: Postgraduate Medicine. 102(2):161-162,165-166, 171-172,175-177; August 1997. Summary: This journal article for health professionals explains how applying diagnostic labels to patients in a vulnerable state may actually escalate illness, thus teaching patients to stay sick. The article uses the diagnostic labels of chronic fatigue, irritable bowel syndrome, and fibromyalgia to illustrate how such labeling may perpetuate illness, and it presents the diagnostic criteria for these conditions. In addition, arguments against a major role for psychological illness in fibromyalgia are provided. The article concludes that the disease-illness paradigm may be harmful to certain individuals and that physicians need to learn about circumstances where hunting for a diagnosis may be harmful to the health of the patient. 46 references and 4 tables.
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The Effects of Muscle Fatigue on Neuromuscular Function and Anterior Tibial Translation in Healthy Knees Source: American Journal of Sports Medicine. 24(5):615-621. 1996. Summary: This journal article for physicians investigated the effect of quadriceps and hamstring muscle fatigue on anterior tibial translation and muscle reaction time in 6 men and 4 women, all healthy, with an average age of 21.3 years with no known pathologic knee conditions. Each patient underwent a knee examination, arthrometer measurements of tibial translation, subjective functional assessment, and an anterior tibial translation stress test before and after quadriceps and hamstring muscle-fatiguing exercise. The recruitment order of the lower extremity muscles in response to anterior tibial translation did not change with muscle fatigue. However, results showed that an average increase of 32.5 percent in anterior tibial translation (range, 11.4 percent to 85.2 percent) after fatigue. Muscle responses in the gastrocnemius, hamstring, and quadriceps originating at the spinal cord and cortical level showed significant slowing and, in some cases, an absence of activity after the quadriceps and hamstring muscles were fatigued. The authors indicate that increases in displacement after fatigue strongly correlated (0.62 to 0.96) with a delay in cortical activity (intermediate and voluntary). Muscle fatigue, which appears to affect the dynamic stability of the knee, alters the neuromuscular response to anterior tibial translation. It is suggested that fatigue may play an important role in the pathomechanics of knee injuries in physically demanding sports. 3 tables, 1 figure, and 26 references. (AA)
Federally Funded Research on Fatigue The U.S. Government supports a variety of research studies relating to fatigue. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP
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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
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(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 fatigue. 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 fatigue. The following is typical of the type of information found when searching the CRISP database for fatigue: •
Project Title: A CASE-CROSSOVER STUDY OF SHARPS-RELATED INJURIES Principal Investigator & Institution: Mittleman, Murray A.; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2006 Summary: (provided by applicant): Injuries caused by sharp medical devices are common with an estimated 400,000 to 800,000 American healthcare workers injured each year. Injured healthcare workers are at risk for blood-borne viral illnesses, including hepatitis B and C, HIV infection and other less common diseases. The direct medical costs of evaluating and treating sharps-related injuries is approximately $500 million annually. Despite the recent adoption of safer medical devices, the risk of sharps-related injury remains unacceptably high. Relatively little is known about potentially preventable transient etiologic factors that immediately precede these injuries. In this revised application we propose to conduct a case-crossover study of 1,000 healthcare workers who sustain a sharps-related injury recruited from six hospitals in Boston and Baltimore. We will evaluate risk factors in the following domains: 1) worker-related factors such as rushing, fatigue, distraction and feelings of anger 2) procedure-related factors such as uncommon, unusual or emergency procedures 3) workplace-related factors such as working short-staffed, overtime or while on-call and 4) device-related factors such as use of an unusual or malfunctioning device. We will also evaluate differences in the risks between workers with differing characteristics such as age, gender, profession, and history of prior sharps-related injuries. The effect of risk factors in continuous exposure settings such as operating rooms and intermittent exposure settings such as inpatient units and outpatient clinics will be evaluated. In a pilot study 90 healthcare workers were interviewed by telephone. Forty were nurses and 28 were trainees. Twenty were injured while scrubbed in an operating room or procedure suite and 15 had known exposures to HIV or hepatitis C. Among our preliminary findings, an increased risk of sharps-related injury was associated with rushing (RR 5.1, 95% Cl 3.08.7), anger (RR 4.7, 95% Cl 1.9-12.2), distraction (RR 8.6, 95% Cl 4.3-17.2), and multiple passes (RR 3.1, 95% Cl 1.6-3.5). There were trends toward higher risk while working short staffed, and among surgeons working in a bloody operative field. Trends toward lower risk were seen with emergency procedures, and while being taught.Successful completion of this study may identify modifiable risk factors for hospital-acquired sharps-related injuries. This knowledge may lead to individual and systems level riskreduction interventions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
(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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Project Title: A ROLE FOR INTRINSIC TENDON CELLS IN OVERUSE INJURY Principal Investigator & Institution: Derwin, Kathleen A.; Cleveland Clinic Foundation 9500 Euclid Ave Cleveland, Oh 44195 Timing: Fiscal Year 2003; Project Start 01-MAR-2003; Project End 31-JAN-2006 Summary: (provided by applicant): Overuse injuries and other tendon disorders represent a common challenge in orthopaedic medicine, resulting in chronic pain, functional disability and even tendon rupture. Most chronic tendon injuries and disorders are believed to start from repeated exposure to low-magnitude forces that 'injure' the tissue microscopically. However, the role of repetitive loading-- so-called 'overuse'-- in the pathogenesis of chronic tendon injury is not well-understood. In particular, tendinosis is a condition where degenerative changes occur in the absence of inflammation. In these cases it is speculated that fatigued tendon loses its endogenous reparative ability. Repetitive microtrauma may overwhelm the ability of tendon cells to repair damage, or even incite them to respond in a manner that is degradative to their local extracellular matrix. Continued repetitive activity may lead to an accumulation of damage that eventually disrupts the structure of the tendon. Because chronic tendon injuries are believed to start from repeated exposure to low-magnitude forces, we hypothesize that they are the result of cell-mediated processes (e.g., aberrant repair and/or directed degradation) rather than material fatigue. We will explore this hypothesis in an organ culture model where tendon cells can be maintained in their native three-dimensional environment. To differentiate between damage that is cellmediated and damage due to material fatigue alone, we will first establish and then cyclically load a devitalized tendon explant to assess material damage. We will then investigate if cyclic mechanical load will instigate a damage response in vital tendon explants and whether the loads are less than those required to acutely damage devitalized tendon. A role for intrinsic tendon cells in the pathogenesis of tendon overuse injury would be implied by a lower damage threshold in vital tendon. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: A TWIN STUDY OF CHRONIC FATIGUE SYNDROME IN SWEDEN Principal Investigator & Institution: Pedersen, Nancy L.; Karolinska Institute Tomtebodavagen 11F Stockholm, Timing: Fiscal Year 2001; Project Start 15-AUG-2001; Project End 31-JUL-2004 Summary: Despite considerable research, fundamental questions about CFS remain at best partially answered. These questions include its definition, validity, the degree to which it results from genetic versus environmental factors, the nature of the substantial comorbidity observed with other conditions, and the basis of the female preponderance. The overarching aim of this project is to shed light on a number of basic questions about CFS via a large, population-based classical twin study. First, we will collect data on approximately 32,000 adults aged 42-65 years (13,000 complete twin pairs) who are members of the population- based Swedish Twin Registry for persistent fatigue, several overlapping conditions (fibromyalgia, irritable bowel syndrome, tension headache, allergy/eczema, generalized anxiety disorder, and major depression), and a detailed medical history. Second, the medical records of all twins who appear to have CFS-like illness and a subset of those with "CFS-explained" will be requested via an efficient national retrieval system. Following expert review, these individuals will be classified in regard to the CDC CFS criteria. Obtaining these unique data will allow us to address a set of critical questions regarding CFS. First, we will estimate the prevalence of CFS and its common comorbidities (fibromyalgia, irritable bowel syndrome, tension headache,
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allergy/eczema, generalized anxiety disorder, and major depression) in one of the largest samples yet studied. Second, we will use a variety of multivariate techniques to derive an empirical typology of prolonged fatigue and to assess how this typology compares to the CFS definition. Third, we will quantify the genetic and environmental sources of variation for CFS and its comorbid conditions. Fourth, critically, we will examine the influence of gender on these sources of variation. Finally, we will analyze the patterns of comorbidity between CFS and fibromyalgia, irritable bowel syndrome, tension headache, allergy/eczema, generalized anxiety disorder, and major depression using multivariate twin analyses and thereby to estimate the extent of overlap between the shared and unique genetic and environmental sources of variation. In concert with other twin studies being conducted by the investigators and their collaborators, we hope to hasten progress in understanding the etiology of CFS by parallel studies in multiple populations. The current proposal has several unique aims and represents a costeffective means to extend this work in an epidemiological sample that is arguably the best twin registry in the world. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SYNDROMEN
ACTIVITY
INTERVENTION
FOR
CHRONIC
FATIGUE
Principal Investigator & Institution: Jason, Leonard; Professor; Psychology; De Paul University 1 E Jackson Blvd Chicago, Il 60604 Timing: Fiscal Year 2001; Project Start 20-SEP-2000; Project End 31-AUG-2005 Summary: The primary purpose of this study is to evaluate the efficacy of the nurse delivered behavioral interventions of graded activity with cognitive therapy and graded activity alone in comparison to a cognitive therapy alone control condition in a target sample of 120 persons with CFS. This study will: 1) test the hypothesis that graded activity with cognitive therapy will yield significant improvements in physical and role functioning in comparison to the cognitive therapy alone control condition; and 2) test the hypothesis that graded activity alone will yield significant improvements in physical and role functioning in comparison to the cognitive therapy alone control condition. In addition, this study will test, as a secondary Aim, that graded activity alone will be as effective as graded activity with cognitive therapy in improving physical and role functioning in CFS. Since medical utilization rates for CFS patients are high and medical therapies for CFS have been largely unsuccessful, the study of a potentially effective behavioral intervention for the illness may offer an opportunity for a substantially improved quality of life in these debilitated patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SCLEROSIS
APATHY
AND
COGNITIVE
IMPAIRMENT
IN
MULTIPLE
Principal Investigator & Institution: Christodoulou, Christopher; Neurology; State University New York Stony Brook Stony Brook, Ny 11794 Timing: Fiscal Year 2001; Project Start 28-AUG-2001; Project End 31-JUL-2003 Summary: (Adapted from Applicant's Description): While researchers have searched for a relationship between the cognitive deficits and depression that are both common in multiple sclerosis (MS), numerous investigations have failed to find an association. This failure may stem from the multifaceted nature of depression. Measures of depression tap a spectrum of symptoms (e.g., dysphoric/depressed mood, somatic complaints), and some may be more relevant to cognition than others in neurological disorders such as
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MS. While apathy has been historically associated with depression, recent evidence indicates that apathy represents an important and distinct neuropsychiatric phenomenon in its own right. Researchers recently found that apathy played a key role in predicting cognitive dysfunction in a variety of neurological disorders (e.g., Parkinson's disease, progressive supranuclear palsy). In contrast, no link was found between cognitive impairment and dysphoric mood, a core feature of depression. While a relationship between apathy and cognitive impairment has been identified in over half a dozen neurological populations, it has not been adequately examined in MS. Apathy has been associated with neuroanatomical damage to regions that are often affected by the MS disease process (e.g., prefrontal cortex). In addition, apathy has been linked to neuropsychological deficits commonly found in MS (e.g., in working memory, executive functions). The proposed study will demonstrate how apathy, when separated from other factors traditionally associated with depression, can serve as a key marker of cognitive dysfunction in persons with MS. Subjects will consist of 80 MS patients. Apathy will be measured with the Apathy Evaluation Scale and the Apathy subscale of the Neuropsychiatric Inventory. Subjects will complete a battery of cognitive tasks focussed on executive functioning and working memory. It is hypothesized that apathy will correlate negatively with performance on tests of executive functioning and working memory, and that apathy will significantly add to the explanation of variance in such performance beyond that accounted for by other neuropsychiatric variables measuring depression, fatigue, pain, and sleep disturbance. Empirical support for the initial hypotheses will lay the foundation for further rehabilitative research designed to improve both apathy and cognitive functioning in persons with MS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ARE FIBROMYALGIA AND CHIARI I MALFORMATION RELATED? Principal Investigator & Institution: Buchwald, Dedra S.; Professor; Medicine; University of Washington Seattle, Wa 98195 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2006 Summary: Fibromyalgia (FM) is a common condition of unknown etiology characterized by widespread muscle pain, sleep disturbances, fatigue, and various subjective neurological complaints. FM also frequently co-occurs with chronic fatigue syndrome, a condition similar to FM, whose hallmark is persistent, disabling fatigue. Many mechanisms for FM have been postulated but none has gained widespread acceptance or withstood the rigors of repeated scientific inquiry. Chiari I malformation (CIM), a hindbrain malformation associated with impairment of cerebral spinal fluid (CSF) flow, and syringomyelia, a cavitation of the spinal cord found in up to 80 percent of CIM patients, are neurological disorders. Although CIM patients typically seek medical attention for valsalva or exercise-related headaches, some present with non-specific complaints that are difficult to associate with CIM or syringomyelia. Common misdiagnoses for CIM include migraine, psychiatric disorder, multiple sclerosis, and FM. Successful treatment for symptomatic CIM patients, with or without syringomyelia, involves surgery to correct the presumed underlying pathophysiology by normalizing CSF flow in the hindbrain and enlarging the posterior fossa of the cranium. The overall safety and efficacy of the most common approach, a posterior fossa craniectomy and cervical laminectomy to expand the posterior fossa volume, is well supported in the literature. Recently, some FM patients have been treated with a posterior fossa and cervical operation. This procedure, performed by a select group of neurological surgeons, has attracted the attention of patients, the media, and the medical community. Hundreds, perhaps several thousand, of these operations have been performed without
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Fatigue
any scientific support for the safety or efficacy of this intervention in FM. The purpose of this study is to establish the relationship of hindbrain anomalies and cervical cord problems to FM. The Specific Aims are to: 1) determine the prevalence of CIM and cervical syringomyelia among patients with FM (with and without CFS) and pain- and fatigue-free controls using magnetic resonance (MR) imaging; 2) compare the clinical correlates and physical examination findings in these FM patients with and without CIM. There are plans to gather information on symptoms, and perform blinded neurological and MR examinations in 213 FM patients and 71 pain- and fatigue-free control subjects. MR sequences will quantitate posterior fossa anatomy, posterior fossa CSF volume, tonsillar position, and cervical spinal cord and canal pathology. To measure physiological parameters such as CSF velocity and direction of flow in the craniocervical junction, there are plans to employ cardiac gated phase-contrast cine-MR imaging. This study will assess the usefulness of MR imaging in the evaluation of FM patients with and without CFS, and may identify those who might benefit from surgery for hindbrain abnormalities and dissuade others from undergoing a potentially harmful intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ASSESSMENT AND VALIDATION OF TONGUE FATIGUE FOR SPEECH Principal Investigator & Institution: Solomon, Nancy P.; Assistant Professor; Henry M. Jackson Fdn for the Adv Mil/Med Rockville, Md 20852 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): Fatigue is a common clinical symptom in persons with neuromotor disorders, many of whom have a concomitant dysarthria. To track fatigue-related changes with treatment or disease progression, an objective measure is needed to quantify fatigue. The long-term objectives of this research are to validate a clinical assessment of tongue fatigue and to examine the role of tongue fatigue in disordered speech. A noninvasive, nonaversive physiologic assessment technique has been designed and preliminarily tested to reflect the sense of effort associated with fatigue. The first specific aim is to use this technique to test individuals with Parkinson?s disease (PD), amyotrophic lateral sclerosis (ALS), and a group of sex- and age-matched, neurologically normal, control subjects. The benefit of this line of research is to provide a simple objective assessment of fatigue. According to the clinical literature, fatigue can exacerbate dysarthria; however, data are not available to substantiate this claim. The second specific aim of this research, therefore, tests the assumption that speech is more susceptible to fatigue in persons with dysarthria than in normal speakers. The study attempts to induce acute tongue fatigue with speech-like tongue exercises in the same groups of subjects (ALS, PD, neurologically normal) and to demonstrate effects on tongue function. The exercise consists of fast syllable repetitions involving lingual targets and movements. Tongue fatigue, indicated by the fatigue measure tested under Aim 1, is expected after the tongue exercises in the disordered groups. As a control for the potential effects of overall lassitude and reduced motivation, the subjects will perform the task with the hand before and after the speech-like exercises as well; no difference is anticipated. Furthermore, functional effects will be examined by comparing speech produced before and after the tongue exercises. This aim will provide evidence to support the clinical relevance of the exacerbation of dysarthria by fatigue and further validate the constant-effort technique as an indicator of fatigue. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BONE MORPHOLOGY
FATIGUE
&
RESORPTION:EFFECTS
OF
13
DAMAGE
Principal Investigator & Institution: Vashishth, Deepak; Biomedical Engineering; Rensselaer Polytechnic Institute 110 Eighth Street Troy, Ny 12180 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Age-related non-traumatic fractures are a major health problem. Historically, only bone mass was considered to predict fracture risk but recent studies show that microdamage may also contribute to bone fragility. The relationship between microdamage and bone fragility is not completely understood. Microdamage formation is a combined function of local strain mode and tissue properties. Linear microcracks form under compressive loading and run from cement line to cement line while diffuse damage forms under tensile loading as submicroscopic cracks in interstitial bone. Preliminary studies show older bone forms damage in compression and display an immediate loss of stiffness in the primary phase of fatigue, followed by a short secondary phase. Age-related non-traumatic fractures may, therefore, result from the differences in the mode and magnitude of microdamage formation. Differences in the mode and magnitude of microdamage formation may also alter bone resorption. Preliminary studies demonstrate bone resorption in vitro is restricted to 'packets' of bone separated by cement lines from the unresorbed bone. Direct mechanical insult to the cement line, observed frequently with linear microcracks, may increase bone resorption and contribute to bone fragility. The goal of this proposal is to understand how damage morphology affects bone quality. Four-point bend fatigue tests will be conducted with in vitro resorption and nanoindentation tests to investigate whether: (H1) Cement lines act as a barrier to bone resorption; (H2) Linear microcracks, and not diffuse damage, are associated with a greater loss of stiffness in the primary phase and a shorter secondary phase of bone fatigue; (H3) Linear microcracks are associated with greater bone resorption area than diffuse damage; and (H4) Younger bone forms more diffuse damage than linear microcracks, undergoes proportional local tissue stiffness loss in tension and compression, and has a longer fatigue life. Older bone forms more linear microcracks than diffuse damage, undergoes greater local stiffness loss in compression than in tension, and has a shorter life. This project will: (a) Identify the role of damage morphology in bone quality; (b) Establish a relationship between local tissue properties and damage morphology; and (C) elucidate a cement line based mechanism to restrain osteoclastic bone resorption. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CANCER, CATABOLIC STEROIDS, EXERCISE AND QUALITY OF LIFE Principal Investigator & Institution: Schwartz, Anna L.; Associate Professor; Primary Care Nursing; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 01-SEP-1998; Project End 31-MAR-2003 Summary: The purpose of this study is to compare the effects of two exercise interventions (aerobic and resistance exercise) on cancer-related fatigue (CRF, weakness, body mass, bone density and quality of life in cancer patients receiving catabolic steroids. The combination of CRF, weakness, physical decline, and debilitation are common and well- documented side effects of cancer treatment that affect a patient's quality of life during and after treatment, and result in loss of productivity. The primary specific aim of the study is to test the effects of two home-based exercise programs, aerobic exercise versus resistance exercise, on newly diagnosed cancer patients receiving
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Fatigue
chemotherapy regimens that include catabolic steroids. The secondary aims are to test the directional relationship between type of exercise, CRF, weakness, and quality of life. Eighty subjects will be enrolled and followed for 1 year. A randomized, clinical trials, repeated measures design will be used. Measures of CRF (Schwartz Cancer Fatigue Scale, Profile of Mood States fatigue and vigor subscales, and daily measure) and quality of life (Side Effect Symptom Checklist, Symptom Impact Profile subscales, and Positive Affect Negative Affect Scale) will be obtained at monthly intervals. Measures of weakness (1- repetition maximum test, DEXA scans of body mass) and quality of life (DEXA scans of bone density and the 12-minutes walking distance) that are likely to show smaller increments of change will be measured at 3 months. Analysis will be by intent to treated, blocking on gender and chemotherapy protocol. Repeated measures analysis will be used to determine the effects of the intervention on each of the study variables. Interventions that improve functional ability and prevent the long-term complications associated with catabolic steroids may help to control the side effects of treatment, improve quality of life, and have a positive impact on the cost of health care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CARDIOVASCULAR CALCIFICATION PATHOPHYSIOLOGY & TREATMENT Principal Investigator & Institution: Levy, Robert J.; Professor; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-JUL-1986; Project End 31-JUL-2003 Summary: It is hypothesized that bioprosthetic heart valve calcification is caused by a pathologic disruption of the cuspal extracellular matrix (ECM). Results from the most recent programmatic studies have demonstrated that ethanol pretreatment, by altering cuspal type I collagen structure, reduces the initial extent of calcification. However, dynamic ECM events (see Progress Report) including, post-implant cuspal deposition of Tenascin C (TN-C) and matrix metalloproteinases, molecular damage to collagen due to cuspal biomechanics, and loss of glycosaminoglycans (GAG), have also been discovered by our group to adversely affect the outcome of bioprosthetic heart valve replacement surgery. The Specific Aims: I. Hypothesis: Calcification is caused by post implant extracellular matrix mechanisms. Approach: Characterize the calcification associated ECM signaling events that occur post implantation, comparing control and ethanol pretreated valve cusps using established animal models (rat subdermal and sheep mitral valve replacements) in order to mechanistically connect ECM signaling to the calcification process. II. Hypothesis: Valve failure is also caused in part by cuspal fatigue leading to collagen denaturation, and loss of GAG' s. Approach: Investigations of the biomechanics of fatigued type I collagen, and intact valves, comparing collagen structure and GAG loss after in vitro fatigue (Collagen and intact prostheses), and In Vivo use (sheep retrievals). We will focus on the regional cuspal mechanisms that lead to foci of calcification in mechanically stressed regions. III. Hypothesis: Stabilization of GAG's can mitigate against the calcification mechanism and biomechanical deterioration of bioprostheses. Approach: Chemical reaction investigations for immobilizing GAG's, to assess the positive effects on biomechanics and inhibition of biomineralization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CARDIOVASCULAR SEQUELLAE OF RESPIRATORY MUSCLE WORK Principal Investigator & Institution: Dempsey, Jerome A.; Professor; Population Health Sciences; University of Wisconsin Madison 750 University Ave Madison, Wi 53706
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Timing: Fiscal Year 2002; Project Start 01-SEP-1977; Project End 31-MAR-2007 Summary: (provided by applicant): We propose to determine the physiological and clinical importance of metaboreflexes originating in the inspiratory and expiratory respiratory muscles in regulating blood flow and its distribution at rest and exercise. The rationale for this proposal is based on findings in humans which show that: a) mechanical unloading of the respiratory muscles in heavy exercise causes a reduction in stroke volume and cardiac output and vasodilation and increased blood flow in locomotor muscles; b) that fatiguing the diaphragm causes a time-dependent increases in muscle sympathetic nerve activity (MSNA) in the resulting limb; and c) that central inspiratory motor output has no influence on MSNA in the intact human. Aim 1: We will voluntarily increase inspiratory and expiratory muscle effort in healthy humans at rest, during plantar flexion exercise and in hypoxia to determine the threshold and sensitivity of the respiratory muscle metaboreflex in response to progressive increases in respiratory muscle force output and fatigue. We will also determine the combined effects - additive or multiplicative - of combinations of forearm and diaphragm submaximal and fatiguing exercise. Outcome measures include: a) MSNA (via peroneal nerve microneurography); b) femoral arterial blood flow and vascular conductance (measured beat-by-beat with a Doppler ultrasound imaging technique). Aim 2: We will use local infusions of metabolites into the diaphragm and abdominal expiratory muscles in a chronically instrumented dog model in order to quantify the sensitivity and compensatory capabilities of the respiratory muscle metaboreflex and its effect on blood flow distribution at rest and exercise. This animal model will also be used to address the effects of the limb locomotor muscle metaboreflex on distribution of blood flow to the respiratory muscles during exercise. Aim 3: In patients with chronic heart failure of varying etiology, we will apply ventilatory assist in the form of pressure support or proportional assist mechanical ventilation to determine the influence of respiratory muscle work and intra-thoracic pressure on exercise performance, on stroke volume and cardiac output and on limb locomotor muscle blood flow and vascular resistance at rest and exercise. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CAREGIVER COPING SKILLS TRAINING FOR LUNG CANCER Principal Investigator & Institution: Keefe, Francis J.; Professor and Associate Director; Psychiatry; Duke University Durham, Nc 27706 Timing: Fiscal Year 2002; Project Start 06-JUN-2002; Project End 31-MAY-2007 Summary: (provided by investigator): Symptoms such as pain, fatigue, paroxysmal coughing, and dyspnea are major concerns of lung cancer patients and their caregivers. The focus in management of such symptoms traditionally has been on the patient. Studies of caregivers, however, have documented that the psychosocial impact of providing care to family members with lung cancer is profound. The ultimate goal of this research is to develop more effective ways to help patients and caregivers cope more effectively with problematic symptoms experienced by lung cancer patients. The proposed study seeks to evaluate the efficacy of a new, caregiver assisted coping skills training protocol. 500 early stage lung cancer patients (Stages I to IIIA) and their caregivers will be randomly assigned to one of two conditions: 1) Caregiver-assisted coping skills training-systematically trains caregivers in methods for guiding the patient in use of coping skills for symptom management (i.e. relaxation training, imagery, activity pacing, and communication skills), or 2) Cancer education and support-a comparison condition that provides patients and caregivers with information on the nature of lung cancer and treatment methods and controls for attention and contact.
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Assessment measures to be collected before and after treatment and at 4- and 14-months follow-up will include patient reports of major symptoms (pain, fatigue, coughing, and dyspnea), quality of life, depression, anxiety, self efficacy and quality of relationship with the caregiver and caregivers' ratings of mood, strain, and quality of relationship with the patient. If caregiver-assisted CST is effective, future studies could evaluate this training in other cancer populations (e.g. breast cancer, prostate cancer). Future studies could also identify the particular caregiver-assisted CST components (e.g. relaxation training, imagery training, or activity pacing methods) that contribute most to treatment effects. By isolating the active ingredients of training, one can streamline it, making it more cost-effective and more readily available to the larger population of patients having lung cancer. The proposed study rigorously evaluations methods for enhancing the effects of caregiver-assisted coping skills training in cancer patients and their caregivers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CBT FOR CHRONIC INSOMNIA IN BREAST CANCER SURVIVORS Principal Investigator & Institution: Riggs, Raine L.; Psychiatry; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755 Timing: Fiscal Year 2003; Project Start 26-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): The primary goal of the proposed study is to determine the efficacy and patient acceptability of a manualized cognitive behavioral treatment for chronic insomnia (CBTCI) in early stage breast cancer survivors with chronic insomnia. Sleep complaints are common among cancer survivors. In particular, chronic insomnia is almost twice as prevalent among breast cancer survivors as it is among the general population. Chronic insomnia may result in fatigue, cognitive impairments, mood disturbance, increased pain, and immunosuppression, all of which negatively affect a woman's quality of life and may play a role in the recurrence of cancer. While a highly efficacious, safe intervention exists for the treatment of chronic insomnia, it has not yet been applied to cancer survivors. In the proposed study, 60 early stage breast cancer survivors, matched on potentially important prognostic factors such as age, menopausal status, and time elapsed since initial treatment, will be recruited from the Breast Oncology Center at the Dana Farber Cancer Institute. The women will be randomized to one of two groups. One group of breast cancer survivors will receive eight, individual, weekly CBTCI sessions and the other group will receive eight, individual, weekly cognitive behavioral placebo sessions (CBP). All participants will provide self-report data on their sleep, fatigue, depressive symptoms, and pain levels throughout the study. Participants will also complete patient satisfaction questionnaires at the conclusion of treatment to assess treatment acceptability and credibility. It is hypothesized that the women in the CBTCI group will experience statistically and clinically significantly improvements in self-reported sleep and sleep quality, while the women in the CBP group will remain stable. It is also hypothesized that increased sleep quality will be related to decreased levels of depressive symptoms, fatigue, and pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CHARACTERIZATION OF TENDON DAMAGE ACCUMULATION Principal Investigator & Institution: Wang, Vincent M.; Orthopedics; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2005
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Summary: (provided by applicant): Tendon injuries such as those of repetitive overuse and cumulative trauma (e.g., carpal tunnel syndrome) are a major source of pain and disability, yet the mechanism of low-level injury and progression of tendon pathology is unknown. Animal models of tendon healing, while important, do not provide insight into the response of tendons to cumulative wear and tear. A comprehensive series of experiments is proposed herein to systematically characterize damage initiation and progression resulting from controlled levels of imposed mechanical fatigue. A novel mechanical testing protocol will be developed and implemented to reproducibly induce increasing levels of tendon damage which will be quantified using engineering damage parameters. Additional indices of tendon viscoelastic behavior will be obtained from mathematical modeling of the experimental data. Microstructural studies on fatigueloaded tendons will be used to define the physical manifestation of fatigue damage and to correlate the structural changes with mechanical measures of degradation. Successful completion of these proposed studies will establish the necessary damage-degradation relationships needed to assess in vivo cellular responses following tendon injury. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SYNDROMEN
CIRCULATORY
DYSFUNCTION
IN
CHRONIC
FATIGUE
Principal Investigator & Institution: Stewart, Julian M.; Professor; Pediatrics; New York Medical College Valhalla, Ny 10595 Timing: Fiscal Year 2001; Project Start 24-AUG-2001; Project End 31-JUL-2005 Summary: Chronic fatigue syndrome (CFS) is associated with orthostatic intolerance which often takes the form of postural orthostatic tachycardia syndrome (POTS) in adolescents. Preliminary data suggest the novel concept that defective vasoconstriction produces POTS in CFS with cardiac autonomic changes as a secondary response. CFS patients will be compared to healthy controls and to controls with simple faints to test 3 hypotheses: 1) Blood is redistributed peripherally and redistribution is enhanced during orthostasis producing increased microvascular filtration and dependent edema. Central hypovolemia causes decreased cardiac output, reflex tachycardia and reduced cerebral blood flow. This is enhanced during orthostasis producing increased microvascular filtration, dependent edema, and peripheral pooling. These changes alter the interstitium, and cause reflex tachycardia, reduced cerebral blood flow and often hypotension. Blood volume and cardiac output using the indocyanine green dye dilution technique will be measured supine, during conventional 700 head-up tilt, and during low angle head-up tilt. Cerebral blood flow velocity (CBFv) will be estimated by transcranial Doppler ultrasonography. Thoracic, splanchnic, and pelvic vascular volumes will be measured by impedance plethysmography, and limb blood flow, arterial flow, venous volume-pressure relation, and venous pressure will be measured by venous occlusion strain gauge plethysmography. These will show increased blood flow to lower extremities when upright. Central hypovolemia will occur and will reduce CBF and produce symptoms of CFS. Cardiac autonomic status including baroreflex will be assessed by heart rate and blood pressure variability and transfer function. Baroreflex and heart rate variability will be decreased and blood pressure variability will be increased related to circulatory deficit 2) The defect in vasoconstriction is heterogeneous comprising abnormal arterial baroreflex mediated sympathetic vasoconstriction in one subgroup of CFS patients and abnormal local vasoconstriction in a second subgroup with defective veno-arteriolar reflex (arterial baroreflex insensitive dysfunction). Low angle tilt will be used to activate baroreflex mediated and local reflexes. Local reflexes including myogenic, metabolic and veno-arteriolar will be sorted out through use of
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Fatigue
supine testing designed to specifically stimulate a specific reflex (limb hang, large pressure step and reactive hyperemia) and measuring peripheral resistance. 3) Cardiac autonomic findings are secondary to circulatory changes. Thus, tachycardia relates to vagal withdrawal because of circulatory insufficiency. CFS patients will be treated with midodrine or placebo in a cross-over study. Using supine and low angle tilt experiments, circulatory measurements and psychological instruments will be combined to demonstrate that circulatory abnormalities, autonomic abnormalities and symptoms correct in a subgroup of CFS patients with low resting peripheral resistance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL RESEARCH IN SUPPORTIVE CARE FOR CANCER Principal Investigator & Institution: Nail, Lillian M.; Professor; Off/Nursing Res Develop & Util; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: (Applicant's Description) This Research Career Development Award application focuses on clinical investigation of approaches to supportive care in cancer. The specific aims are to: 1) enhance the development of the applicant's program of research in cancer supportive care; 2) contribute to the training of new clinical investigators in supportive care for cancer; and 3) build collaborative interdisciplinary research efforts in supportive care. The focus on supportive care for cancer builds on the applicant's extensive prior work, career goal of improving the care of people with cancer and at risk for cancer, and addresses important current concerns about the quality of cancer care. Recently, leading cancer care organizations have identified the need for research on symptom management, behavioral issues, psychosocial responses, and the experience of cancer survivorship. The pool of investigators conducting programs of clinical research in this area is limited and future progress is contingent upon devoting resources to research training and development. The applicant has a strong record of success in clinical research training, mentoring predoctoral and postdoctoral students through to the launch of their independent careers, conducting high quality clinical research in the area of supportive care for cancer, and establishing collaborative interdisciplinary relationships. The applicant's current work is on adjustment following cancer treatment (PI), fatigue management during treatment (Coinvestigator), and factors related to uptake of colonoscopic screening and genetic testing among adults and children at high risk for colon cancer (K07 sponsor). A study proposed in this application is to examine relationships among perceived level of fatigue, hematologic changes in response to myelosuppressive chemotherapy, and other treatment side effects and symptoms. This study addresses an important gap in knowledge about factors contributing to perceptions of fatigue experienced by people undergoing active cancer treatment. This application takes advantage of new programmatic initiatives at the Huntsman Cancer Institute (HCI) and coincides with the consolidation of clinical cancer care services at HCI. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CONTINGENT FEEDING OF PRETERMS TO REDUCE HYPOXEMIA Principal Investigator & Institution: Thoyre, Suzanne M.; None; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2005 Summary: Preterm infants experience breathing irregularities that lead to significant and frequent episodes of hypoxemia during bottle feeding. Recurrent, transient
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hypoxemia may contribute to the development of dysfunctional oral-motor feeding patterns, increased expenditure of energy and poor growth, and neurologic injury. The goals of the proposed mentored research are to refine and test the effectiveness of an individualized, contingently-structured feeding intervention for hospitalized preterm infants designed to minimize hypoxemia during bottle feeding. The feeding intervention will begin with an assessment feeding during which the infant's feeding skills and regulatory problems are identified and an individual approach to feeding is designed. Then the infant will be fed once by a standard approach and once by the intervention approach. The intervention approach will consist of strategies that are applied to all infants, for example, preparing the infant to feed, and a contingently-structured component with specific strategies based on the type of feeding difficulties presented by the infant during the feeding. In addition, the efficacy of the addition of supplemental oxygen for the minimization of hypoxemia will be explored with infants who do not respond adequately to the intervention. The intervention will be compared to the standard feeding approach on measures of infant readiness at the outset of the feeding, the number and severity of hypoxemic events during the feeding, and post-feeding measures of feeding tolerance using multivariate repeated measures ANOVA. The investigator's educational aims for the K01 are: (a) to expand knowledge of the respiratory physiology of feeding for preterm infants; (b) to expand knowledge of the development of swallowing in preterm infants and the physiologic bases for supporting effective swallowing and breathing coordination during early preterm infant feeding; (C) to develop competence in the assessment and measurement of swallowing patterns, the identification of swallowing difficulties, and the design of appropriate interventions for swallowing dysregulation; (d) to develop skill in coding behavioral indicators of fatigue during feeding and identifying early behavioral indicators of fatigue, and to develop effective strategies to prevent or respond to fatigue during feeding, (e) to develop skills in designing and implementing longitudinal intervention studies and analyzing longitudinal data, in preparation for submitting an R01 grant proposal on prevention of hypoxemia during preterm infant bottle feeding. The R01 will propose testing the intervention throughout the period of learning to oral feed during hospitalization and examining outcomes of growth, development of feeding skills, and neurodevelopment. If the intervention is effective in improving these outcomes, it will be taught to nurses and parents, who are the primary feeders of preterm infants during hospitalization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DENTAL CASTING OF TITANIUM ALLOYS Principal Investigator & Institution: Okabe, Toru; Regents Professor & Chair; Biomaterials Science; Texas A&M University Health Science Ctr College Station, Tx 778433578 Timing: Fiscal Year 2002; Project Start 01-MAY-1996; Project End 31-MAR-2007 Summary: Titanium offers an ideal advantage for biomedical and dental applications: it is nontoxic to humans. Dentistry has lagged behind medicine in practical applications of titanium. The motivation behind the previous and the proposed studies is to learn more about this metal in order to develop its full potential for dentistry. In the previous grant period (1996- 2000), we performed studies on several aspects of dental titanium casting and gained a great deal of knowledge on the casting process itself, on the experimental alloys showing promise for dentistry, and on methods of producing castings that will be acceptable for dental prostheses. The initial project period laid the groundwork for further study in all areas; this renewal proposal is a logical progression of this research
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program. We propose to refine what we have already learned by expanding our study to ternary and multicomponent alloys. We will study high alloy titanium (greater than 5 percent alloying elements), low alloy titanium (less than 5 percent alloying elements), and titanium intermetallic compounds. Our general hypothesis is that these refined alloy systems will produce properties equaling and possibly surpassing those of presently used dental casting alloys. Additional testing will provide more knowledge in ancillary areas, such as in reducing the reaction of the molten metal to the investment material through face-coating the mold. In addition to tensile fatigue evaluation, fracture toughness and fatigue resistance will be examined using a notchless triangular prism fracture toughness test. Mold filling will be examined by finite element modeling to predict void occurrence. Bond strength of the alloys to porcelain will be analyzed with 3-D finite element modeling. Selected alloys will be examined for cytotoxicity with typical testing methods. The specific aims to be addressed are: 1) to evaluate the proposed experimental binary, ternary, and multicomponent alloys (including intermetallics) for mechanical properties pertinent to the requirements for dental applications; 2) to examine the quality of the cast experimental alloys based on the requirements for acceptable dental prostheses in the areas of mold filling, casting accuracy, and subsurface structures; 3) to evaluate the corrosion behavior and biocompatibility of the experimental alloys; 4) to examine the characteristics of cast experimental alloys necessary for dental applications, including bond strength to porcelain, machinability, and wear behavior; and 5) to evaluate the fatigue resistance and fracture toughness of the experimental cast alloys. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROSTHESIS
DEVELOPMENT
OF
A
SPINAL
INTERVERTEBRAL
DISC
Principal Investigator & Institution: Buttermann, Glenn R.; Dynamic Spine, Llc 1725 Park Ave Mahtomedi, Mn 55115 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-DEC-2003 Summary: (provided by applicant): Chronic back pain is a common disability in which spinal fusion surgery is sometimes beneficial. Far more functional outcomes would be obtained with a successful intervertebral disc prosthesis If commercialized world-wide, it has been estimated that disc prostheses would be implanted at a rate of one million per year, after five years of marketing with potential sales of two billion dollars. This SBIR Phase I project will perform research to develop a spinal device that will restore function of the spine and relieve back pain for patients with intervertebral disc degeneration. Dynamic Spine is pursuing the development of an intervertebral disc replacement. Historically, severe knee and hip degeneration were treated with fusion of the joint which decreased pain but eliminated motion. Currently, hip and knee fusion have almost been entirely eliminated due to the enormous success of prosthetic hip and knee replacements. For back pain due to disc degeneration that has not responded to nonoperative treatment, spinal fusion is recommended. Spinal fusion improves pain but limits motion and hence function, and also increases stress on neighboring discs which over time predisposes to additional disc degeneration. A successful disc replacement is not yet available. Dynamic Spine is developing a prototype disc replacement which is unique from others currently in development and has characteristics which should overcome deficiencies of other disc prototypes. A US patent has been obtained and international patents are pending. The objective of Phase I is to demonstrate that the device restores normal spine biomechanics (range of motion and stiffness) and is durable in fatigue testing.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EFFECTS OF OPIOIDS ON SLEEP AND FATIGUE Principal Investigator & Institution: Dimsdale, Joel E.; Professor; Psychiatry; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2005 Summary: (provided by applicant): The goal of this R21 application is to refine an experimental design to examine the impact of commonly used pain medications on sleep and next-day fatigue. However, before such studies can be conducted in patients with acute or chronic pain associated with cancer or other severe chronic illness, crucial information is needed to optimize the study design. This proposal seeks to answer certain experimental methodological design questions that can be safely, quickly, and inexpensively addressed in healthy volunteers. This R21 application will generate data guiding the research design and power estimates for subsequent RO1 applications intended to address the impact of pain medication on sleep and fatigue in patients with acute or chronic pain. There are 5 specific aims: 1. Characterize the effect of a typical nighttime dose of MS-Contin and methadone on cytokines, polysomnographic sleep and on rest/activity patterns in healthy volunteers: 2. Characterize daytime fatigue the day after drug administration with self-reported measure of fatigue and mood 3. Characterize neuropsychological performance on the day after drug administration. 4. Estimate the covariance structure of sleep measures to assess the comparative advantages of a crossover or parallel groups design. 5. Evaluate the necessity of repeated first nights and whether this is the optimum design for follow-up studies. Over a two-year period, 50 healthy volunteer subjects will be examined with polysomnography, actigraphy, and neuropsychological tests. Data will be collected on self-reported mood and fatigue, as well as proinflammatory cytokine levels (IL-6, IL1beta, and TNF-alpha. The study design involves a double-blind, placebo-controlled crossover. Each individual will be admitted to the UCSD GCRC on 3 pairs of nights. Each admission will feature an acclimation night in the sleep laboratory followed by a night providing placebo, MS-Contin (15 rag) or methadone (5 mg). On the morning after each dosing subjects will complete fatigue and mood ratings and will perform a brief neuropsychological test battery. They will also undergo actigraphy monitoring for 3 continuous days to examine whether there are subtle lingering effects of the drugs. Blood levels ofproinflammatory cytokines will be obtained at various points before and after drug dosing and the next morning to test the hypothesis that opioid-induced changes in these cytokines are associated with sleep disruption and increased fatigue. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ELASTIC/PLASTIC HUMAN JOINT COMPLIANCE Principal Investigator & Institution: Gottlieb, Gerald L.; Professor; None; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 01-DEC-1983; Project End 31-MAY-2005 Summary: (Adapted from the Investigator's Abstract): Our long-term aim is to achieve a deeper understanding of how the brain interacts with the environment to produce coordinated voluntary movement through the control of the peripheral, neuromuscular apparatus. This study continues our theoretical development of the rule-based model that we have proposed for control of voluntary limb movements. Our experiments proceed from the premise that the ultimate goal of any motor theory is to predict the behavior of measurable variables, not merely in terms of each other but in terms of the
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externally given definition of the movement task. The unifying theme of all the proposed experiments is to expand and validate the model as a basis for understanding how the central nervous system performs simple movements and continually adapts to ever changing tasks and environments. To this end, we propose experiments to study single-joint, flexion-extension movement at the elbow. We will examine kinematic, kinetic and myoelectrical changes brought on by different manipulations of the movement task. Two tasks examine dynamic changes in the patterns, brought on by behaviorally realistic task demands or fatigue. A third task examines the distinction between forward and backward internal models for dealing with external perturbations. The fourth task examines the postural aspects of the central commands and the relatively little studied aspects of how the CNS controls the transition from movement to posture. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ELECTROPHYSIOLOGICAL BASES OF STIMULANT DRUG PREFERENCE Principal Investigator & Institution: Gabbay, Frances H.; Research Assistant Professor; Henry M. Jackson Fdn for the Adv Mil/Med Rockville, Md 20852 Timing: Fiscal Year 2001; Project Start 07-SEP-1996; Project End 31-JUL-2002 Summary: (Applicant's Abstract) The general aim of the research proposed in this application is to examine subjective and electrophysiological bases of stimulant drug preference. Using a laboratory-based preference procedure, we will select two groups of subjects: A stimulant-preferring group that chooses to self-administer d-amphetamine over placebo and a placebo-preferring group that has the reverse preference. The response to placebo and two doses of d-amphetamine will be assessed, in separate sessions, using a test battery comprising measures derived from the resting electroencephalogram (EEG), event-related brain potentials (ERPs) recorded during tests of auditory and visual sustained attention, auditory ERPs recorded during a combined oddball/novelty paradigm, standing stability and self-reports of subjective effects. The 55-minute battery will be administered once before and three times following damphetamine ingestion to permit drug effects to be analyzed over time. In two studies (Study I: N=50 males; Study II: N=50 females), drug response of individuals who choose to self-administer d-amphetamine (n=25) will be compared to that of individuals who choose not to self-administer d-amphetamine (n=25). The hypotheses are as follows: (1) Subjects preferring d-amphetamine will, in response to placebo, show subjective and electrophysiological changes over time consistent with diminished arousal (e.g., decreases in subjective ratings of arousal, increases in ratings of fatigue, increases in low-frequency of EEG activity and decrements in vigilance performance); (2) Subjects preferring d-amphetamine will show the following response to d-amphetamine: Increases in self-reports of arousal and EEG signs of increased activation, and more effective allocation of attention to stimuli. In addition, we will test the following hypotheses relevant to sex differences: (3) Using data from the preference-testing phase of the study, we will test the hypothesis that a greater proportion of females than males will prefer d-amphetamine over placebo. Based on animal studies of d-amphetamine effects, we hypothesize further that (4) females will exhibit more intense subjective and electrophysiological responses to d-amphetamine than males; and, based on previous human studies of drug preference, we predict that (5) the relationship between drugpreference and d-amphetamine response will be the same in males and females (i.e., that, in both sexes, preference for d-amphetamine over placebo will be associated with stimulant-like subjective and electrophysiological effects). The studies proposed in this
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application will examine relationships among individual differences in preference for damphetamine, baseline subjective and electrophysiological characteristics, and subjective and electrophysiological response to d-amphetamine. Accordingly, this research will link behavioral, subjective and electrophysiological data in analyses of individual differences in the effects of stimulant drugs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EMG-BASED METHODS FOR TESTING NON-KEYBOARD IMPUT DEVICES Principal Investigator & Institution: Bonato, Paolo; None; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2003 Summary: My doctoral and postdoctoral training has focused on advanced signal processing techniques for the analysis of surface electromyographic (EMG) signals recorded during dynamic contractions. My work as Research Assistant Professor at the NeuroMuscular Research Center of Boston University has been oriented toward the development and application of EMG analysis techniques to real life situations (e.g., lifting and load carrying) of interest in ergonomics. The use of surface EMG in ergonomics has been limited in the past by the inability of traditional analysis techniques to extract spectral information from surface EMG signals that are recorded during dynamic contractions. Recent developments in EMG analysis have made techniques available that appear to overcome such limitations. My long-term goal is to establish a research career in electromyography by applying advanced EMG analysis techniques to ergonomics. The NeuroMuscular Research Center at Boston University provides an ideal place to pursue my career goals. The mentorship of Prof. Carlo J. De Luca and Prof. Serge H. Roy, the availability of laboratory space and equipment, and the opportunity for discussions with colleagues (e.g., Prof. Gerald Gottlieb, Prof. Lars Oddsson, who are well-know and respected scientists in areas related to the research herein proposed) are unique opportunities to motivate the success of the project. In addition, the mentorship of Dr. Lawrence Hettinger, director of human factors and ergonomics at Arthur D Little, constitutes a great help to ensure that this research project, and my future career goals, will give me the opportunity of addressing problems of paramount importance in ergonomics. The proposed research is to establish preliminary work toward the definition of standards for the assessment of nonkeyboard input devices (Computer mouse) using EMG-based methodologies. The work is based on establishing a relationship between time and frequency parameters of the EMG signal and the different designs of computer mice. The identification of different patterns of muscle use and localized fatigue for different input devices will lead to future studies to develop a user-friendly assessment procedure for application in the field of ergonomics. Future studies by the applicant will focus on utilizing the innovation to gain a better understanding of overuse injury mechanisms related to work tasks and the operation of devices in the workplace. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ENHANCED DURABILITY OF BIOPROSTHETIC HEART VALVES Principal Investigator & Institution: Sacks, Michael S.; Associate Professor; Bioengineering; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 15-FEB-2001; Project End 31-JAN-2005
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Summary: (Verbatim from Applicant's Abstract): Porcine bioprosthetic heart valves (PBHV) continue to fail from calcification and mechanical damage. We have demonstrated for PBHV that cyclic fatigue induces loss of radial compliance, tensile strength, and flexural rigidity. Clinically, about 85 percent of all PBHV fail with tearing, and some fail with little or no calcification. These and other studies demonstrate that while not a strict prerequisite for calcification, maintaining tissue structural integrity is a prime factor in inhibiting PBHV calcification and extending durability. Our long-term goal is the development of rigorous engineering principals for improving PBHV, based on a thorough understanding of tissue-and organ-level biomechanics. During the cardiac cycle cusps undergo large flexural displacements, subjecting the layers to alternating tensile and compressive stresses. Cuspal flexural rigidity, and hence the stresses during flexure, are substantially increased by chemical treatment. Since PBHV are fibrous composite materials, it is likely that they are very susceptible to compressive stress induced damage. We hypothesize that a major mechanism of PBHV failure is structural damage independent of calcification, resulting from high compressive stresses present in the chemically treated tissue extracellular matrix (ECM) during cuspal flexure. An in-depth understanding of the fatigue life behavior of the chemically treated porcine aortic valve cusp independent of PBHV design is a critical first step towards the development of novel chemical treatments that seek to mitigate the effects of structural damage. This will ultimately aid in the rational development, as opposed to the current ad-hoc approach, of novel chemically modified collagenous biomaterials for more durable PBHV. We will test our hypothesis with the following specific aims: 1. Determine how chemical treatment alters cuspal layer micromechanics. 2. Quantify PBHV cuspal deformation during the cardiac cycle. 3. Determine how long-term cyclic fatigue alters PBHV later structure and mechanical properties. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EXERCISE AS A TREATMENT FOR TONGUE WEAKNESS IN AGED RATS Principal Investigator & Institution: Connor, Nadine P.; Research Director; Surgery; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2003; Project Start 08-JAN-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Fatigue and weakness are common complaints of elderly people related to sarcopenia, or the loss of skeletal muscle mass, organization, and strength. Little is known concerning the pathophysiology and age-related sequelae of sarcopenia in muscles of the head and neck. This knowledge is important inasmuch as alterations in muscle character may underlie deficits in speech and swallowing, which are significant clinical problems in elderly people. The tongue has a vital role in speech and swallowing, and poor lingual control is associated with both speech and swallowing impairment. However, muscles of the tongue have been understudied. Our hypothesis is that age-related alterations in tongue function are based upon naturally occurring denervation-reinnervation processes, and that these processes can be reversed or prevented via exercise. This hypothesis will be tested in a rat model by comparing physiological, molecular, and histological parameters of old rat tongue muscles with young muscles, and with old tongue muscles that have undergone chronic nerve stimulation to model exercise. The proposed research has 2 specific aims: (1) To quantify changes in neuromuscular morphology predictive of age-related tongue weakness; and (2) To determine underlying morphological and physiological changes induced by tongue exercise in old rats. Physiological experiments will be performed in vivo in the tongue in young rats and in 2 groups of older rats. In the same animals, molecular
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analyses of myosin heavy chain expression, and histological analyses of neuromuscular junctions will be performed. Exercise will be modeled via bilateral chronic stimulation of the hypoglossal nerves. Analyses of covariance (a combination of analysis of variance and regression) will be used to determine the degree to which muscle contractile properties can be predicted from molecular and histological characteristics. Further analyses of variance will be performed to compare the physiological, molecular, and histological variables of interest as a function of age group (Specific Aim 1) or age by exercise (Specific Aim 2). This work is innovative and important in establishing potential morphological bases for the alterations in physiological function observed with tongue muscle senescence. Further, this work will be highly significant in discovering a neuromuscular basis for the putative benefits of exercise in the prevention and treatment of age-related swallowing impairment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EYE-COM 6/MSV CAMERA: A DROWSINESS DETECTING BIOSENSOR Principal Investigator & Institution: Torch, William C.; Ndc & Wsdc Washoe Sleep Disorders Center Disorders Center Reno, Nv 89502 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-MAY-2002 Summary: (provided by applicant) This SBIR study proposes the creation of the realtime operator fatigue-monitoring EYE-COM 6 CAMERA System (EC-6 Cam)--a composite biosensor derived from the fuision of two complimentary monitoring technologies: (i) the MULTI-SENSORY VISION IR CAMERA (MS V-Cam) and (ii) the EYE-COM 5 poly-sensor scanning array. Using computer imaging technology, MS VCam analyzes video images of an operator's face to extract ocular and eye-blink characteristics, pupillary size and movement, and eye--metrics that typically reflect wakefulness/drowsiness. EYE-COM 5 monitors eyelid movement via a close range IR poly-sensor based on differential IR-light reflection off the eyes and lids. The multisensory EC-6 Cam, based on the fusion of these two technologies, overcomes limitations of the each technology. Through its linear array of IR biosensors and a proximallyplaced IR micro-camera attached to a wrap-around eyeglass frame, EC 6 measures eyeblink and ocular-related parameters both sedentary and highly mobile individuals in all lighting situations and unlimited domains. Its metrics include eye-blink velocity (EBV), acceleration (EBA), -frequency (EBF), -duration (EBD), percentage-time eyes are closed (PERCLOS), pupillary size, eye movements and gaze. The goal of this project is to build, test and validate, by means of performance/vigilance protocols, the highly versatile and robust composite EC-6 Cam which will work in all stationary and mobile domains. EC6Cam makes possible the derivation of a Composite Fatigue Index (CFI) based on multiple, rather than a single fatigue-related metric alone (e.g. PERCLOS). EC-6 Cam, as a Communicator and Controller, has at least 30 other commercial civilian and military applications. PROPOSED COMMERCIAL APPLICATIONS: Safety, communication, assistive and research applications include monitoring operator-alertness/drowsiness in trucks, buses, trains, avionics/aerospace- marine/submarine-light/heavy industry and military operations, including pilot G-LOC/fatigue; for silent communications; as an electro-mechanical, electronic or computer remote communicator/controller for the elderly, injured, disabled or respirator-dependent ICU patient, as an ambulatory clinical/research biosensor for neurological disorders, sleep/EEG- medicalpsychological- and pharmaceutical studies measuring therapeutic/toxic effects (e.g. modafanil/stimulants in narcolepsy; L-DOPA in Parkinson's disease; alcohol or amphetamine driver impairment); as a lie-detector and as a robotic controller.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FAMILY HOME CARE FOR CANCER-COMMUNITY BASED MODEL Principal Investigator & Institution: Given, Barbara A.; Professor; None; Michigan State University 301 Administration Bldg East Lansing, Mi 48824 Timing: Fiscal Year 2003; Project Start 17-JUN-1998; Project End 31-MAR-2007 Summary: (provided by applicant): This revised competitive renewal application seeks to determine among family caregivers and patients with advanced (stages III or IV) disease who are undergoing a course of chemotherapy and who report both pain and fatigue during the past 7 days, the effect of an 8-week, 6-contact problem-solving, self care management intervention upon the number of symptoms, physical role impact, social function and emotional distress when compared with family caregivers and patients with identical inclusion criteria but who are exposed to an attention control intervention. The Patient Intervention for Management of Symptoms and Support (PIMSS) assists patients and their caregivers to address and manage three problem domains; symptoms, function (physical role impact and social function), and emotional distress. Problems in each domain are addressed through 4 intervention themes; selfcare behaviors, communication with family and providers, information-teaching, and counseling and support. Evidenced-based intervention strategies and NCCN guidelines are selected from computer assisted documentation that allows nurses to individualize strategies for implementation and to enhance patient self-efficacy so that strategies are retained following the intervention. Patients are directed to communicate with their family caregivers to assist them to implement interventions at home and to respond to requests for assistance. Patients and caregivers in both arms of the trial receive the same number of in-person and telephone contacts. Both groups receive toolkits. The attention control intervention and toolkit provides no content related to symptoms, function or distress. Thus the effect of content provided in the experimental arm may be separated from attention alone. This research will accrue 350 patients from three cancer enters with an attrition rate of 30% to retain the needed 244 cases (122 per arm) for the final analyses. The primary outcome on which power is calculated is the number of symptoms at 9 weeks. This research builds carefully upon evidence from a current RCT which supports the impact of chemotherapy, stage, and presence of pain and fatigue upon the risk of poor outcomes. If a shorter, more intense intervention can improve the outcomes of patients at high risk, this provides theoretically based evidence of the "value added" contribution of behavioral interventions towards improving outcomes important to patients and families. That would make such interventions compelling additions to clinical practice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FATIGUE & GENDER IN DYNAMIC STABILITY AND LOW-BACK PAIN Principal Investigator & Institution: Granata, Kevin P.; Associate Professor; Orthopaedic Surgery; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2001; Project Start 30-SEP-1998; Project End 31-AUG-2005 Summary: Occupationally-related low back disorders (LBDs) are the leading cause of lost work days and the most costly occupational safety and health problem facing industry today. Research concludes the biomechanical stability of the spine plays a significant role in low-back injury and prevention. Stability is achieved through a complex mechanical balance between external load and neuro- physiologic control
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factors including active muscle stiffness, reaction time and response amplitude. Personal factors such as gender and fatigue contribute to LBD risk because they influence neuromuscular response characteristics and associated stability. Unfortunately, existing analyses of spinal stability ignore the dynamic response characteristics of the neuromuscular system. To control LBD risk, to assure safer gender inclusion in the workplace, to facilitate work/rest and training schedules to prevent fatigue related injury prevention, and to improve clinical and rehabilitation assessment; it is necessary to quantify how neuromuscular response dynamics influence spinal stability. It is also necessary to understand how gender, fatigue and spinal posture influence these neuromuscular control factors and the associated risk of spinal instability. The goal of this research is to quantify dynamic stability of the spine and the influence of gender, fatigue, and spinal posture on musculoskeletal stability. Neuro- physiologic components of dynamic spinal stability, including truck stiffness, reaction time and response amplitude, will be measured form a sudden loading protocol and incorporated into a biomechanical model that will quantify dynamic spinal stability. Empirical measures of spinal stability will be recorded from potential energy protocols published from our laboratory. The experiments are designed to change spinal stability requirements without changing biomechanical equilibrium while observing trunk muscle coactivity associated with the recruitment of stability. These will provide empirical estimates of stability and be employed to validate the dynamic stability model. The influence of gender, fatigue and spinal posture on dynamic stability and neuromuscular response dynamics will be evaluated through each of these protocols. Research has established an epidemiologic link between neuromotor response behavior and LBD risk. The proposed effort represents the first to consider the biomechanics of dynamic neuromotor behavior in the control of spinal stability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FATIGUE, SLEEP AND CIRCADIAN RHYTHMS IN BREAST CANCER Principal Investigator & Institution: Ancoli-Israel, Sonia A.; Professor; Psychiatry; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 92093 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2005 Summary: Fatigue is described as a major complaint in patients undergoing chemotherapy. Yet it is unknown whether the fatigue has any relationship to the quality or quantity of sleep or to the sleep/wake circadian rhythm cycle. One of the easiest circadian rhythms to measure is sleep/wake activity. Sleep may also play an important role in the quality of life of these patients. If patients with synchronized rhythms show better tolerance to treatment, then synchronizing the rhythms with light therapy before the start of therapy would be encouraged. Before treatment studies or synchronization studies can be implemented however, more understanding is needed about the relationship between fatigue and sleep, about the normal circadian rhythms in cancer patients and what happens to rhythms during traditional therapy. Current technology allows for non-invasive, ambulatory measurements of circadian rhythms and sleep/wake activity. We propose to study sleep/wake activity cycles in outpatients with breast cancer to examine the relationship between fatigue experienced during the day with sleep/wake cycles and with the quality and quantity of sleep recorded at night; to examine the effect of fatigue and desynchronized sleep/wake rhythms on quality of life and mood (e.g., depression) during multiple cycles of treatment; to examine whether sleep/wake rhythms influence a patient's tolerance to treatment; to examine the effect of chemotherapy on sleep/wake rhythms and quality and quantity of sleep, over the time
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course of multiple cycles of chemotherapy; to examine the relationship between light exposure and circadian rhythms. This will be accomplished by placing Actillumes on patients for 72-hour periods each week of cycle one and cycle four of chemotherapy. At each visit questionnaires evaluating sleep, fatigue, depression and quality of life will be administered. In addition, since many of these women will be older, each woman will have a complete polysomnogram to rule out sleep disordered breathing and periodic limb movements in sleep. Results will provide a scientific basis for future intervention studies, particularly studies with light therapy which can re-synchronize rhythms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FATTY LIVER DISEASE AND HEPATIC ENERGY HOMOSTATIS IN SH* Principal Investigator & Institution: Diehl, Anna M.; Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 15-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): Obesity is associated with insulin resistance, diabetes mellitus, hypertension, and dyslipidemia; less well known is its association with non-alcoholic fatty liver disease (NAFLD). The prevalence of NAFLD is 14-21 percent in some populations, is more common in those who are diabetic or over age 45, and can lead to fibrosis and cirrhosis. Recent evidence indicates that NAFLD is a consequence of disordered hepatic energy homeostasis. Several emerging lines of evidence suggest the overall hypothesis that disordered hepatic energy homeostasis and subsequent NAFLD may play a central role in mediating the adverse metabolic effects of obesity and may influence the success of weight loss interventions. Unfortunately, prior clinical studies have been limited. We, therefore, have the following specific hypotheses: 1) NAFLD and disordered hepatic energy homeostasis will be common in SHOW participants; 2) NAFLD will be associated with disordered energy homeostasis, AfricanAmerican race and male gender; 3) disordered hepatic energy homeostasis will be associated with a proinflammatory state, and adaptive decreases in normal energy requirements; 4) those with disordered hepatic energy homeostasis will have a weaker response to the SHOW intervention compared to those with normal hepatic energy homeostasis; and 5) the SHOW intervention will improve NAFLD and hepatic energy homeostasis in those with little or no defect in hepatic energy homeostasis but worsen it in those with moderate to severe defects. To test these hypotheses we propose a single center ancillary study to the SHOW trial. The study sample for the ancillary study would be the 313 SHOW participants enrolled at Johns Hopkins. We will measure symptoms of hunger and fatigue (0, 6, 12 mo.) and collect additional data including liver enzymes (0, 6, 12 mo.), MRI Spectroscopy (0, 12 mo.), and ketone bodies, insulin levels, and proinflammatory cytokines (0, 12 mo.) The main outcomes will be the prevalence, correlation, and 1-year progression of NAFLD and disordered hepatic energy homeostasis. Our secondary outcomes will be weight change, physical activity, dietary intake, and symptoms of hunger and fatigue in those with and without NAFLD and disordered hepatic energy homeostasis. If our hypotheses are confirmed, this study will establish blood and other clinical markers of NAFLD and disordered hepatic energy homeostasis, which will facilitate population based research; advance our understanding of the pathophysiology of NAFLD; establish disordered hepatic energy homeostasis as a biologic modifier of behavioral approaches to weight loss; and determine whether weight loss improves NAFLD or poses unsuspected risks. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FLUID-STRUCTURE SIMULATION FOR PROSTHETIC HEART VALVES Principal Investigator & Institution: Chandran, Krishnan B.; Professor and Chairman; Biomedical Engineering; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2003; Project Start 05-AUG-2003; Project End 31-JUL-2007 Summary: (provided by applicant): Artificial valves have been used to replace diseased human heart valves for more than four decades. Thrombus deposition and ensuing complications remain significant with implanted mechanical valves and the patients require long-term anti-coagulant therapy. In tissue valves, the leaflets exhibit structural alterations and tear due to fatigue failure requiring replacement surgery in about 10-12 years. Large flexure stresses during the opening and closing have been implicated in structural alterations and leaflet tear. In vitro experiments have yielded limited, but valuable information on the stresses on the leaflets during the valve function. With the advent of high-speed computing capabilities, computational fluid dynamic (CFD) analysis has been used to study the valve flow dynamics in detail. Finite element (FE) structural analysis has also been employed to analyze for the stress distribution on the leaflets with static and dynamic pressure loads and the results have been correlated with zones of structural failure and leaflet tear. Development of a rigorous fluid-structure interaction (FSI) analysis coupling the fluid flow with the corresponding leaflet motion is very important in the accurate simulation of valve function during a cardiac cycle. The goal of this project is to develop a three-dimensional (3D) simulation of unsteady flow through bioprosthetic valves incorporating a rigorous fluid-structure interaction algorithm. The CFD analysis will employ the state-of-the-art arbitrary LagrangianEulerian (ALE) technique employing arbitrarily shaped elements. Experimentally derived non-linear constitutive model for the aortic valve cusps will be incorporated in the FE analysis. FSI algorithm will be developed to couple the interaction between the fluid and the valve leaflet and the simulation results will be validated with data on the leaflet deformation and fluid velocity measured from in vitro experiments on bioprosthetic valves. The FSI simulation, once validated, can be used to compute the stresses developed during the opening and closing phases on the tissue valves. It will be further employed to assess the effect of geometric changes and tissue preservation towards minimizing the flexure stresses during the valve function in order to improve the durability of the bioprostheses. The deliverable end product of this project will be a physiologically realistic, tissue valve simulation incorporating a validated FSI algorithm. The simulation will have the potential for significant improvement in the prosthetic valve designs towards improved functionality. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: FREE RADICALS AND MUSCLE DYSFUNCTION IN HEART FAILURE Principal Investigator & Institution: Supinski, Gerald S.; Professor; Medicine; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2005 Summary: Recent work indicates that the intrinsic force-generating capacity and metabolic function of skeletal muscles are altered in patients with heart failure, and that skeletal muscle dysfunction contributes to fatigue and breathlessness in these patients. The underlying mechanism by which these myopathic changes occur in heart failure, however, is currently unknown. The purpose of the studies in this proposal is to test the hypothesis that some or all of the myopathic changes that develop in this condition are
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due to excessive myocyte generation of free radicals. We postulate that heart failure elicits an increase in myocyte phospholipase A2 (PLA2) activity levels, and that arachidonic acid generated by PLA2 interacts with the electron transport chain to augment free radical formation in resting and contracting muscle. We further propose that the radicals so produced react with and modify protein and lipid components of muscle which, in turn, alters muscle force generation and fatiguability. These hypotheses will be tested in three groups of experiments; in all studies a coronary ligation model will be used to produce heart failure in rats. The purpose of Objective I studies is to find evidence of heightened free radical formation by skeletal muscle in heart failure; experiments will measure both indices of free radical reaction with cellular constituents (i.e. lipid and protein oxidation products) and directly measure free radical formation by muscle using novel fluorescent techniques. Objective II studies will determine the cellular pathways responsible for free radical generation by skeletal myocytes in heart failure and, more specifically, determine if and by what process phospholipase A2 modulates muscle free radical generation in this condition. In Objective III, we will examine the role of free radicals in inducing muscle weakness and excessive fatiguability by determining if administration of free radical scavengers to heart failure animals preserves normal muscle function. Our preliminary studies provide the first evidence that excessive skeletal muscle free radical generation in heart failure is linked to reductions in muscle force-generating capacity in this condition. These data suggest that the proposed experiments should provide important information regarding the pathogenesis of heart failure-related skeletal muscle dysfunction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HEALING TOUCH, IMMUNITY, AND FATIGUE IN BREAST CANCER Principal Investigator & Institution: Lutgendorf, Susan K.; Associate Professor; Psychology; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): Breast cancer patients use Complementary and Alternative Medicine (CAM) in greater proportions than any other group of cancer patients. The primary reason breast cancer patients cite for use of CAM is strengthening the immune system. Healing touch (HT) is a CAM treatment frequently used by cancer patients to reduce adverse side effects of chemotherapy and radiation and to enhance immunity. HT is classified by NIH as a "biofield" therapy as its effects are proposed to be secondary to manipulation of "energy fields" around the body of a patient. A recent meta-analysis has demonstrated relatively large effects of HT on well being and on physiological parameters, even from brief treatments. However, to date, there are no data on the effects of HT on immune function among breast cancer patients during treatment. This is particularly important as several immune parameters show long-term suppression or alteration, particularly after combined adjuvant chemotherapy and radiation among breast cancer patients. Additionally, there are no data on the effects of HT on the common side effects of breast cancer treatment which can include profound fatigue and radiation-induced skin damage. Physiological mechanisms underlying possible effects of HT are also poorly understood. This study is designed to reduce this knowledge gap by examining how HT affects cellular immune function and biomarkers related to two of the most problematic side effects of breast cancer treatment, fatigue and radiation-induced tissue damage. Effects on the subjective experience of fatigue and clinician rated skin damage will also be noted. Participants will be 42 early stage breast
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cancer patients who are receiving a standard course of radiotherapy following breast conservation surgery and chemotherapy. The significance of this study is that it will provide preliminary data on a) feasibility of this intervention in a breast cancer population, b) the impact, if any, or HT on these intermediate outcome measures, c) information on mechanisms of action, and d) whether the magnitude of the impact is large enough to be sufficient clinical significance to be examined in future Phase II and III dose and efficacy trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HITACHI MODEL H-7600-1 ELECTRON MICROSCOPE Principal Investigator & Institution: Dym, Martin; Professor and Chairman; Cell Biology; Georgetown University Washington, Dc 20057 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2004 Summary: (provided by applicant): In the early eighties, the PI received funds from the NCRR program to purchase an electron microscope, and at that time we bought the JEOL 1200EX. This microscope, operated by the Department of Cell Biology, has served as a shared resource at our Medical Center. Unfortunately, the microscope has been very unreliable in recent years and indeed for the past six months it has only worked sporadically due to extensive water damage resulting from a ceiling flood. Although both the condenser and objective lenses are being replaced, JOEL cannot rule out continued problems as a result of the initial water damage. It is therefore essential that we obtain a replacement EM as soon as possible since a number of faculty members at Georgetown have research projects that depend upon high quality electron microscopy. We wish to purchase the Hitachi Model H-7600-1; this microscope has many advantages and improvements over our aging JEOL 1200EX that would significantly enhance our ability to carry out the projects described in this grant proposal. Included among these advantages are greater reliability, ease of operation, digital imaging of sections, increased specimen stability in the electron beam, increased number of specimens which can be evaluated at one time, enhanced use for morphometric analysis, montage collection, ease of surveying of samples, and ability to identify and return to specific regions on specimen grids. The ability to have computerized alignment together with maintenance of such important viewing factors as consistent brightness regardless of operating Kv or magnification facilitates the ease of surveying samples and the taking of electron micrographs. Finally, the user-friendly operation and ease of control manipulation significantly reduces user fatigue and facilitates multi-user usage. We believe that it is important that this microscope be procured as soon as possible to enable us to continue to meet the commitments to the research projects as outlined in our grants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HIV, AGING, AND COGNITION--A SYNERGISM? Principal Investigator & Institution: Goodkin, Karl; Professor & Director; Psychiatry and Behavioral Scis; University of Miami-Medical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2001; Project Start 15-SEP-1998; Project End 31-MAY-2003 Summary: (Applicant's Abstract): Over 14 percent of persons diagnosed with AIDS in South florida and 10 percent nationally are over age 50 years. Although HIV infection is frequently accompanied by cognitive impairment without disorder, minor cognitivemotor disorder (MCMD) or HIV-associated dementia (HAD), few HIV+ individuals over age 50 years have been studied to date. Yet, HIV-associated disease progression
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may be more rapid in older individuals, and HIV affects many of the same cognitive processes altered by aging. Further, age appears to be an independent risk factor of HAD. The overall objective of the proposed study is to determine whether aging and HIV infection have a synergistic effect on the frequency and rate of progression of cognitive impairment and cognitive-motor disorder (MCMD and HAD). That is, are the effects of both aging and HIV on cognition significantly greater than the simple sum of the effects of each one alone? If so, these effects on cognition are expected on selfperceived functional status related to cognition and on the level and rate of decline in overall activities of daily living. Age has been associated not only with decreased CD4 cell count in HIV+ individuals but also with increased plasma viral load. Hence, it is hypothesized that older HIV+ individuals will show increased viral load and decreased CD4 cell count (as well as rate of change) than the comparison groups, controlling for anti-retroviral medication use (and adherence), CDC stage of disease, hemoglobin level, and other factors related to clinical disease progression. Moreover, the investigators have recently reported that cognitive-motor impairment in the otherwise asymptomatic stage of infection is associated with an increased risk of mortality. A longitudinal study is proposed herein of 286 total subjects -- 106 late symptomatic (AIDS-diagnosed) individuals (53 older, 53 younger); 106 early symptomatic (non-AIDS) HIV+ individuals (53 older, 53 younger) and 74 HIV- control subjects (37 older, 37 younger). Performance on a cognitive battery sensitive to HIV serostatus; cognitive-motor impairment and disorder (MCMD and HAD); functional status; plasma HIV load; CD4 cell count; and mortality are the proposed outcomes, controlling for sociodemographics, distressed mood, Axis I disorder, physical health status, alcohol/psychoactive substance use, prescribed medication use, pain, fatigue, and nutritional status. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IL-LB AND MEAL PATTERNS: OVARIAN HORMONES AND CCK Principal Investigator & Institution: Butera, Peter C.; Professor; Psychology; Niagara University Niagara University, Ny 14109 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2004 Summary: (provided by applicant): Interleukin (IL-1) is a cytokine that is released by monocytes and macrophages activated during the acute phase response soon after infection or injury. IL-1 is responsible for many of the responses to inflammation and also induces a constellation of symptoms known as sickness behavior" (e.g., malaise, fatigue, decreased eating and drinking, lack of interest in usual activities; Hart, 1988). When administered to rats and mice, IL-1 causes profound alterations in behavior including a suppression of food and water intake (Kent et al., 1995). Previous research provides strong evidence for sex differences in immune function and its modulation by gonadal steroids, indicating that in both human and nonhuman animals females are immunologically stronger then males (Homo-Delarche et al., 1991). Consistent with these observations is the finding that the behavioral responsiveness of female rats to IL-1 is influenced by ovarian hormones (Butera et al., 2001). In this report, the anorectic effects of IL-1 were greater in estradiol-treated ovariectomized females than in untreated controls. Similar findings have also been reported for the febrile response following peripheral treatment with IL-1 (Mouihate et al., 1998). These data indicate that the effects of IL-1 in female rats are influenced by estradiol and suggest that interactions between gonadal steroids and cytokines may contribute to sex differences in the immune response. The general goals of this proposal are to further characterize this endocrine-immune interaction by examining the effects of IL-1 Beta on spontaneous meal patterns during the rat estrous cycle. Examining changes in the microstructure of
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feeding behavior will provide a better understanding of the ways in which ovarian hormones and IL-1 interact with direct controls of eating (Smith, 2000) to produce the changes in food intake previously observed. The research will evaluate a potential physiological mechanism for these effects on food intake by examining the role of endogenous CCK in estrogen/IL1 interactions. The role of IL-1 in the normal control of food intake will also be evaluated by determining whether changes in endogenous IL-1 contribute to the decrease in food intake that occurs during the proestrus phase of the rat estrous cycle. Information obtained from these experiments will not only contribute to our understanding of how cytokines and gonadal steroids influence ingestive behavior, but will also illustrate how interactions between the endocrine and immune systems may contribute to sex differences in the immune response and disease anorexia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INFRARED MICROSPECTROSCOPY FOR CERVICAL CANCER SCREENING Principal Investigator & Institution: Diem, Max; Professor; Chemistry; Hunter College 695 Park Ave New York, Ny 10021 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): This proposal is aimed at establishing Infrared Microspectroscopy (IR-MSP) as a faster, less expensive, more objective and more accurate technology for the detection of cervical dvsplasia than presently used methods. Screening for cervical disease is presently carried out via a cytological procedure (the Papanicolaou, or "Pap" test), that was first proposed in the late 1940's [Papanicolaou, 1948]. Although regularly scheduled gynecological screening using the Pap test has reduced the incidence of, and mortality from, cervical cancer enormously, there remains a relatively high rate of inaccurate or inconclusive diagnoses [US Department of Health and Human Services, 1989]. Classical cytology is a visual inspection method based on locating and recognizing cells with altered morphology as an indicator of disease. The morphological changes are a consequence of cellular mutations. Although well established, this approach suffers from the fact that the interpretation of morphological change is human-based and therefore, subjective in nature. Furthermore, operator fatigue, training and experience influence the quality, reliability and reproducibility of cytological diagnoses. To alleviate the inherent limitation of visual inspection, computer based inspection by imaging technology has been developed and utilized over the past ten years. However, computer based image analysis has not significantly improved the reliability of the diagnoses, and has not proved cost effective [Hutchinson, 1996]. IRMSP is a novel technique that recognizes abnormality by detecting cellular composition and variations therein, rather than by changes in morphological features. In fact, IR-MSP detects the precursor of the morphological change. The actual measurement carded out in IR-MSP is objective and quantifiable; consequently, the diagnostic method is more sensitive, specific, reproducible and reliable than existing methods. In this proposal, the methodology for IR-MSP testing of cervical smears will be developed, including the purification of the exfoliated cells, preparation of a cell monolayer on a suitable substrate, spectral imaging of about 104 individual cells via an infrared microspectrometer equipped with a focal plane array detector, and analysis of the collected data via multivariate statistical methods to arrive at a diagnosis. This work has the potential to improve cervical cancer screening by further reducing false positive and false negative diagnoses, and introducing fast and point-of-care routine screening tests. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: INTERNATIONAL SYMPOSIUM ON MOTOR CONTROL USING TMS Principal Investigator & Institution: Hortobagyi, Tibor; Associate Professor; Exercise and Sport Science; East Carolina University 1000 E 5Th St Greenville, Nc 27858 Timing: Fiscal Year 2004; Project Start 01-JAN-2004; Project End 31-DEC-2004 Summary: (provided by applicant): This application is a single-year request of support for an international symposium, "Mechanisms of Movement and Sensation Using Transcranial Magnetic Stimulation" (TMS) as part of the XVth biennial Congress of the International Society of Electrophysiology and Kinesiology (ISEK), Boston, June 18-21, 2004. The rationale for the symposium is that in this era of specialization, research subdisciplines on the one hand and basic researchers and therapists on the other, tend to separate. This symposium is an effort to minimize this separation. The symposium's aim is to generate a novel synthesis of basic science and clinical mechanisms of motor cortex plasticity and thus facilitate the design of rehabilitation programs. Pascual-Leone, cochair, (US), will provide a historical perspective on TMS and rTMS. Valero Cabre (US) will discuss the effects of TMS and rTMS on the basic electrophysiological and metabolic properties of cortical neurons with reference to Parkinson's disease. Hortobagyi (US) will discuss the contralateral organization of the human nervous system. Taylor (Australia) will address the mechanisms of central fatigue in polio and chronic fatigue syndrome. Sawaki (US) will present on training dependent plasticity of the motor cortex as evidence for short-term motor memory, specifically in stroke. Rothwell (UK) will address the effect of afferent input on motor cortex organization and plasticity in healthy subjects and in patients with dystonia and hand cramps. Manto (Belgium) as cochair will moderate the discussions. The symposium will provide maximal interaction between speakers and attendees as it will take place in a plenary session format as the only ongoing session. Through student discounts, it will provide an economical opportunity for biomedical trainees to attend. The presentations will be published in IEEE Engineering in Medicine and Biology, making a substantial impact on the field by attracting the interest of neurologists, clinical neurophysiologists, basic and clinical movement and sensation neuroscientists, physical therapists, biomechanists, biomedical engineering researchers, roboticists, educators and students from the US and abroad. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: LAYERED CERAMIC ENDOSSEOUS DENTAL IMPLANTS Principal Investigator & Institution: Khandkar, Ashok C.; Amedica Corporation 2116 S Lakeline Dr Salt Lake City, Ut 84109 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JAN-2002 Summary: Recent developments and experience in aerospace/engineering applications has established a clear superiority of layered composite ceramics that have simultaneously high fracture toughness, high strength and excellent damage resistance to cyclic loads. The application proposes to optimize these materials for Dental implant applications. The materials and laminate design proposed promise to allow a tough, fatigue and damage resistant implant that also has favorable esthetic qualities, owing to the "white" coloration, matching that of natural teeth. The enhanced mechanical properties of the layered composite ceramic implant will enable it to withstand the intraoral occlusal stresses. In Phase 1, there are plans to develop ceramics with high fracture toughness and damage resistance, exceeding that of current state-of-the-art zirconium. By comparing static and dynamic (Cyclic fatigue) biomechanical properties with current Ti alloy, alumina-porcelain and zirconium implants, The intent is to establish the
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superiority of the materials. In Phase 2, the optimized materials will be used to fabricate implants, which will be designed and tested in conjunction with implant manufacturers. PROPOSED COMMERCIAL APPLICATION: NOT AVAILABLE Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LIGHTWEIGHT DURABLE WHEELCHAIR FROM ENGINEERING RESIN Principal Investigator & Institution: Hermes, Matthew E.; Turbo Wheelchair Company, Inc. 235 Twinspur Ct Roswell, Ga 30076 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2003 Summary: (Applicant's Abstract): There is a glaring need for low cost manual wheelchairs that withstands daily use trauma, are light enough to transport and still remain rolling. This proposal follows a successful Phase I in which the 26 pound merlinchair, a glass filled nylon prototype, passed the double drum and curb drop ANSI fatigue durability tests. Turbo has assembled a strong team in plastics, medical devices, wheelchair and computer technology with broad base knowledge, cross over experience and a solid track record for producing products. In Phase II we will: design and fabricate preproduction tooling, develop molding processes, assemble and test preproduction wheelchairs. Diverse users will ride, and caretakers will push the post Phase I modified prototype chairs and evaluate them. From user reports SFSU will guide further refinements. We expect at least two separate chair configurations to result. Contract molding, in house assembly, testing and more evaluation by the users/caretakers group will provide data for final design parameter& TWC will fabricate 200 preproduction chairs for Phase III institutional and user distribution and for attracting capital necessaiy for producing Merlinchairs. Users and advocates have begged for chairs with MerlinChairs' attributes. TWC anticipate that Merlinchair will be widely used and accepted. PROPOSED COMMERCIAL APPLICATION: The North American wheelchair market exceeds $650 million in annual sales. Manual chairs account for just under one-half the dollar volume. In phase III TURBO Wheelchair will capture approximately 6-10% ($20-32.5million) of the manual chair market within 5years on the basis of a durable, folding solid seat, affordable engineering resin based product. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MANAGEMENT OF CANCER-RELATED FATIGUE AND SLEEP QUALITY Principal Investigator & Institution: Barsevick, Andrea M.; Director of Nursing Research and Educati; Fox Chase Cancer Center Philadelphia, Pa 19111 Timing: Fiscal Year 2003; Project Start 15-FEB-1999; Project End 31-JAN-2007 Summary: (provided by applicant): An important shift is now occurring in symptom management research to examine symptom clusters rather than single symptoms. The overall aim of the proposed research is to extend our scientific understanding of symptom management by examining the effect of an intervention for two target symptoms commonly reported during cancer treatment, fatigue and insomnia. We will also examine the effect of the intervention on two related symptoms, pain and depression, that are not targeted by the intervention. The investigators will extend the science through the design that allows us to test hypotheses about the added value of targeting insomnia, as well as fatigue, and about the process that underlies the clustering of the target and related symptoms. The specific aims of the proposed research are to: 1) test the efficacy of a combined fatigue/sleep intervention on the target
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symptoms of fatigue and insomnia and on functional performance; 2) examine the degree to which improved sleep quality mediates the effect of the intervention on fatigue; 3) examine the relationships among fatigue, insomnia, pain, depression, and functional performance to generate hypotheses about the processes underlying clustering of these commonly reported symptoms during cancer treatment. The proposed research will use an experimental design to compare an individual management plan for fatigue/sleep with a control group that equates for time and attention. The study will be implemented in two clinical sites including an academic health science center (Barrett Cancer Center of the University of Cincinnati) and a comprehensive cancer center (Fox Chase Cancer Center in Philadelphia). Participants will be randomly assigned to the intervention or the control group. The major outcomes of interest include the target symptoms of fatigue and insomnia and the related symptoms of pain and depression. In addition, functional performance, a dimension of quality of life, will be evaluated. The investigators will use traditional repeated measures ANOVA to test the efficacy of the intervention. Multiple regression analysis will be used to test the mediation hypothesis in which the relationship between the intervention and fatigue is partially accounted for by the improvement in sleep quality due to the intervention. Multiple statistical techniques will be used to develop and explore models that could explain covariation among symptoms that are seen as clusters. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MASSAGE THERAPY FOR CANCER-RELATED FATIGUE Principal Investigator & Institution: Avins, Andrew L.; Assistant Clinical Professor; Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 01-MAR-2001; Project End 31-DEC-2002 Summary: (APPLICANT'S ABSTRACT): The proposed project is a randomized pilot trial of a Swedish-style massage therapy intervention for the treatment of fatigue in patients who are undergoing cancer chemotherapy. Fatigue is the most common complaint of patients receiving treatment for cancer, but is often difficult to treat and causes a substantial decrement in patients' quality of life. Massage therapy is a noninvasive intervention used in many patients with cancer for symptom control. Prior small studies have suggested some efficacy of bodywork therapies in conditions characterized by fatigue, such as fibromyalgia and chronic fatigue syndrome. Based on these results, massage therapy may provide an important adjunct in ameliorating fatigue and enhancing cancer patients' well being. The proposed study is a 12-week, randomized, three-arm, parallel-comparison clinical trial comparing the effects of a Swedish-style massage regimen to a sham bodywork control and a usual-care group for fatigue reduction in cancer patents undergoing chemotherapy. Sixty patients with breast, ovarian, prostate, or colo-rectal cancer will be enrolled; the primary outcome measure is a quantitative assessment of fatigue symptoms. In addition to obtaining estimates of efficacy, this Exploratory/Developmental Research Grant (R21) application also proposes several research design innovations to address critical methodological issues that have plagued prior studies of complementary and alternative medicine (CAM) interventions in general, and bodywork therapies, in particular. 1) Current quantitative assessment tools often fail to fully capture the nature and degree of change in highly subjective conditions and their impact on an individual's functioning and quality of life. We propose to add a novel qualitative research component to study changes in participants' perceptions of fatigue severity and its impact on their lives. 2)
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Most prior studies in bodywork interventions have failed to adequately control for the non-specific effects of the time spent with a practitioner and physical contact between the provider and participant. We propose to test a unique control condition (in addition to a usual-care control arm) to account for these effects. 3) Prior studies of bodywork therapies have neglected important psychological and sociocultural factors associated with subjects' participation and outcomes. We will examine these issues within the qualitative research component. 4) Because bodywork involves close personal physical contact, gender issues may complicate the provision and success of massage therapy. We will study these effects using qualitative methods, as well as a stratified randomization of gender-concordant and gender-discordant pairs to examine outcomes. This study should provide not only important data on the potential efficacy of massage therapy for the treatment of fatigue, but also advance the methodology for studying CAM interventions for difficult-to-treat symptomatic conditions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MECHANISMS OF RADIATION INDUCED FATIGUE IN CANCER Principal Investigator & Institution: Bower, Julienne E.; Brain Research Institute; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): The broad goal of this research proposal is to elucidate the basic mechanisms underlying radiation-induced fatigue in patients with localized breast or prostate cancer, focusing on psychological and immunological factors that may contribute to fatigue during and after treatment. Preliminary studies conducted by our group have identified psychological and immune parameters associated with fatigue in breast cancer survivors, including several markers of immune activation. Pilot testing will first be conducted to determine which of these immune parameters are influenced by radiation treatment. The main phase of the study will involve a prospective, longitudinal examination of 150 breast and prostate cancer patients receiving external beam radiation therapy. Subjects will be recruited from the UCLA Radiation Oncology Clinic and will be assessed psychologically and immunologically before treatment onset, at biweekly time points during treatment, and at three longer-term follow-ups. The specific aims of the study are: 1) to determine whether changes in the immune system induced by radiation therapy are associated with changes in fatigue, 2) to evaluate the role of psychosocial factors as predictors and correlates of radiation-induced fatigue, 3) to evaluate the effects of irradiated site and treatment volume on fatigue, and 4) to identify individuals whose fatigue does not remit following treatment and determine the correlates of acute vs. more enduring fatigue. Information gained from this project will advance our understanding of radiation-induced fatigue, thereby paving the way for the development of interventions to help manage and reduce this problem and improve quality of life for cancer patients receiving radiation therapy. The proposed research project will enhance the candidate's existing research skills in health psychology and psychoneuroimmunology and promote the development of new skills necessary for an academic career in cancer prevention and control. Together with a targeted program of didactic instruction, this project will prepare the candidate to become a fully independent behavioral scientist in the field of cancer prevention and control research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHANISMS OF RHINITIS IN CFS Principal Investigator & Institution: Baraniuk, James N.; Professor; Medicine; Georgetown University Washington, Dc 20057 Timing: Fiscal Year 2002; Project Start 01-JUL-1997; Project End 31-MAY-2005 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHANISMS OF SKELETAL MUSCLE FATIGUE Principal Investigator & Institution: Williams, Jay H.; Associate Professor; Human Nutrition, Foods, & Exercise; Virginia Polytechnic Inst and St Univ 460 Turner Street, Suite 306 Blacksburg, Va 24060 Timing: Fiscal Year 2001; Project Start 01-MAR-1994; Project End 31-JUL-2004 Summary: (Adapted from the applicant's abstract): Acute skeletal muscle activity often leads to the development of fatigue. The effects of fatigue are most often seen in venues such as the athletic arena, work site and rehabilitation clinic. In most instances, skeletal muscle fatigue results in decreased athletic performance and work productivity. However, in a number of cases, fatigue can increase ones susceptibility to orthopedic and musculo-tendinous injury and may lead to the development of muscle soreness. Although these consequences and the personal and financial costs of fatigue are well known, the mechanisms meditating this phenomenon are not completely understood. If means are to developed to prevent and alleviate both fatigue and its end results, then it is imperative that the fatigue process be fully understood. The overall objective of the proposed research is to gain insight into the mechanisms which mediate skeletal muscle fatigue. Fatigue appears to result from alterations in the excitation -contraction coupling process secondary to changes in the functional properties of the sarcoplasmic reticulum and the contractile apparatus or in the communication between the transverse tubule and SR. For years, it has been known that the onset of fatigue is associated with a reduction in the level of muscle glycogen and an accumulation of lactate. In addition, other glycolytic metabolites are elevated within the muscle fiber. This suggests that some aspect of carbohydrate metabolism influences skeletal muscle force output, possibly the depletion of glycogen or the accumulation of metabolites. Accordingly, the specific aims of this proposal are as follows. First, to determine if glycogen metabolites alter CA and SR function as well as TT-SR communication. Second, to determine if glycogen extraction, in vitro, alters CA and SR function as well as TT-SR communication. Third, to determine if glycogen depletion in skeletal muscle, in vivo, alters CA and SR function as well as TT-SR communication. The results of the proposed experiments will provide much needed information regarding the mechanisms which mediate skeletal muscle fatigue. In addition, it will attempt to identify direct links between muscle glycogen levels, CHO metabolism and the fatigue process. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MECHINABLE PERFORMANCE/PROPERTIES
CERAMICS:OPTIMIZING
Principal Investigator & Institution: Rekow, E. Dianne.; Director of Translational Research; Basic Science and Craniofacial Biology; New York University 15 Washington Place New York, Ny 10003 Timing: Fiscal Year 2002; Project Start 01-JUL-1995; Project End 31-MAR-2007
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Summary: (provided by applicant) The full potential of esthetic ceramic-based restorations cannot yet be realized. Shaping-induced damage, exacerbated by fatigue damage during normal chewing, dramatically reduces their initial strength. Since residual strengths fall to values close to occlusal forces, it is not surprising that clinical success of molar crowns has been disappointing. All-ceramic posterior bridges with acceptable success rates over 5-10 years remain a dream. Survival of the crowns is a complex set of interactions between material, fabrication, design, and service variables. In Phase I, our team developed fundamental understanding in damage initiation and accumulation in materials recommended for posterior dental crowns. The influence of microstructure, fatigue and machining parameters on damage have been characterized in monolithic materials. By layering these materials, the conflicting demands for strength and esthetics can be met. Through rational design, the inevitable damage can be managed, yielding a damage tolerant structure which can withstand microcracks within a layer without sacrificing the structural integrity of the system. The overall objective of our revised proposal is to develop a fundamental understanding of damage initiation and accumulation in all-ceramic dental crowns as a function of materials, crown design, and fabrication variables. Our overall approach to meeting this objective is to progress systematically from simple flat-layer structures in normal axial loading toward crown geometries in complex loading, working with clinically-relevant materials at all stages. Ultimately, crowns on extracted teeth mounted in a pseudo bone-PDL system will be subjected to typical cyclic occlusal loading in a wet environment. Our "deliverables" are (1) a design specification guiding development of new materials and (2) fundamental understanding of damage initation, propagation, and accumulation, culminating in a robust model for predicting clinical behavior of combinations of new materials, tooth preparation design, and crown design. With these outcomes, it will be possible for the first time to use basic materials properties to accurately predict application-based performance of new materials. Investigation to accomplish these goals are organized in four projects: (1) Damage Modes and Failure Mechanisms, (2) Complex Loading, Crown Geometry, and Performance, (3) Novel Joining Methods and Interfacial Fracture Mechanics, and (4) Fatigue Performance of Layered Ceramic Crowns on Teeth. The scientific effort will be complemented and supported by two cores: (1) Statistics and Data Analysis Core and (2) Integration and Administration Core. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MICRODAMAGE, REMODELING
OSTEOCYTE
INTEGRITY
AND
BONE
Principal Investigator & Institution: Schaffler, Mitchell B.; Professor; None; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2001; Project Start 15-SEP-1992; Project End 31-JUL-2002 Summary: It is postulated that osteonal remodeling serves to remove and replace regions of compact bone which accumulate microdamage due to fatigue. However, little is known about the damage or remodeling responses which occur at the levels of fatigue expected to result from normal wear and tear. How bone remodeling units "target" microscopically damaged areas of bone is unknown. Effective targeting and removal of damaged bone is essential for maintaining skeletal integrity. Recent data indicates that ultrastructural-level bone matrix damage dominates the early fatigue process in human bone, rather than the typical linear microcracks which have been widely thought to represent primary fatigue process. The role of this predominant fatigue damage mode on activation of intracortical remodeling processes is currently unexplored. Using our modification of the ulnar bending model of Torrance et al (112), adult rat ulnae can be
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fatigued in vivo, to initiate intracortical resorption activity. Studies also suggest that decreased osteocyte viability occurs with fatigue and injury, and that areas of altered osteocyte integrity can be associated with intracortical resorption, independent Of microdamage. The proposed studies will examine a) whether early, ultrastructural level fatigue damage in bone initiate intracortical remodeling, b) how bone fatigue affects osteocyte integrity, and c) whether changes in osteocyte integrity are a determinant of intracortical remodeling. Specifically, we will use the rat ulnar fatigue model for three interrelated experiments: 1) In vivo fatigue loading, combined with confocal microscopy and bone histomorphometry will be used to determine temporal and spatial associations of matrix-level damage processes with intracortical remodeling. 2) We will determine the specific associations of bone matrix microdamage and osteocyte viability or osteocyte injury/loss of viability, and examine the mechanism by which osteocyte degeneration occurs in fatigue loaded bone. Osteocyte integrity relative to local bone damage state will be assessed using a newly developed methods for in situ detection of osteocyte viability (versus injured, nonviable cells). A combination of in situ cytochemical staining techniques and electron microscopy will be used secondarily to assess the mechanism of osteocyte degeneration. A specific focus will be on the question of whether apoptosis is characteristic of the response of osteocytes to fatigue. 3) We will determine the spatial and temporal associations between intracortical resorption and viable/nonviable osteocytes by combinin a roaches from the recedin studies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MITIGATING CANCER TREATMENT-RELATED FATIGUE BY EXERCISE Principal Investigator & Institution: Mock, Victoria L.; Director of the Center for Nursing Resea; None; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 31-MAR-2005 Summary: Fatigue is the most frequently reported unmanaged symptom of cancer patients receiving chemotherapy or radiation therapy. Despite the prevalence of fatigue and its profoundly negative effect upon functional status and quality of life, little research has been published on interventions to prevent or treat fatigue. The purpose of this randomized controlled clinical trial is to test the effectiveness of a nurse-directed walking exercise program to mitigate fatigue and maintain physical functioning during treatment for prostate, breast, or colorectal cancer. Subjects will be stratified by cancer diagnosis and randomized to exercise (EX) or usual care (UC) groups. Subjects in the EX group will be prescribed an individualized home-based walking exercise program that the patients will maintain throughout their cancer treatment. Subjects in the control group will receive the usual care given during cancer treatment. In addition, both groups will receive a booklet, Managing Fatigue. All subjects will be assessed by treadmill and self- report at pretest (baseline before cancer treatment) and at posttest (end of radiotherapy or chemotherapy). In addition, fatigue and other symptoms will be assessed during treatment for both groups. Follow-up symptom assessments and activity levels will be determined at one month, three months, and six months posttreatment. The major outcome variable is fatigue level; additional variables are physical functioning (VO2 max, body composition, muscle strength), emotional distress, difficulty sleeping, and health related quality of life. Groups will be compared by MANCOVA. Multivariate regression procedures will be used to determine the predictors of cancer-related fatigue and of adherence to exercise during cancer treatment. This study is significant as it tests the effectiveness of a low-cost self-care health promotion activity in mitigating fatigue, the most common and distressing
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symptom of cancer treatment. The biobehavioral outcomes include both subjective selfreported symptoms and objective physiologic changes in functional capacity and performance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMPLICATION
MOTOR
LEARNING
IN
CFS--NEURAL
DYSFUNCTION
Principal Investigator & Institution: Servatius, Richard J.; Neurology and Neurosciences; Univ of Med/Dent Nj Newark Newark, Nj 07103 Timing: Fiscal Year 2001; Project Start 02-AUG-1999; Project End 31-MAY-2003 Summary: Chronic Fatigue Syndrome (CFS) patients have registered cognitive complaints such as impaired concentration, memory lapses, and confusion. These complaints are cited as the most debilitating aspect of their disorder. Our pilot study, funded through the New Jersey Chronic Fatigue Research Center, showed that acquisition of a new motor response is impaired in CFS patients. Failure to acquire the classically conditioned eyeblink response was associated with white matter abnormalities in the prefrontal cortex, which are more prevalent in CFS patients without a concurrent psychiatric diagnosis. The present proposal seeks to determine the nature and diagnostic specificity of the learning deficit, as well as advance our understanding of the pathophysiology of some of the cognitive complaints in CFS. We will compare acquisition of the classically conditioned eyeblink response in CFS patients without a concurrent diagnosis of depression to CFS patients with concurrent depression, depressed patients, and healthy sedentary controls. A two-tone discrimination procedure, wherein one tone (CS+) predicts the onset of the unconditioned stimulus (US) and one which does not (CS-), will be used. In this study, we will address two hypotheses derived from neuropsychological research, namely, that CFS patients without depression have slower information processing and they are also impaired in their ability to processes complex auditory information. To address the former, we will manipulate the time between CS+ onset and US onset, the interstimulus interval. To address the latter, we will reverse the contingencies between the CS+ and CS- with respect to the US. Learning of the eyeblink response will be related to performance on neuropsychological tests. We will also obtain MRI scans to quantify brain abnormalities. In this manner, we will relate the prevalence of brain abnormalities in CFS patients to learning and memory impairments. In the absence of a medical marker of the disorder, the diagnosis of CFS relies on concordance with the current case definition. The lack of a medical marker also hinders efforts toward an identification of the pathophysiology of CFS. Our strategy will be to employ a learning and memory paradigm about which a great deal is known concerning the underlying neuroanatomy, neurophysiology and neuropharmacology. We will then be in a position to relate learning abnormalities to brain pathology as measured in MRI scans and characterized by neuropsychological deficits. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MURINE SLEEP PHENOTYPE DURING MICROBIAL INFECTIONS Principal Investigator & Institution: Toth, Linda A.; Professor; Pharmacology; Southern Illinois University Carbondale 900 S. Normal Carbondale, Il 629014709 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 31-JUL-2003 Summary: Work conducted in my laboratory has demonstrated that microbial infections induced by numerous pathogenic agents cause alterations in normal sleep patterns, and
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that facets of the immune response to microbial challenge are likely to mediate these behavioral effects. Identifying the factors that cause fatigue and excessive or disturbed sleep during microbial infections and developing effective interventions for these disabling symptoms could improve the economic well-being and quality of life of many individuals. My long-term goal is to define the genetic and inflammatory mechanisms that mediate fatigue and altered sleep propensity during infectious disease. To that end, I recently completed an analysis of genetic contributions to altered sleep patterns in influenza-infected mice. My preliminary data indicate that a discrete subset of genes is likely to account for large and consistent differences in influenza-induced sleep in different strains of inbred mice. This application proposes to build on that work by identifying the genetic and pathologic mechanisms that mediate sleep responses to other types of microbial challenges and by integrating the new data with our previous findings. A genome-wide approach to identifying candidate genes will be applied in the proposed aims. As the critical first step in identifying genes that regulate infectioninduced alterations in sleep, we will characterize the sleep patterns of prototypic strains of mice after specific microbial challenges. We will use those data to select the most efficient strategies for mapping quantitative trait loci for infection-related sleep phenotypes using recombinant inbred mice. Identifying the genes that modulate infection-induced sleep is an important step toward discovering gene products that influence disease susceptibility and symptomatology. Studying the mechanisms by which genes and their products modulate sleep will ultimately improve our understanding of processes that control normal sleep and contribute to sleep disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEURAL CIRCUITRY UNDERLYING CHRONIC STRESS EFFECTS Principal Investigator & Institution: Bhatnagar, Seema; Psychology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-JAN-2007 Summary: (provided by applicant): Chronic exposure to stress in the form of major adverse life events is associated with the development of disorders such as depression, anxiety and post-traumatic stress disorder and chronic fatigue syndrome. Changes in activity within the hypothalamic-pituitary-adrenal (HPA) axis are important features of these disorders and likely reflect plasticity in brain circuitry that coordinates these neuroendocrine responses with behavioral and autonomic function. Animals undergoing chronic stress exhibit many of the neuroendocrine autonomic and behavioral changes seen in individuals with disease. Using HPA activity as our primary endpoint, we have identified the posterior division of the paraventricular nucleus of the thalamus (pPVTh) as a critical mediator of HPA responses in chronically stressed rats though it does not seem to be functionally active in rats exposed to acute stress. Therefore, the pPVTh seems to control HPA activity specifically within the context of prior stress experience. In this proposal, we seek to characterize the neural circuits that mediate the primarily inhibitory effects of the pPVTh on HPA activity. The efferent projections of the pPVTh are limited and are primarily to limbic structures including the amygdala, prefrontal cortex and bed nucleus of the stria terminalis but also to a hypothalamic region that can more directly control HPA activity. Our general hypothesis is that the pPVTh exerts its influence through changing activity in limbic structures but not hypothalamic structures since limbic regions are more capable of evaluating sensory information within the context of past stress history. More specifically, we will determine whether the pPVTh can exert its inhibitory influence on HPA activity by acting on limbic GABA-ergic systems (Aim 1) and/or by serving as a
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site of negative feedback effects of glucocorticoids released by the chronic stress exposure (Aim 2). Aim 3 focuses on the pathways through which cholecystokinin released within the pPVTh alters HPA activity specifically in chronically stressed rats and Aim 4 will examine how central CRF systems interact with the pPVTh and its associated limbic circuitry. Given the specificity of pPVTh effects to the chronic stress state, characterizing this pPVTh-limbic circuitry is fundamental to understanding the association between chronic stress and changes in physiology and behavior that can lead to disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEURAL MECHANISMS IN MUSCLE FATIGUE Principal Investigator & Institution: Enoka, Roger M.; Professor; Kinesiology & Appld Physiology; University of Colorado at Boulder Boulder, Co 80309 Timing: Fiscal Year 2002; Project Start 15-APR-2002; Project End 31-MAR-2005 Summary: The endurance capacity of muscle varies with the task that is performed. We found that the endurance time for a submaximal isometric contraction with the elbow flexor muscles was twice as long when the wrist was attached to a force transducer compared with when it supported an equivalent inertial load. Although the subject sustained a constant force when the wrist was restrained by a force transducer and maintained a constant elbow angle when supporting the inertial load, the resultant muscle torque and the rate of increase in the average EMG were identical for the two tasks. Nonetheless, additional results suggested that the descending drive to the motor neurons was greater during the constant-position contraction. We hypothesize that endurance time of the elbow flexor muscles is less for a constant- position contraction compared with a constant-force contraction due to greater excitatory descending drive to the motor neurons and greater inhibitory feedback from the muscles. According to this hypothesis, the difference in endurance time for the two tasks is attributable to differences in the input received by the spinal motor neurons. We propose three specific aims (Aims 1 to 3) to examine the, descending- drive component of the hypothesis and two aims (Aims 4 and 5) to assess the inhibitory-feedback component. The hypothesis predicts that motor unit activity will be greater during the constant-position contraction (Aim 1) and that endurance time will be briefer when the gain of the position-feedback signal is increased (Aim 2) and vibration is applied to the active muscles (Aim 3). Furthermore, the hypothesis predicts that the decline in maximum discharge rate of motor units in the contralateral muscles (Aim 4) and that the increase in mean arterial pressure (Aim 5) will be greater after the constant-position contraction. We are not aware of another study that has examined the contribution of neural mechanisms to the fatigue experienced during constant-force and constant-position isometric contractions. The outcomes will provide novel information on the physiological adjustments that occur during isometric contractions, which are the most common form of muscle activity, and will have direct application to the design of work tasks in ergonomics and the prescription of physical activities in rehabilitation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NEURAL MECHANISMS RESETTING THE AGED CIRCADIAN PACEMAKER Principal Investigator & Institution: Duncan, Marilyn J.; Associate Professor; Anatomy and Neurobiology; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2002; Project Start 17-JUL-1996; Project End 31-AUG-2007
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Summary: (provided by applicant): Aging induces deficits in circadian rhythms in restactivity, hormone secretion, and other functions. The normal expression of circadian rhythms depends upon the ability of the circadian pacemaker in the hypothalamic suprachiasmatic nucleus (SCN) to respond to timing signals conveyed by several afferent pathways, including serotonergic neurons. During aging, the pacemaker loses its ability to respond appropriately to several timing signals including serotonergic drugs, such as 8-OH-DPAT. Our findings from the previous funding period have shown that this age-related loss of sensitivity is associated with a large loss of specific serotonin7 (5-HT7) receptor binding sites in the dorsal raphe nucleus (DRN). The DRN is a target site for 8-OH-DPAT induction of circadian phase shifts and a source of innervation of two other circadian substrates, the median raphe nucleus (MRN) and the intergeniculate leaflet (IGL), which both communicate with the SCN. The proposed project will test the following working hypothesis: Age-related reduction in 5-HT7 receptors in the DRN attenuates 8-OH-DPAT modulation of neurotransmission within the MRN and IGL. Reduced communication with the MRN and IGL leads to age-related deficits in phase resetting of the circadian pacemaker in the SCN. The specific aims are: 1) To determine the significance of the age-related reduction in 5-HT7 receptors in the DRN for circadian phase shifts, 2) To identify the neurochemical phenotype of 5-HT7 receptor-containing cells in the DRN, 3) To elucidate the role of the IGL and MRN in mediating the phase-shifting effects of 8-OH-DPAT microinjections in the DRN, and 4) To determine the factors responsible for the age-related loss of 5-HT7 receptors in the DRN. These proposed studies focus on the DRN as an important locus of aging of the circadian timing system. The DRN not only communicates with circadian substrates, but also with brain structures, such as the hippocampus and pedunculopontine tegmental nucleus, regulating memory and sleep, respectively. These processes also exhibit deficits with aging, which may reflect age-related changes in the function of the DRN. The proposed project will elucidate whether the 5-HT7 receptors in the DRN are an important target for new pharmacotherapeutic approaches to ameliorate the disrupted circadian rhythms, especially sleep-wake cycles, that disturb the elderly as well as jet travelers and shift workers. Deterioration of circadian rhythms compromises an individual's health by causing chronic fatigue, lowering resistance to disease, impairing cognition and memory, and reducing longevity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROBEHAVIORAL PHARMACOLOGY OF STIMULANTS Principal Investigator & Institution: Cunningham, Kathryn; Associate Professor; Pharmacology and Toxicology; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2001; Project Start 01-MAY-1990; Project End 31-MAY-2005 Summary: (Adapted from the Investigator's Abstract) Illicit cocaine use continues to be a pervasive problem in the United States; the State of Texas cites cocaine abuse as its greatest illicit drug threat. Cocaine intoxication, dependence and withdrawal are marked by psychological (e.g., euphoria, depression, anxiety, anhedonia, craving) and physiological symptoms (e.g., fatigue, hyperphagia, anergia). An elucidation of the neural mechanisms that underlie the in vivo effects of cocaine is required in order to design effective psycho- and pharmacotherapeutic approaches to the treatment of cocaine addicts. The behavioral effects of cocaine are critically dependent upon mesocorticolimbic circuits, particularly the pathway that originates in dopamine (DA) cell bodies in the ventral tegmental area and terminates in the nucleus accumbens. Serotonin (5-hydroxytryptamine, 5-HT) is involved in the etiology of psychotic (e.g.,
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schizophrenia), affective (e.g., anxiety, depression) and somatic disorders (e.g., obesity). The innervation and localization of 5-HT1B, 5-HT2C or 5-HT4 receptors in mesocorticolimbic circuits and the ability of cocaine to inhibit 5-HT reuptake suggest that 5-HT contributes to the in vivo effects of cocaine. The current literature and our preliminary data support differential roles of each receptor in modulating spontaneous and cocaine-stimulated behavior. In the present proposal, the role of 5-HT1B (Aim 1), 5HT2C (Aim 2) and 5-HT4 receptors (Aim 3) in the locomotor stimulant and discriminative stimulus effects of cocaine will be investigated using novel ligands and receptor knockdown techniques. The pattern of immediate early gene expression in the presence vs. absence of receptor-specific ligands will be employed to localize the site of action of each receptor. Based upon these maps, microinfusions of 5-HT1B, 5-HT2C or 5HT4 receptor ligands or antisense oligonucleotides will be targeted to identified mesocorticolimbic nuclei in order to clarify the site of action for each receptor in spontaneous and cocaine-evoked behaviors. Modifications in 5-HT1B, 5-HT2C and 5HT4 receptors during withdrawal will also be established via analysis of behavior and levels of receptor mRNA and protein expression in brain at several time-points following termination of intermittent cocaine exposure. The experiments outlined will yield significant information concerning the interplay between 5-HT receptors and cocaine, elucidate the manner in with 5-HT controls DA in vivo and help to define the specific and unique roles of these receptors in behavior. As a consequence, new insight into the potential therapeutic strategies for cocaine dependence and a number of psychiatric disorders dependent upon normal 5-HT function will be gained. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROONCOLOGY Principal Investigator & Institution: Buckner, Jan C.; Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2001; Project Start 01-JAN-1982; Project End 31-DEC-2005 Summary: The NCCTG Neuro-Oncology Program consists of three components: Cancer Treatment Trials, Neurobehavioral Studies, and Laboratory Correlates. These complementary components contribute to improving duration and quality of life in patients with primary central nervous system malignancies and to enhancing our understanding of the underlying disease process. During the previous grant cycle, in low-grade glioma patients, we observed that 65 cGy radiation is not better than 50 cGy; pro-carbazine, CCNU, grade glioma patients, we observed that 65 cGy radiation is not better than 50 cGy; procarbazine, CCNU, and vincristine (PCV) is an active regimen as initial therapy; and deletions in chromosomes 1p and 19q are associated with the diagnosis of low-grade oligodendrogliona, but not with low-grade oligoastrocytoma. In patients with high-grade glioma (glioblastoma multiforme, anaplastic oligoastrocytoma), we demonstrated that recombinant alpha interferon does not improve survival when added to radiation and BCNU, but is considerably more toxic; than grading (grade 3 versus grade 4) has significant prognostic value in patients with anaplastic oligoastrocytoma; and that, grade for grade, patients with anaplastic oligoastrocytoma have a statistically significant improved survival compared to those with pure astrocytoma. Moreover, tumoral EGFR amplification, absence of p53 mutations, and PTEN deletions are associated with poor survival in anaplastic astrocytoma patients. Glioblastoma and gliosarcoma patients have essentially identical clinical courses and genetic abnormalities. In recurrent glioma patients, we identified two active regimens: MOP (nitrogen mustard, vincristine, and procarbazine) and irinotecan. Ph. Pharmacokinetic studies demonstrated increase in CPT-11 clearance and
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variable metabolism in patients receiving irinotecal and anti-convulsants concurrently. Non-glioblastoma patients were more likely to respond to treatment than those with recurrent glioblastoma. Neurobehavioral studies indicated that good baseline Folstein and Folstein mini-mental status examination (MMSE) score is associated with better survival on multi-variate analyses. Few patients with high-grade glioma had diminished mini-mental examination scores at one year and 18 months in the absence of tumor progression. Conversely, reduction in mini-mental status examination scores correlated strongly with both at diagnosis, and were more likely to have cognitive decline to have cognitive decline as a consequence of treatment compared with younger patients. In patients with primary CNS lymphoma, we found a high response rate with CHOP (Cyclophosphamide, doxorubicin, vincristine, and dexamethasone), but the duration of benefit was very short. As in patients with high-grade glioma, MMSE scores declined in close association with tumor progression. Future plans include continued evaluation of agents with radiosensitizing properties including cisplatin and irinotecan. We will continue to evaluate the efficacy of new regimens in recurrent glioma patients, including pyrazoloacridine plus carboplatin and the rapamycin analog, CCI 779. NCCTG has recruited investigators demonstrating experience with inhibitors of tumor invasion, as well as gene therapy. There are two main gene therapy approaches current in preclinical investigation: fusogenic membrane glycoproteins such as the measles virus F and H proteins and the truncated Gibbon Ape Leukemia virus surface protein (GALV). Neurobehavioral studies, including evaluation and treatment of impaired cognitive status, depression, fatigue, and excessive daytime somnolence, are in process. Pharmacokinetic studies to investigate interactions among chemotherapeutic agents and anti-convulsants will continue. Studies of genetic alterations in glioma, especially anaplastic astrocytoma and low- grade glioma, will be expanded through collaborations with Drs. Robert Jenkins (Mayo) David James (Mayo), and Bert Feuerstein (UCSF). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROPHYSIOLOGICAL AND PSYCHOPHYSICAL STUDIES IN PAIN Principal Investigator & Institution: Campbell, James N.; Professor; Neurosurgery; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 30-SEP-1978; Project End 31-DEC-2004 Summary: (Adapted from the Investigator's Abstract) The long range objective of this research is to use neurophysiological and psychophysical techniques to develop a better understanding of pain perception. This strategy of correlative neurophysiological and psychophysical studies is a powerful technique to develop an understanding of neural encoding mechanisms. In our research we correlate the response of primary nociceptive afferents, obtained from single fiber recordings in the anesthetized monkey, with the response of human subjects, based on ratings of subjective magnitude. With this approach we have been able to make major inroads regarding the understanding of the peripheral as well as central neural mechanisms of pain and hyperalgesia. These studies provide a foundation to purse research on patients in order to understand and treat neuropathic pain. This proposal builds on prior work by continuing investigations into the role of nociceptors in normal pain sensation and by continuing neurophysiological and psychophysical studies of the mechanisms of hyperalgesia at the site of injury (primary hyperalgesia) and of hyperalgesia in the uninjured skin surrounding an injury (secondary hyperalgesia). These studies of primary and secondary hyperalgesia form the basis for investigations of hyperalgesia in neuropathic pain, a common and debilitating form of chronic pain. Numerous questions will be probed to address such
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issues as: (1) how does the branching structure of nociceptors affect signal processing? (2) What is the basis of fatigue in nociceptors? (3) Capsaicin is a potent drug in causing pain and hyperalgesia but also has therapeutic potential. Which classes of nociceptors signal the pain from capsaicin, and which classes are vulnerable to the toxic effects of capsaicin? (4) Two models of secondary hyperalgesia will be tested to gather information about the likely central nervous system mechanisms of this pathological feature of pain. (5) Finally these studies of hyperalgesia in normal volunteers will be directly applied to test highly focused hypotheses regarding the mechanisms and possible treatments of neuropathic pain in patients. This hypothesis driven research interrelates basic and clinical research in a mater that has excellent potential for promoting the understanding and treatment of pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROPROSTHESIS PERFORMANCE - NERVE CUFF ELECTRODES Principal Investigator & Institution: Triolo, Ronald J.; Orthopaedics; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2003; Project Start 25-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): The primary objective of this investigation is to address the limitations of currently available first generation functional electrical stimulation (FES) systems for standing after spinal cord injury by a) activating a greater portion of the targeted muscles to increase available knee extension moment and b) selectively recruiting synergistic muscles to offset fatigue. We will accomplish this through the innovative application of nerve-based cuff electrodes in a series of translational research studies designed to build upon existing animal work and safely and efficiently introduce them into human clinical trials. All current implanted FES systems for standing utilize muscle-based stimulating electrodes that only partially activate the available motor unit pool. While more than adequate for smaller and lighter implant recipients, this approach yields insufficient knee extension moment for heavier or taller candidates. Such individuals require more complete activation of the quadriceps to achieve acceptable functional standing, while simultaneously avoiding the counterproductive hip flexion caused by the femorally innervated sartorius and rectus femoris. The first goal of this study is to demonstrate the feasibility of utilizing stimulating nerve cuff electrodes in standing neuroprostheses, and thus extend the potential user population to individuals who currently cannot take advantage of the technology due to their size and weight. The proximal femoral nerve trunk is composed of numerous fascicles serving structures both advantageous and counterproductive to stable upright standing. Animal studies have demonstrated that a stimulating nerve cuff placing multiple contacts around the nerve can selectively activate individual fascicles within the nerve. The second goal of this investigation is to generate a realistic model of cuff-nerve geometry and determine the fascicular selectivity of multi-contact cuff electrodes on the multi-fascicular human femoral nerve via computer simulation analyses. This will result in an optimized cuff design that maximizes selectivity without detailed a prior knowledge, and thus suitable for clinical use. The third and final goal of this project is to establish the acute and chronic performance of multi-contact cuff electrodes in vivo in human volunteers. Intermittent and cyclic stimulation to individual contacts of chronically implanted electrodes on the distal peripheral nerve branches innervating the vastus lateralis and intermedius will allow fibers to rest while maintaining a constant net submaximal joint moment, effectively increasing duty cycle and allowing some recovery from fatigue. Selectivity of multi-contact nerve cuff electrodes on the proximal femoral nerve will be established in a series of acute intra-
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operative tests. Completion of this project will extend the functionality of existing neuroprostheses and provide immediate benefit to current system users. It will expand the potential user population, improve consistency of standing performance across individuals, and delay the effects of fatigue. Selective activation of individual muscles from a single multi-contact cuff electrode around a multi-fascicular nerve trunk will simplify the surgical installation of systems that provide more advanced functions such as stepping and stair climbing. Thus, in addition to their immediate impact on the functionality and performance of standing systems, the proposed studies will build a foundation for future developments in lower extremity neuroprostheses by selectively activating the appropriate fascicles in the proximal femoral nerve trunk. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROTHERAPY OF FIBROMYALGIA Principal Investigator & Institution: Nelson, David V.; Behavioral Neuroscience; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-MAY-2005 Summary: (provided by applicant): Fibromyalgia (FM) is one of the most puzzling of the chronically painful disorders. It involves a core symptom of chronic widespread musculoskeletal pain at specific tender point (TP) sites on physical examination and is typically accompanied by fatigue, disordered sleep, cognitive complaints, an array of other somatic complaints, as well as psychological distress and significant impairments in functioning. Although largely championed and defined by rheumatologists, FM is now increasingly recognized to have a basis in central nervous system dysfunction. Treatments to date have been only partially effective and typically of modest benefit. Many persons with FM remain persistently dysfunctional and often disabled. This has given greater impetus for patients to seek complementary and alternative medicine (CAM) therapies. Within the scope of CAM, recent developments in biofeedback using electroencephalograph (EEG) or brainwave information have suggested some potential for application to FM. A novel variant of EEG biofeedback known as the Flexyx Neurotherapy System (FNS) uses very small pulses of electromagnetic energy to stimulate changes in brainwave patterns. The specific aim of this study is to evaluate the efficacy of FNS for the reduction of FM symptoms in a randomized, double-blind, placebo-controlled trial comparing two groups each of 20 patients who receive either the active intervention or a sham treatment for the same number of sessions. It is expected that immediately at the conclusion of treatment and at 3- and 6-month follow-up, patients receiving the active treatment will score significantly better on the primary outcome measure, the Fibromyalgia Impact Questionnaire total score. In terms of secondary outcome measures, it is further expected that patients receiving the active treatment will demonstrate significantly decreased heat sensitization (an objective indicator of abnormal central nervous system activity), fewer TPs and higher pressure thresholds to elicit TPs, less fatigue, improved cognitive functioning, reduced psychological distress, less depression, and improved quality of sleep. Preliminary data from this exploratory/developmental project will justify larger randomized, doubleblind, placebo-controlled clinical trials of FNS and comparisons to other treatments for FM, and may provide a basis for investigating correlates and potential mechanisms of change. This program of research may contribute to immediate clinical applications to reduce FM symptoms and to better understanding of mechanisms of FM. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: NURSING INTERVENTIONS TO ENHANCE OLDER WOMENS EXERCISE Principal Investigator & Institution: Conn, Vicki S.; Professor; None; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2001; Project Start 01-SEP-1997; Project End 31-JUL-2003 Summary: (Adapted from the Investigator's Abstract): Exercise rates among older women remain low despite documented health benefits of exercise. This project's primary aim is to compare the efficacy of two nursing interventions designed to increase exercise among community-dwelling older women: (1) theory-based education on exercise vs. standard instruction, and, (2) prompts to exercise vs. no prompts. The theory-based nursing intervention teaches women (1) sources of self-efficacy information including performance mastery, vicarious performance, physiological stimuli, and verbal persuasion; and (2) theory of planned behavior beliefs about commitment, fatigue, time management, and the health consequences of exercises. The standard instruction condition uses typical instruction materials from organizations such as American Heart Association. The prompting nursing intervention includes weekly and biweekly phone calls and mailed materials to prompt exercise. Ergometers and activity diaries will be used to examine the effects of the experimental conditions on the response variables of exercise and physical activity during a 24-month period. This project's secondary aim is to examine the relationship between changes in exercise and subsequent functional status and health-related quality of life. The secondary outcome variables, functional status and health-related quality of life, will be measured with the Medical Outcomes Study Form 36, the Cooperative Information Project charts, and the MacArthur functional status scales. A two way factorial experimental design with repeated measures pre-and post-intervention will be used to compare the effects of the two nursing interventions. The study's primary aim will be analyzed using repeated measures analysis of variance with two between-group factors (theory-based education vs. standard instruction and prompt vs. no prompt) and one within-subject factor (time). Findings on the effectiveness of these two nursing interventions will help refine nursing strategies for increasing exercise among community-dwelling older women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PAIN AND SYMPTOMS OF CANCER: ASSESSMENT AND TREATMENT Principal Investigator & Institution: Cleeland, Charles S.; Professor/Director; Anesthesiology/Crit Care; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 01-JUL-1986; Project End 31-JAN-2008 Summary: (provided by applicant): Cancer-related symptoms are often poorly treated even when effective symptom management is available. Based on previous work, this project will focus on a major barrier to good symptom management -- inadequate assessment. Reduction of symptoms is a major treatment goal for patients with advanced lung cancer. These patients have a poor prognosis and multiple symptoms such as pain, fatigue, and emotional distress. As more cancer therapy is done on an outpatient basis, patients go longer without symptom assessment. Minority patients are at greater risk for both poor symptom assessment and management. Frequent assessment using computer/telephone-based interactive voice response (IVR) systems may improve both the assessment and management process. The three objectives of the proposed research are: (1) Using the IVR system, to longitudinally assess the prevalence,
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severity, and interference caused by multiple symptoms in patients with advanced lung cancer, and to characterize factors, including minority and nonminority membership, that may lead to differences in symptom treatment and outcomes. This study will help identify the most distressing symptoms that these patients have, and when, in the course of the disease, they will be most severe. (2) Based on the longitudinal study, to develop symptom severity thresholds that indicate a need for provider notification, and to modify existing symptom management protocols to help providers respond quickly when notified that a patient is symptomatic. (3) To examine, in a randomized clinical trial, the effectiveness of combining IVR assessment, provider notification, and availability of guidelines in reducing symptom burden in advanced cancer, and to compare the effectiveness of this method between minority and non-minority patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PREVENTION INTERVENTIONS IN HISPANIC AND ANGLO CHILDREN Principal Investigator & Institution: Kennedy, Christine M.; Family Health Care Nursing; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 01-MAY-2000; Project End 31-JAN-2004 Summary: In the 1990's the leading causes of morbidity and mortality in childhood involve risk-taking. There is also an increasing prevalence among children of poor diet and sedentary lifestyle habits, which are risk factors for chronic adult diseases. Traditional health care approaches to modify these behaviors have produced disappointing results. Since high amounts of television viewing have been implicated as a contributor to these behaviors, this study will examine the influence of television on Hispanic and Anglo children's risk-taking and dietary intake, and test the effectiveness of a family based intervention in reducing children's television viewing, reducing their risk-taking behaviors and improving their dietary intake. As prevention, health promotion and self care become more significant modalities to achieve individual and community health, new interventions need to be empirically tested and disseminated. The intervention is based on "The Interaction Model of Health Behavior". This mulitphasic model provides a broad framework for investigating how various antecedents predict complex behavioral outcomes. The intervention offers a behavioral approach to alternative strategies and incentives to reduce television viewing by children and their families. Using a prospective,randomized longitudinal trial design, the investigators will examine the effects of age- and culture- specific interventions to modify children's behaviors in a sample of ethnically diverse children and their families. We hypothesize that children who experience the intervention will report less TV viewing, have fewer risk-taking behaviors, make healthier food choices, and demonstrate more preventive health behaviors. The child's motivation, health perceptions, self- esteem and coping strategies, as well as mother's stress, fatigue and health motivations will be explored. The effects of potential covarying influences on children's health behaviors such as gender and ethnicity will also be examined, as will family characteristics, social influences, family functioning, and parental motivation in health behaviors, fatigue, and stress. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SYNDROMEN
PSYCHIATRIC
COMORBIDITY
IN
CHRONIC
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FATIGUE
Principal Investigator & Institution: Friedberg, Fred; Psychiatry and Behavioral Scis; State University New York Stony Brook Stony Brook, Ny 11794 Timing: Fiscal Year 2001; Project Start 05-AUG-2001; Project End 31-JUL-2006 Summary: The purpose of this application is twofold: 1) To provide a systematic plan for career development of the Candidate as a clinical researcher; and 2) to present a preliminary study application based on a sound research plan. The career development plan involves: a) taking graduate courses in advanced statistics and research methods, behavioral assessment, and ethical issues; and b) supervision by two mentors of the conduct of research by the Candidate. The Specific Aims of the preliminary study are to: 1) compare in vivo and traditional retrospective outcome measures in patients with chronic fatigue syndrome (CFS) in order to assess the ecological validity of traditional measures in both naturalistic outcome (NO) and clinical outcome (CO) studies; 2) test the hypothesis, via secondary data analysis in the CO study, that a clinically meaningful classification of CFS patients into high and low functioning subgroups can be made on the dimension of physical functioning and validated with its relationship to role functioning, CFS symptom severity, and psychiatric symptomatology; and 3) test the hypothesis, via secondary data analysis in the CO study, that graded activity with cognitive therapy is more effective for low function participants and that cognitivebehavioral coping skills treatment is more effective for the high function subgroup. The NO and CO studies involve cohorts of 100 and 120 patients, respectively. Data collection will include 21 (NO study) or seven (CO study) consecutive daily in vivo assessments of physical activity (actigraphy), energy, fatigue, and affect. In vivo assessments will take place at baseline and at a 24 month follow-up in the NO study, and at baseline, treatment termination, and three, six, and 12 month follow-up intervals in the CO study. The findings of this study will have important implications for clinical management of this debilitating illness. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: QUALITY OF LIFE INTERVENTION IN BREAST CANCER SURVIVORS Principal Investigator & Institution: Dow, Karen H.; Professor and Research Coordinator; Nursing; University of Central Florida 12443 Research Pky, Ste 207 Orlando, Fl 32828 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-MAY-2005 Summary: (provided by applicant): Problems that negatively affect quality of life (QOL) are a major concern among more than 1.7 million breast cancer survivors in the United States. QOL is considered a multidimensional construct that incorporates dimensions of physical, psychological, social, and spiritual well-being. The purpose of this study is to test the effectiveness of an individualized, multidimensional quality of life intervention (Breast Cancer Educational Intervention [BCEI]) on QOL for women with newly diagnosed, early stage I or II breast cancer in the first year after initial treatment. The BCEI is based on extensive preliminary research studies by the investigators. The five selected QOL problems of fatigue, pain, fear of recurrence, sexuality concerns, and meaning in illness were targeted as high priority areas based on a preliminary study of 298 breast cancer survivors. The specific aim of this study is to test the effectiveness of the Breast Cancer Educational Intervention (BCEI). Three hypotheses will be tested: H1: Breast cancer survivors will experience improved QOL as a result of the BCEI. H2:
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Breast cancer survivors will experience improved QOL in the domains of physical, psychological, social, and spiritual well-being as a result of the BCEI. H3: The effects of the BCEI will be retained over time. The conceptual framework is grounded in the City of Hope Quality of Life Model and principles of cancer patient education. A two-group, repeated measures experimental design with a waiting control group will be used to answer the study aims and research questions. A sample of 250 women with newly diagnosed, early-stage I and II breast cancer who are completing treatment will be recruited from two clinical sites in Florida (M.D. Anderson Cancer Center Orlando) and California (City of Hope National Medical Center). Subjects will be randomly assigned to the Experimental or Waiting Control Group. The BCEI consists of a structured and individualized QOL teaching and skills development program delivered by advanced practice nurses using face-to-face instruction and reinforced with written materials and audiotapes. The BCEI will be administered in three face-to-face visits with three telephone reinforcements, and three evaluation visits. Data collection will occur at three time points for the Experimental Group and four time points for the Waiting Control Group using standardized instruments. Data analysis will use multivariate t-test for two groups (equivalent to MANOVA), and the generalized estimating equation (GEE) model. Study findings are expected to improve our understanding of the incidence of major QOL problems affecting breast cancer survivors, identify individually selected interventions and their effectiveness, and determine theoretically-based interventions that are realistic for implementation by clinicians who provide follow up teaching, support, and surveillance of breast cancer survivors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RADIOTHERAPY EFFECTS ON BRAIN FUNCTIONING IN ADULTS Principal Investigator & Institution: Armstrong, Carol L.; Assistant Professor; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 01-JUN-1997; Project End 31-JUL-2004 Summary: The investigators propose a multidisciplinary project to describe the frequency, nature, and longitudinal course of the effects of radiotherapy (RT) on cognition and cerebral white matter in adults with low-grade, supratentorial brain tumors. They have identified a neurobehavioral model of the early-delayed effects of radiotherapy, characterized by decrement and rebound of semantic memory retrieval. They will investigate the validity of these findings in brain tumor groups with and without radiotherapy. They will concurrently validate the model by comparing it with another cognitive memory model, and will identify the onset of other cognitive changes. The investigators plan to investigate dose-dependent effects of radiotherapy by relating neuropsychological measures to reconstructions of dose burden to hypothesized brain regions. They will also relate dose and neuropsychological outcome to serial magnetic resonance imaging (MRI). They will compare magnetization transfer imaging (MTI) with MRI and expect that MTI will show greater sensitivity and specificity to the latedelayed changes, will differentiate axonal degeneration from edema, and will show higher correlations with neuropsychological measures. Over the five years of the project, the investigators will recruit new patients with low-grade gliomas, pituitary and other low-grade tumors because of their long life expectancies. Patients with gliomas who did not receive radiotherapy will be also sought as a control group. They propose to recruit 220 new cases, and will follow 22 cases from their pilot study over the study period. Hypotheses about treatment effects will be tested using subjects as their own controls and treatment group comparisons. They will conduct neuropsychological evaluation (10 domains and mood/fatigue) at baseline (about 6 weeks post surgery and just prior to
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radiotherapy), 6 weeks post-completion of radiotherapy, trimonthly for one year, and then yearly. Cognitive neuropsychological models of memory search and retrieval over time will be investigated to discern the relation of neurocognitive impairment to brain structure. They will correlate cognitive variables with dose and graded MRI scans of all patients. Dose histograms will quantify dose to hypothesized brain structures and radiation portals. They will gather pilot data on the sensitivity of MTI to radiation effects in 37 cases during the early and late delayed periods. Standard brain regions, tumor sites and specific regions will be examined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REDOX MECHANISMS OF RESPIRATORY MUSCLE STRESS ADAPTATION Principal Investigator & Institution: Clanton, Thomas L.; Professor; Internal Medicine; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2001; Project Start 01-DEC-1994; Project End 31-JAN-2005 Summary: During intense exercise, skeletal muscles must withstand stress in the form of heat, tissue hypoxia, reactive oxygen, steep osmotic gradients, elevated tissue pressure, sheer stress and over-stimulation. Few cells of the body could survive such punishment and yet skeletal muscles survive and adapt to it. To accomplish this, they must be preprogrammed in some primordial way to sense when the environment is threatening and make rapid adaptations in contractile and metabolic activity to reduce the threat to survival. We hypothesize that reactive oxygen is an important signal used for this purpose, particularly under conditions of metabolic stress, such as high energy demand (over-stimulation), low energy supply (hypoxia) or overheating (thermal stress). In this funding period, we will investigate the mechanisms by which reactive oxygen participates in muscle adaptation to stress. The study will focus on isolated, perfused mouse diaphragm. SPECIFIC AIM 1 will test the hypothesis that reactive oxygen is formed as an acute response to hypoxia, heat stress and over-stimulation (resulting in fatigue) and that conditions of disordered O2 supply and demand are necessary prerequisites for this response. Both tissue fluorescence and confocal imaging techniques will be used in these experiments. SPECIFIC AIM 2 will test the hypothesis that reactive oxygen plays an important role as a signaling agent to modify metabolic pathways during stress in such a way as to favor of accumulation of metabolites, preservation of ATP and reduction of creatine phosphate. This will be tested by blocking the effects or reactive oxygen with antioxidants and by using transgenic species with antioxidant over-expression. Measures phosphate metabolism, mitochondrial function, creatine kinase function and activity of other metabolic enzymes will be assessed. SPECIFIC AIM 3 will test the hypothesis that reactive oxygen plays a role in acute changes in the cytoskeleton during stress that promote an increase in muscle "stiffness" and favor preservation of muscle structural integrity. Biophysical measurements of the viscoelastic properties of muscle will be tested before and during stress. These studies should provide new information regarding the adaptive mechanisms muscle in stressful environments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TREATMENTS
REDUCING
JET-LAG
WITH
PRACTICAL
CIRCADIAN
Principal Investigator & Institution: Eastman, Charmane I.; Professor of Psychology; Rush-Presbyterian-St Lukes Medical Ctr Chicago, Il 60612
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Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-MAY-2005 Summary: Jet-lag is one of society's most prevalent disorders. Symptoms include insomnia, daytime sleepiness, fatigue, decrements in alertness and performance, dysphoric mood, loss of concentration, disorientation, and gastrointestinal distress. Jetlag is not just the bane of tourists; it can impair the judgment and performance of businessmen and women, diplomats and the military. The symptoms of jet-lag occur because the internal circadian clock is slow to re-entrain to the sleep/wake schedule required in the new time zone. When several time zones are crossed, travelers are forced to sleep at the "wrong" phase of their circadian cycle, when they are physiologically set for waking, and then try to stay awake when they are physiologically set to sleep. As the circadian clock gradually phase shifts to re-entrain, the symptoms of jet-lag gradually dissipate. It takes longer to adapt after an eastward that after a westward flight, because the circadian clock is slower to advance than to delay. Furthermore, after an eastward flight, circadian rhythms may re-entrain in the wrong direction, e.g., they may delay 16 hrs instead of advancing 8 hrs, further prolonging the symptoms of jet-lag. The investigators propose to test treatments to phase advance the circadian clock before an eastward flight, in order to prevent or reduce the symptoms of jet-lag. The treatments will include 3 days of a gradually advancing sleep schedule, bright artificial light after waking, and afternoon melatonin pills. These treatments are specifically designed to be feasible for real travelers to use at home before a flight. The outcome measures will be the magnitude of phase advance on the day that corresponds to the day of flight, measured from the circadian rhythm of endogenous melatonin secretion. They will also measure the side effects of treatment, the "price" that travelers would have to pay in order to prevent or reduce jet-lag, including sleep loss (from wrist activity monitors and sleep logs) and daytime sleepiness and fatigue (from questionnaires). The goal is to develop practical recommendations for real travelers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: REGULATION OF ACETYLCHOLINE RECEPTORS ON MUSCLE Principal Investigator & Institution: Brehm, Paul; Professor; Neurobiology and Behavior; State University New York Stony Brook Stony Brook, Ny 11794 Timing: Fiscal Year 2001; Project Start 01-APR-1989; Project End 31-JUL-2005 Summary: (provided by applicant): The long term interests of my lab have centered on establishing the respective roles of presynaptic calcium channels and postsynaptic cholinergic receptors in neuromuscular transmission. My lab has traditionally relied on use of developing Xenopus neuromuscular junction where, among other advantages, direct cellular analysis of synapse function can be assessed through voltage-clamp of pre and postsynaptic cells. During the past funding period we initiated study of Zebrafish neuromuscular junction, which is functionally similar to Xenopus, but has the additional advantage that behavioral consequences of synaptic dysfunction are directly ascertained. We have identified Zebrafish mutant lines that exhibit locomotory dysfunction resulting from defects in neuromuscular transmission. Two lines exhibit myasthenia gravis-like symptoms in the form of use-dependent fatigue, and the symptoms can be partially rescued by inhibitors of cholinesterase function. Recently, we have shown the defect in one mutant line results from a defective rapsyn gene, and we have succeeded in rescuing the behavioral defect in the mutant fish. Another line with defective synaptic receptor density shows similar progressive weakness but outgrows the behavioral phenotype with age. Both lines exhibit profound synaptic depression at the nerve-muscle junction when compared to wild type animals. We will use these two lines to establish the mechanisms through which alterations in postsynaptic receptor
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densityleads to the observed synaptic depression. A similar depression can be recorded at Xenopus nerve-muscle synapses where both pre and postsynaptic cells can be voltage clamped. Using this preparation we will determine whether alterations in presynaptic release or postsynaptic receptor desensitization are responsible for synaptic depression. The four specific aims that are proposed merge the collective strengths of in vitro use of Xenopus with behavioral mutants of zebrafish, in order to investigate the mechanisms underlying synaptic plasticity at the neuromuscular junction. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESEARCH VOCALIZATION
TOWARD
OCCUPATIONAL
SAFETY
IN
Principal Investigator & Institution: Titze, Ingo R.; Distinguished Professor; Denver Center for the Performing Arts Performing Arts Denver, Co 802042154 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-AUG-2005 Summary: This research addresses an important public need, the protection of an approximate 5-10 percent of the U.S. workforce who use their voice as a primary tool of trade. Evidence has been growing that occupational voice users, such as teachers, interviewers, counselors, and telephone workers, are at risk for vocal injury because they get inadequate recovery times from prolonged speaking. The underlying hypothesis of our research is that there is a limited vibration dose that vocal fold tissues can absorb. As to hand vibration transmitted by power tools, a safe dose is governed by frequency, tissue acceleration, and duration of exposure. We propose to design and test a dosimeter that measures these governing variables in vocalization, both in a controlled laboratory setting and on the job. We also propose to relate this vibration dose, and recovery times for the dose, to auto-perception of vocal fatigue. Since auto-perception requires little sophisticated instrumentation, we anticipate that a self-monitoring strategy will eventually evolve for all occupational voice users. Voice-economy oriented therapy will be administered to a group of teachers and compared to electronic amplification in its ability to prevent fatigue. The voice- economy therapy is driven by energy conservation principles, derived theoretically on computer simulation models of phonation, as well as by clinically accepted techniques that have withstood a test of time and are used currently by vocal performers. Specific aims are to (1) design and construct the dosimeter, (2) to measure the daily and weekly dose received by approximately 120 teachers on the job, (3) to provide a voice-economy oriented therapy program to a subset of about 60 of these, (4) to relate vibration dose at the larynx to vocal output, (5) to relate auto- perceptive measures of recovery time to vocal fatigue, short term rest periods and tissue health, and 6) to provide amplification to another subset of 20 teachers who are in a classroom setting. The Wilbur James Gould Voice Research Center, a division of the Denver Center for the Performing Arts, is well suited to conduct this study because it already has an active outreach program to the public schools and the business sector. It also has a residency theatre company. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESPIRATORY SYSTEM MECHANICS Principal Investigator & Institution: Boriek, Aladin; Assistant Professor of Medicine and Phys; Medicine; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2001; Project Start 01-APR-1991; Project End 31-MAR-2004 Summary: The respiratory muscles are a major determinant of thoracic cavity shape and thus the distribution of regional ventilation. Respiratory insufficiency is the usual cause
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of death in many primary neuromuscular disorders. Respiratory muscle fatigue is believed to be a major factor in hypercarbic respiratory failure associated with lung and/or cardiovascular diseases. A recent NHLBI workshop summarized the difficulty of studying respiratory muscle fatigue because of our limited understanding of the relationships between tension developed by the respiratory muscles and pressures which expand the thoracic cavity and other parameters which can be measured in intact animals or man. Much of the benefit of lung volume reduction surgery for end stage emphysema is proposed to be secondary to improved function of the respiratory muscles principally the diaphragm. This project utilizes a video roentgenographic technique to determine the regional shape, displacements and muscle shortening of the diaphragm and rib cage to elucidate the basic mechanics of the diaphragm and rib cage. By comparing muscle shortening and curvature of the diaphragm in intact animals under conditions in which the transdiaphragmatic pressure and muscle tension can be measured, the relationship between muscle tension and pressures can be determined. The detailed three dimensional anatomic data provided by this methodology coupled with more conventional physiologic measurements should answer important questions posed by previous studies of the coupling of the diaphragm abdomen and rib cage. The investigators will verify and extend two models of diaphragm structure and functions developed in the current period of the project. These models are consistent with data obtained in this project which contradict previous qualitative models. The models offer testable predictions about the mechanisms of failure of the diaphragm as an inspiratory muscle at high lung volumes. In the current proposal, the investigators will extend our knowledge and techniques developed in animals to study diaphragm and chest wall function in normal humans and patients with severe emphysema before and after lung volume reduction surgery. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RESPONSIVENESS OF THE AGING CIRCADIAN CLOCK TO LIGHT Principal Investigator & Institution: Benloucif, Susan J.; Mol Pharm & Biol Chemistry; Northwestern University Office of Sponsored Programs Chicago, Il 60611 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-JUL-2005 Summary: (adapted from investigator's abstract): The investigator's long-term goal is to understand the basis of and develop effective therapies for chronic sleep disturbances in older adults. One common sleep disorder in older adults is advanced sleep phase, accompanied by sleep maintenance insomnia and early morning awakenings. This can shorten the total sleep time and lead to daytime fatigue and impaired performance. The advance in sleep is associated with an advances in the timing of the circadian core body temperature rhythm which suggests an advance in the timing of the circadian clock. The cause of this advance is unknown. Preliminary date from the investigators laboratory suggests that elderly subjects do not phase delay following exposure to 4000 lux for 3 hours before the temperature minimum, a time that usually does delay the rhythm in younger adults. The first goal of this application is to understand the mechanism underlying the age-related change in responsiveness of the clock to light. The second goal is to assess whether it is possible to compensate for age-related change in the responsiveness of the aging circadian clock to light by either increasing the intensity of the light exposure or by pharmacological treatment with the calcium channel antagonist nimodipine. The proposed experiments will provide a vast amount of data in which to better understand the effect of age on circadian rhythms and sleep and lead to improved treatments for circadian rhythm and sleep disorders in older adults. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RESTORATIVE MATERIAL WEAR FACTORS Principal Investigator & Institution: Baran, George R.; Professor; Mechanical Engineering; Temple University 406 Usb, 083-45 Philadelphia, Pa 19122 Timing: Fiscal Year 2001; Project Start 01-JUL-1990; Project End 31-JAN-2003 Summary: Composite resin restorative materials were introduced to the dental profession approximately thirty years ago. Since that time, incremental improvements in the properties of these materials have made new treatment modalities possible. There have been gradual changes in the clinical failure modes of these materials, due in part to material improvements, and in part to more aggressive treatment planning. The properties of these materials rely on the strengthening and toughening of an organic matrix through the addition of silane-coupled glass of ceramic particles. Recently, fiberreinforced restorative materials have been introduced. Although a considerable amount of data has been collected concerning the effects of matrix cure, filler permit the rational design of new composites. Manipulation of filler-matrix interphase elastic properties has been hindered by experimental difficulties. Although the fast-fracture, fatigue, and wear behavior of proprietary and experimental composites have been studied, there is a lack of a design criterion or probabilistic mechanical approach that would enable estimation of the clinical lifetimes of composites and other brittle dental restorative materials. The long-term goal of this research is to develop and test a model incorporating mechanical properties of materials, finite element techniques, and statistical methods that could be used for the design of new restorative composites. In pursuit, six specific aims are proposed: 1.) to produce and characterize a series of model composites utilizing a 60:40 BISGMA:TEGDMA resin matrix and a spherical or fibrous borosilicate glass filler; variables include volume fraction of iller, silane coupling, and polymerization kinetics; 2.) to produce a series of composites with low filler volume fractions but with exaggerated filler sizes in order to study effects of filler-matrix bonding, residual stress, and matrix plasticity on Mode I and wear crack propagation direction; 3.) to refine a microstructural finite element model in order to predict the elastic properties, strength, and toughness of composites; 4.) to construct a analytical model based on finite elements that is capable of predicting crack propagation directions in composites; 5.) to develop a statistical and fracture mechanics methodology for evaluating the reinforcing capability of spherical, random chopped fiber, and woven fiber reinforcement; 6.) to use the CARES/LIFE software package, with fracture and fatigue data as input, to predict failure probabilities of composites, viscous glass ionomers, and polyacid-modified resin composites when these are used to restore certain cavity preparations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RISK FACTORS AND CONTROLS FOR FALLS FROM HEIGHTS Principal Investigator & Institution: Nussbaum, Maury A.; Associate Professor; Industrial and Systems Engr; Virginia Polytechnic Inst and St Univ 460 Turner Street, Suite 306 Blacksburg, Va 24060 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2007 Summary: (provided by applicant): Falls from heights are a major problem in both industry and general society when measured in terms of economic losses and human suffering. Given that most of these falls are believed to result from a loss of balance, appropriate strategies to address the problem of falls should focus on improving balance control. Existing research has identified a number of major extrinsic and intrinsic factors involved in the control of balance. Only recently has another intrinsic factor, localized muscle fatigue, been shown to influence balance control. Additional research is needed
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to further our understanding of how fatigue contributes to loss of balance and falls. To address this need, three projects are proposed that will use laboratory experiments and biomechanical modeling to investigate and mitigate the effects of localized muscle fatigue on balance control. First, experiments will be conducted to examine and quantify the effects of localized muscle fatigue on balance control and the ability to recover from a balance perturbation. Second, a biomechanical model will be developed to quantify balance control strategies in terms of joint torques and to predict the effects of localized fatigue on these parameters. Third, the effectiveness of two interventions aimed at reducing the adverse effects of fatigue on balance control will be determined. Completion of these projects will provide new information concerning factors that can adversely affect balance control and contribute to the development of intervention strategies for fall prevention. Emphasis is also placed on understanding age-related changes in the effect of fatigue on balance control, in light of epidemiological evidence of high fall risks among older workers and demographic trends toward an aging population and workforce. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ROLE OF MG29 IN E-C COUPLING OF STRIATED MUSCLES Principal Investigator & Institution: Ma, Jianjie; Professor; Physiology and Biophysics; Univ of Med/Dent Nj-R W Johnson Med Sch Robert Wood Johnson Medical Sch Piscataway, Nj 08854 Timing: Fiscal Year 2002; Project Start 01-SEP-1997; Project End 31-AUG-2007 Summary: (provided by applicant): Mitsugumin 29 (or MG29) is a synaptophysin-family member protein localized specifically in the triad junction of skeletal muscle, where the transverse tubular (T-tubule) invagination of plasma membrane touches the terminal cistemae of sarcoplasmic reticulum (SR). The triad junction provides the structural framework for interaction between the dihydropyridine receptor/voltage sensor and the ryanodine receptor (RyR)/Ca release channel, and is essential for the operation of excitation-contraction (E-C) coupling. MG29 appears to be indispensable for triad formation, since swollen T-tubules and vacuolated SR networks are observed in skeletal muscle isolated from the mg29(-/-) mice. The long term goal of this project is to understand the cellular and molecular function of MG29 in E-C coupling of muscle cells, specifically to test the hypothesis that MG29 is a key protein involved in the biogenesis of the T-tubule system, and the proper organization of the T-tubule structure is essential for both short-term E-C coupling and long term cellular Ca homeostasis. A distinct phenotype of mg29(-/-) mice is their increased susceptibility to muscle fatigue, which may be linked to an altered Ca signaling in the mutant muscle. Aim 1 of this project is to correlate the MG29-mediated changes in membrane structure with short-term changes in voltage-induced Ca release (VICR) and Ca-induced Ca release (CICR) in skeletal muscle. The defective membrane structure associated with deletion of MG29 could alter the retrograde interaction between RyR and store-operated Ca channel (SOC) in the plasma membrane, and affect long-term Ca homeostasis in muscle cells. Aim 2 of this project will investigate the mechanism of SOC regulation in skeletal muscle by MG29, by exploring the potential interaction of MG29 with RyR, caveolin-3 and other associated proteins. Aim 3 is designed to further test the role of T-tubule structure in the differential mechanism of Ca signaling in cardiac and skeletal muscles. A transgenic mouse has been generated that switched the mg29 gene from skeletal to cardiac muscle (mhc. mg29). The changes in efficacy of E-C coupling in cardiac myocytes and skeletal myotubes isolated from the mhc-mg29 and mg29(-/-) mice will be compared with the wild type controls, in order to understand the contribution of T-tubules to Ca signaling
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in heart and skeletal muscle and the molecular basis of muscle fatigue. Overall, fulfillment of experiments proposed in this project shall lead us to better understanding of the molecular mechanism of E-C coupling, in particular with respect to the roles of MG29 and RyR in the activation of CICR, VICR, and SOC in cardiac and skeletal muscles. In addition, our studies with the mutant mice will provide new insights into the cellular mechanism of muscle exercise physiology and cardiovascular diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CERAMICS
SELF-HEALING,
FRACTURE
RESISTANT
RESTORATIVE
Principal Investigator & Institution: Griggs, Jason A.; Asst. Professor & Grad. Prog.Director; Biomaterials Science; Texas A&M University Health Science Ctr College Station, Tx 778433578 Timing: Fiscal Year 2002; Project Start 01-JAN-2002; Project End 31-DEC-2004 Summary: Dental ceramics are increasingly prolific as restorative materials because of their esthetic appearance and their intrinsic wear resistance, thermal insulation, and biocompatibility. Unfortunately, the currently available dental ceramics are brittle in comparison to dental alloys. This lack of fracture resistance compromises their strength and reliability, resulting in decreased lifetime expectancy. Previous strategies for increasing the lifetimes of dental ceramics have focused on improving the initial strength and tolerance to future damage; however, without a mechanism for repair, damage accumulates, and failure is inevitable. In contrast, natural materials have relatively low resistance to mechanical damage, but their usefulness is maintained over time by healing any damage that is sustained before it accumulates. The overall objective of this project is study self-healing mechanisms by which dental ceramics may exhibit mechanical fatigue resistance and increased longevity. This objective will be accomplished through incorporation of smectite clay particles in hydrothermal glass to form ceramic matrix composites, which will close cracks through the swelling of reinforcing particles. The experimental materials will be designed for use in esthetic, allceramic dental restorations. A commercially available low fusing ceramic (Duceram LFC) will be used as the control material for investigation of the following hypotheses: l) moisture- activated swelling of clay particles is a source of increased fracture resistance, 2) a maximum mean free path of 45 mum between reinforcing particles acts as a threshold for increased fracture resistance, 3) a mean reinforcing particle size smaller than 0.39 mum will result in materials with greater translucency than currently available ceramic core materials, 4) smectite clay-reinforced porcelains will exhibit similar or superior biocompatibility compared to unreinforced dental porcelain, and 5) smectite clay-reinforced porcelains will exhibit hardness and abrasive potential lower than those of unmodified dental I porcelain. These efforts may elucidate the mechanisms of fatigue failure and may result in materials that will fill the public demand for long-lasting, esthetic dental restorations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SIGNALS CONTROLLING OSTEOCYTE VIABILITY Principal Investigator & Institution: Bellido, Teresita M.; Research Associate Professor of Medicine; University of Arkansas Med Scis Ltl Rock 4301 W Markham St Little Rock, Ar 72205 Timing: Fiscal Year 2001; Project Start 27-AUG-1996; Project End 31-MAR-2006
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Summary: The functional syncytium comprising osteocytes, osteoblastic cells, marrow stromal cells, and endothelial cells of the blood vessels is thought to be the mechanosensory apparatus by which bone, as an organ, detects the need for mechanical adaptation and microdamage repair and initiates the appropriate adaptive responses. Consistent with this, studies leading to this project have revealed that the increased bone fragility that results from glucocorticoid excess in mice and humans is associated with increased bone fragility that results from glucocorticoid excess in mice and humans is associated with increased osteocyte apoptosis. Conversely, bisphosphonates and intermittent PTH, two treatments that are effective in steroid-induced osteoporosis (as well as estrogens, androgens, and calcitonin) prevent osteocyte and osteoblast apoptosis in vitro and in vivo. In addition, it has been demonstrated in vitro than the antiapoptotic effect of bisphosphonates and estrogens results from rapid activation of the extracellular signal-regulated kinases (ERKs) and that mechanical signals also cause ERK activation in osteocytic cells. Collectively, these lines of evidence give credence to the hypotheses that disruption of the osteocyte network by apoptosis, resulting from hormonal or strain changes, may contribute to microdamage accumulation and increased bone fragility; whereas prevention of osteocyte viability may increase bone strength. Hormonal, pharmacological, and mechanical signals converge on common signal transduction pathways that influence the viability of osteocytes and the integrity of the lacuno-canalicular network, to orchestrate the appropriate addition or removal of bone and participate in the detection and repair of fatigue microdamage. To advance this hypothesis, the effects of pro- and anti-apoptotic agents (glucocorticoids and bisphosphonates) as well as mechanical signals on focal adhesion molecules (FAK and Pyk2), MAP kinases, intracellular calcium, and connexin channels and hemichannels will be determined in vitro. Further, the contribution of osteocyte apoptosis to mechanical strength will be studied using a murine model of glucocorticoid excess treated with bisphosphonates. These studiers should chart the signaling pathways controlling osteocyte viability and advanced our understanding of the contribution of altered prevalence of osteocyte apoptosis to bone strength. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SKELETAL MUSCLE FATIGUE IN OLDER ADULTS Principal Investigator & Institution: Kent-Braun, Jane A.; Associate Professor; Exercise Science; University of Massachusetts Amherst 408 Goodell Building Amherst, Ma 01003 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): The overall goal is to determine the magnitude and mechanisms of age-related changes in muscle fatigue (decrease in maximal forcegenerating capacity, MVC). Clarification of the influence of age on fatigue has important implications for health and the maintenance of independent living in aging. We will study the ankle dorsiflexor and knee extensor muscles of healthy young (20-35 yrs) and older (70-85 yrs) adults. Muscle Metabolism and Perfusion (Years 1-2). ATP for muscular work is synthesized by 3 pathways: the creatine kinase (CK) reaction, oxidative phosphorylation and anaerobic glycolysis. Inadequate ATP supply can result in fatigue. Specific Aim I, Metabolic Capacity: To determine whether older muscle exhibits a decreased capacity to produce ATP. we will use magnetic resonance spectroscopy (MRS) to measure the capacities of these pathways. Hypotheses IA-C: Dorsiflexors will show A) similar CK kinetics, B) similar oxidative capacities, C) lower peak glycolytic rates in older adults. Hypotheses ID-F: Knee extensors will show D) similar CK kinetics, E) lower oxidative capacity in older, F) lower peak glycolytic rates in older adults. Specific Aim 2, Muscle Perfusion: To examine the relationships between
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dorsiflexor muscle strength, contraction intensity and blood flow occlusion, we will measure the reactive hyperemia of young and older adults using functional MR imaging during a series of isometric contractions. Hypothesis 2A: There will be no difference by age in the force (N) at the intersection of the bilinear relationship between the hyperemic response and absolute force. Hypothesis 2B: The intersection of the relationship between the hyperemic response and relative force will occur at a higher percentage of MVC. Muscle Fatigue (Years 3-5). Both muscle group and type of contraction may alter the outcome in studies of muscle fatigue in aging. Specific Aim 3, Muscle Group Specificity in Fatigue: To determine the impact of muscle and contraction type on the extent and mechanisms of fatigue in aging, we will compare dorsiflexor and knee extensor fatigue during maximal intermittent and maximal sustained isometric contractions We will measure activation, contractile function, metabolism and hyperemia. Hypothesis 3A: During the intermittent protocols, older will fatigue less and show less decrease in muscle pH. Hypothesis 3B: During the sustained protocols, older and young will fatigue similarly and have the same metabolic response. Hypothesis 3C: The magnitude of the age-based increase in fatigue resistance during the intermittent protocol will be greater in the dorsiflexors compared to the knee extensors. Specific Aim 4, Task Spec Specificity in Fatigue (Exploratory): In Years 4 and 5, we will 1) measure fatigue, activation and contractile function in the 2 muscle groups using isovelocity contractions, 2) use the Hill Model to investigate the role of contractile and series elastic properties in fatigue, and 3) develop methods to perform dynamic fatigue studies in the MRS system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SLEEP DISRUPTION IN NEW PARENTS: AN INTERVENTION TRIAL Principal Investigator & Institution: Lee, Kathryn A.; Professor and Livingston Chair; Family Health Care Nursing; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 01-JAN-2001; Project End 31-DEC-2003 Summary: This longitudinal study utilizes a stress and coping framework to test an intervention to minimize the stress of sleep disruption and thereby improve the outcomes for new parents after the birth of their first infant. Data from the principal investigator's previous research and knowledge of sleep hygiene principles provide the basis for this proposal. The primary aim is to test the effects of an environmentalbehavioral intervention on sleep, fatigue, well-being, and marital satisfaction. This intervention will be introduced prior to delivery to allow the couple to adapt to the equipment involved in the intervention. Hypotheses will be tested using repeated measures analysis of variance to determine mean group differences. It is expected that: 1) The experimental group of new mothers (n=60) and new fathers (n=60) will have significantly fewer awakenings, and higher sleep maintenance than control mothers (n=60) and fathers (n=60) at all 4 postpartum time points; 2) The experimental group of new mothers and new fathers will report significantly lower fatigue and higher wellbeing and marital satisfaction compared to controls at all four postpartum time points (2, 4, 8, and 12 weeks). A secondary aim is to describe the success by which new parents incorporate this intervention into their lifestyle and evaluate its feasibility for other firsttime parents. Level of satisfaction with the intervention package will be ascertained for both experimental fathers and experimental mothers before and after mothers return to work. Results from this study will be useful in developing an educational intervention package for distribution to all adults preparing for parenthood. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SLEEP REGULATION AND TUMOR NECROSIS FACTOR Principal Investigator & Institution: Krueger, James M.; Professor of Neurobiology; Vet & Comp Anat/Pharm/Physiol; Washington State University 423 Neill Hall Pullman, Wa 99164 Timing: Fiscal Year 2001; Project Start 01-AUG-1993; Project End 31-JUL-2005 Summary: (provided by applicant): Sleep is of central importance to neurobiology because to understand how the brain works, we will have to decipher the mechanisms and functions of sleep. The function(s) of sleep remain unknown and the humoral and neural mechanisms of sleep are incompletely understood. Most people intuitively recognize that sleep increases after sleep loss or during the course of an infection. There is much evidence that those sleep responses, as well as physiological sleep, are regulated, in part, by humoral mechanisms. We hypothesize that tumor necrosis factor alpha (TNF-alpha) is one of the key substances in sleep regulation. This hypothesis is based on studies showing: 1) TNF-alpha induces non-rapid eye movement sleep (NREMS); 2) inhibition of TNF-alpha inhibits spontaneous sleep and sleep responses induced by sleep loss or bacterial products; 3) TNF mRNA and TNF brain levels correlate with sleep propensity; 4) in humans, circulating TNF levels correlate with electroencephalogram slow-wave activity and increase after sleep loss or during several pathologies with associated fatigue, e.g., sleep apnea, rheumatoid arthritis, preeclampsia, multiple sclerosis. The proposed experiments seek to understand in mechanistic detail how TNF-alpha is involved in sleep regulation. We will determine whether blocking TNF-alpha or TNF-alpha production centrally attenuates systemic TNF-alpha-induced sleep responses; preliminary data show that vagotomy attenuates systemic TNF-alpha-induced NREMS (Specific Aim #1). We will investigate TNF-alpha regulation of NREMS within specific TNF-active sites in brain (Specific Aim #2). Preliminary data indicate that microinjection of TNF-alpha into the preoptic area enhances NREMS, whereas microinjection of an inhibitor of TNF-alpha reduces NREMS. Pharmacologic blockage of prostaglandins, adenosine, and interleukin-1, and sleep manipulation using sleep deprivation and acute mild increases in ambient temperature to enhance sleep, will be combined with microinjections of TNF-alpha or TNF-alpha inhibitors. We will also use gene arrays to determine the time course of sleep-sensitive changes in brain for TNF and TNF superfamily member mRNAs. Anticipated results will provide molecular-mechanistic advances to understand sleep regulation as well as aid our general understanding of cytokine regulation in the brain. We anticipate that results will be directly relevant to therapeutics, e.g., a TNF soluble receptor has already been shown to reduce fatigue associated with rheumatoid arthritis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: STAINING MICRODAMAGE
TECHNIQUES
FOR
MICRO-CT
IMAGING
OF
Principal Investigator & Institution: Roeder, Ryan K.; Aerospace and Mechanical Engr; University of Notre Dame 511 Main Bldg Notre Dame, in 46556 Timing: Fiscal Year 2002; Project Start 24-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): When bone is subjected to overloading or fatigue, its apparent elastic modulus decreases. The decreased modulus is the macroscopic manifestation of microdamage, microcracks, and, in cancellous bone, the fracture of trabeculae. The resulting localized decreases in the apparent level stiffness may result in an increased fracture risk due to redistribution of loads. From a biological adaptation standpoint, damage with the bone tissue is believed to stimulate remodeling. As such,
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damage development in bone has implications for both whole bone strength and bone adaptation. Current methods of assessing the presence of microdamage are limited to two-dimensional imaging of thin sections, and provide minimal information regarding the three-dimensional distribution of damage or orientation of cracks. However, the effects of damage on bone strength and stiffness cannot be fully assessed without this information. It has been shown that the modulus reduction of cortical bone differs for different modes of damaging loads. Similar findings have been reported for cancellous bone. These differences are likely due to different damage patterns, or localization of damage. Thus, the ability to quantify the three-dimensional distribution and location of damage in bone will provide insight into the concomitant macroscopic property changes. The goal of this study is to develop a methodology for three-dimensional detection and visualization of microdamage and microcracks in bone specimens in vitro using micro-computed tomography (muCT). A radio-opaque marker will be developed which preferentially attaches to damaged regions of bone by chelating to exposed calcium (e.g. on the new surfaces created by microcracks). The marker will appear as regions of increased density in muCT, allowing visualization of the damage pattern in three dimensions. Specifically, the aims of the study are to: 1. Identify one or more metal chelating agents having two or more carboxy functional groups (multi-functional carboxylic acids or proteins) that will chelate with both calcium in bone and one or more heavy metal ions which act as a radio-opaque markers. 2. Determine the optimum stain chemistry (Chelating agent and metal, concentrations, pH), staining technique, and exposure time for labeling microdamage in bone. 3. Identify the optimal scanning parameters for imaging microdamage in bone using micro-computed tomography (muCT) for each variant in the stain chemistry and staining technique. 4. Image the three-dimensional damage developed in cortical bone specimens following low cycle fatigue in four point bending. Differences in damage patterns due to pure bending and combined bending and shear loading will be identified. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STRESS, ADRENERGIC AND INFLAMMATORY FACTORS IN 4 DISORDERS Principal Investigator & Institution: Light, Kathleen C.; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2001; Project Start 01-AUG-1999; Project End 31-JUL-2004 Summary: Chronic fatigue syndrome (CFS), Temporomandibular Disorder (TMD) and Fibromyalgia (FM) are common chronic disabling disorders whose pathogenesis and treatment are not well understood, but which share four characteristics: sensitivity to life stress, signs of pain system dysregulation, psychological distress and negative affect, and possible alteration of inflammatory mediators. The focus of the present investigation is to compare 40 patients meeting accepted diagnostic criteria for each of these disorders with 40 age- and gender-matched healthy controls and with 40 patients diagnosed criteria for each of these disorders with 40 age- and gender-matched healthy controls and with 40 patients diagnosed with Rheumatoid Arthritis (RA), the prototypical chronic inflammatory disorder. To determine whether there is evidence of dysregulation of autonomic (particularly beta-adrenergic function, hypothalamicpituitary adrenocortical function (HPA), endogenous opioids, and inflammatory cytokine responses, these interacting physiological systems will be assessed during baseline and in response to two standardized stressors, a speech about interpersonal conflict and tourniquet-induced ischemic arm pain. Prior research has confirmed betaadrenergic mediation of stress-induced changes in immune parameters. Thus, each
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subject will be studied twice, once after placebo and once after acute pretreatment with the non-selective beta-receptor antagonist, propranolol, to confirm the hypothesized involvement of beta-receptor activity in the dysregulated responses of the CFS, TMD and FM groups. In a second study, these same patients will be recruited to enter a placebo-controlled, double-blind cross-over treatment trial (6 weeks) of propranolol's potential benefits in normalizing responses to lab stressors and real life demands, in decreasing pain hypersensitivity, and improving somatic and psychological symptoms. A novel aspect of these studies will be their focus on the relationships between HPA axis function, autonomic function and effects upon IL6, IL1beta, and TNFalpha, the cytokines forming the central cascade in initiation of the inflammatory response. This investigation will provide important and needed assessment of basic physiological alterations, as well as more concrete tests of the contribution of stress exposure, in CFS, TMD and FM patients. Further, by clarifying the hypothesized role of beta-adrenergic activity and benefits of beta-blockade, it also provides a starting point for research on more effective medical treatment in disorders which have been medically difficult to manage. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STRUCTURE & PROPERTIES OF HIGH PALLADIUM DENTAL ALLOYS Principal Investigator & Institution: Brantley, William A.; Professor; Restorative/Prosthetic Dentrsy; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2000; Project Start 01-AUG-1994; Project End 31-JUL-2004 Summary: (Adapted from the Applicant's Abstract): High-palladium alloys have become popular for metal-ceramic restorations and implant-supported prostheses, because of their much lower cost than gold alloys and their good mechanical properties. However, there is limited scientific knowledge about relationships between complex structures of these alloys and relevant clinical properties. For example, small compositional differences can result in unexplained substantial changes in mechanical properties, as well as metal-ceramic bond strength. A three-year project is proposed to continue research on structure-property relationships for commercial high-palladium alloys. Transmission electron microscopy (TEM) will be used to complete analyses of the tweed ultrastructure and learn whether this constituent dominates all high-palladium alloys, to determine the fundamental mechanisms for hardness and strength of these alloys, and to obtain basic information about creep and distortion of castings during fabrication of dental prostheses. Scanning electron microscopy (SEM) with x-ray energydispersive elemental analyses (EDS), x-ray photoelectron spectroscopy (XPS) and TEM will provide fundamental knowledge about the differences in metal-ceramic bond strength for various alloys. SEM/EDS analyses will also provide new information about the major roles of secondary microstructural phases for the hardness of these alloys, a matter of clinical concern. Flexural and tensile creep experiments will be performed at stress and high-temperature regimes appropriate for the fabrication of dental prostheses, to compare the creep resistance of representative alloys and determine whether single or multiple creep mechanisms are involved. Cyclic loading experiments using appropriate in vitro media, and both unnotched and notched test specimens, will establish the roles of alloy composition and microstructure for fatigue limits and crack propagation rates. XPS analyses of fracture surfaces will provide information about roles of various phases and impurities for failure. The results from this project will guide scientific development of new high-palladium alloys with optimum structures
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and properties, permitting delivery of improved, less expensive dental care to the public. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: STUDY OF T CELL CHARACTERISTICS AND ADHESION MOLECULES Principal Investigator & Institution: Bergasa, Nora V.; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2008 Summary: Primary biliary cirrhosis (PBC) is chronic liver disease of unknown etiology. Histologically, PBC is characterized by a progressive immunologically mediated inflammation known as chronic nonsuppurative destructive cholangitis (CNSDC) that leads to bile duct destruction, ductopenia and biliary cirrhosis. At present there is no cure for PBC. The most common symptoms associated with PBC are fatigue and pruritus. More than 90% of patients with PBC are women. The average age of diagnosis is about 50 years. Asymptomatic patients have a four-fold increase in mortality when compared to the U.S.A. population matched for age and the median survival from the onset of symptoms is 7.5 to 9 years. PBC is considered a model autoimmune disease; it is associated with hypergammaglobulinemia, autoantibodies, defects of immune regulation, and an increased incidence of other autoimmune conditions (thyroiditis, Sjogren's syndrome, scleroderma). The liver injury is characterized by a rich inflammatory infiltrate composed of CD4+ and CD8+ cells, cytokines, adhesion molecules and other immunologic mediators. The consequence of CNSDC is biliary cirrhosis and liver failure. The only treatment approved to treat PBC is ursodeoxycholic acid (UDCA), which appears to delay the time to liver transplantation but does not cure for the disease. Thus, the need for the provision of effective and safe treatments for PBC is clear. Patients with PBC may benefit from treatment with an appropriate immunosuppressive drug. Mycophenolate mofetil meets the criteria of a superior immunosuppressive agent. In this proposal we are going to explore immune mediators of PBC including T cells and adhesion molecules in patients with PBC and the effect of treatment with MMF in combination with UDCA on these factors in patients who are participants in a clinical trial. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE BIOMECHANICS OF OCCUPATIONAL SHOULDER INJURIES Principal Investigator & Institution: Karduna, Andrew R.; Rehabilitation Sciences; Mcp Hahnemann University Broad & Vine Sts Philadelphia, Pa 19102 Timing: Fiscal Year 2001; Project Start 01-AUG-2000; Project End 31-JUL-2002 Summary: Although the National Institute of Occupational Safety and Health (NIOSH) has identified a clear epidemiological link between repetitive arm motion and shoulder disorders in the workplace, there are few scientific data available regarding the biomechanics of this connection. This is surprising considering that occupational shoulder disorders have a direct medical cost of 4 billion dollars annually in the United States. There is evidence that repetitive motion is associated with muscle fatigue and abnormal shoulder motion, which in turn may lead to damage of the rotator cuff musculature. Based on this observation, the overall objective of this research proposal is to develop a simple index of muscle fatigue that is associated with repetitive arm motion and altered scapular kinematics. More specifically, the first specific aim is to determine if repetitive arm motion will lead to altered shoulder kinematics. It is
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hypothesized that fatigue of the scapular muscles during a repetitive arm motion will result in a decrease in scapular motion. The second specific aim is to identify a fatigue index to explain altered kinematics with repetitive motions. A fatigue index based on a muscle's EMG frequency components has been shown to be a good predictor of muscle impairment for low back muscles. It is hypothesized that a similar index for scapular muscles will be associated with alterations in scapular kinematics after repetitive motion. These hypotheses will be tested by having healthy volunteers with no shoulder pathologies perform a simulated work activity until they are fatigued. Based on the findings of NIOSH, this will be a high repetition and low load activity. Kinematics will be measured with a magnetic tracking device that has been found to be both reliable and accurate for measuring scapular motion. Fatigue susceptibility will be identified with a previously established muscle fatigue index. This proposal represents the first step towards developing a screening tool for assessing an individual's ability to resist the potentially harmful consequences of repetitive motion. Ultimately, this information will be used to develop both strategies for modifying work tasks, as well as conditioning programs for workers performing high risk activities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE ROLE OF ATTENTION IN SELF-REGULATION. Principal Investigator & Institution: Mann, Traci L.; Sociology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2007 Summary: (provided by applicant): This project explores the interacting role played by situational factors and individual mental processes in the self-regulation of emotions and behavior. From binge eating to excessive anger, many sources of adverse physical and mental health outcomes revolve around a common theme: the inability of individuals to control their own behavior. The goal of this research is to explain why individuals often fail at self-regulation and how they succeed. According to the analysis presented here, self-regulation typically demands a significant expenditure of mental resources. When those resources are limited in some fashion, the result is a state of affairs we term "attentional myopia," in which individuals can focus on only the most salient internal and external cues, to the neglect of more distal stimuli. Their subsequent behavior is then likely to be under the near-exclusive motivational influence of those "central" cues. This state of attentional narrowing is predicted to lead to disinhibited behavior when salient internal or situational cues serve to promote the behavior in question, and enhanced behavioral inhibition when those cues instead suggest restraint. The specific aims include 1) demonstrating the predictions of the attentional myopia model in studies of the self-regulation of smoking, anger, aggression, and other behaviors, 2) addressing two alternative explanations for phenomena explained by the model, 3) clarifying the specific cognitive processes through which attentional narrowing affects self-regulation, 4) examining whether attentional narrowing serves as the primary mediator between mental/physical fatigue and poor behavioral regulation , and 5) exploring the implications of the model for significant self-regulatory challenges. In a series of laboratory and field studies, cognitive load manipulations are crossed with manipulations of person and/or situational factors, and relevant behaviors are assessed. An enhanced understanding of the personal and situational sources of maladaptive selfregulation will contribute to the promotion of mental health and well-being among at-risk individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: VENLAFAXINE FOR HOT FLASHES FOLLOWING BREAST CANCER Principal Investigator & Institution: Carpenter, Janet S.; None; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 31-MAY-2004 Summary: Hot flashes are the most severe and fourth most prevalent menopausal symptom reported by women with breast cancer. Hot flashes affect over 65 percent of this population, with 59 percent rating the symptom as severe and 44 percent reporting they are extremely distressed by the symptom. Despite the high prevalence, severity and distress associated with this symptom, the scientific basis for managing hot flashes in women with breast cancer is limited. This randomized, double-blind, placebo-controlled crossover trial examines the effectiveness and toxicity of sustained release venlafaxine hydrochloride (37.5 mg po qd) on hot flashes in women following treatment for breast cancer. Venlafaxine is a phenylethylamine derivative that potently inhibits the reuptake of neuronal serotonin and norepinephrine and weakly inhibits the reuptake of dopamine. A secondary aim of this project is to examine the impact of hot flashes on psychological, behavioral, and physical outcomes. This study is based on the Wickham Symptom Management Model which depicts interrelationships between symptoms, symptom management strategies, and symptom management outcomes. Participants (n = 80) who are at least one month post-completion of surgery, radiation, and/or chemotherapy and who have been on tamoxifen (if prescribed) for at least 6 weeks will complete a 2-week baseline hot flash assessment and be randomized to one arm of the crossover trial. At the end of the first 6-week arm, participants will crossover to the opposite study arm for an additional 6 weeks. Outcomes to be assessed include effectiveness of the intervention (hot flash frequency, severity, distress and magnitude), toxicity of the intervention (subjective preference, side effects), psychological outcomes (mood disturbance), behavioral outcomes (quality of life, interference with daily activities) and physical outcomes (fatigue and sleep disturbance). Hot flashes will be measured daily, using a subjective, prospective diary methodology, and weekly, using objective state-of-the art 24-hour physiological monitoring of sternal skin conductance. Other outcomes will be measured weekly. Compliance with the intervention/placebo will be assessed weekly using medication blister pack cards. Timing of outcome assessments is based on limitations of the physiological monitoring device and expected timing of treatment effects. Summary statistics (i.e., mean, slope, maximum response, range, proportion, achievable difference) will be used to effectively reduce the design to a 2 X 2 crossover and data will be analyzed accordingly (i.e., t-tests, linear regression, GEE, mixed model). Study findings will significantly contribute to the scientific basis of hot flash management in women following treatment for breast cancer. 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 3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age.
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unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “fatigue” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for fatigue in the PubMed Central database: •
A population-based study of the clinical course of chronic fatigue syndrome. by Nisenbaum R, Jones JF, Unger ER, Reyes M, Reeves WC.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=269990
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Analysis of 16S rRNA gene sequences and circulating cell-free DNA from plasma of chronic fatigue syndrome and non-fatigued subjects. by Vernon SD, Shukla SK, Conradt J, Unger ER, Reeves WC.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=140017
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Cavitation Fatigue. Embolism and Refilling Cycles Can Weaken the Cavitation Resistance of Xylem. by Hacke UG, Stiller V, Sperry JS, Pittermann J, McCulloh KA.; 2001 Feb 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=64879
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Changes in Immune Parameters Seen in Gulf War Veterans but Not in Civilians with Chronic Fatigue Syndrome. by Zhang Q, Zhou XD, Denny T, Ottenweller JE, Lange G, LaManca JJ, Lavietes MH, Pollet C, Gause WC, Natelson BH.; 1999 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=95652
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Chronic fatigue and chronic fatigue syndrome in the general population. by Bleijenberg G.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=269992
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Detection of Immunologically Significant Factors for Chronic Fatigue Syndrome Using Neural-Network Classifiers. by Hanson SJ, Gause W, Natelson B.; 2001 May; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=96120
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Epidemiology of chronic fatigue syndrome and self reported myalgic encephalomyelitis in 5-15 year olds: cross sectional study. by Chalder T, Goodman R, Wessely S, Hotopf M, Meltzer H.; 2003 Sep 20; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=196393
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Evidence for the Presence of Immune Dysfunction in Chronic Fatigue Syndrome. by Natelson BH, Haghighi MH, Ponzio NM.; 2002 Jul; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=120010
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Fatigue, alcohol, and serious road crashes in France: factorial study of national data. by Philip P, Vervialle F, Le Breton P, Taillard J, Horne JA.; 2001 Apr 7; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=30559
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Frequency of deviant immunological test values in chronic fatigue syndrome patients. by Natelson BH, Ellis SP, Braonain PJ, DeLuca J, Tapp WN.; 1995 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=170136
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Functional status of persons with chronic fatigue syndrome in the Wichita, Kansas, population. by Solomon L, Nisenbaum R, Reyes M, Papanicolaou DA, Reeves WC.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=239865
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.
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Human herpesvirus 6 and human herpesvirus 7 in chronic fatigue syndrome. by Di Luca D, Zorzenon M, Mirandola P, Colle R, Botta GA, Cassai E.; 1995 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=228240
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Human Herpesviruses in Chronic Fatigue Syndrome. by Wallace HL II, Natelson B, Gause W, Hay J.; 1999 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=95690
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Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. by Verdon F, Burnand B, Stubi CL, Bonard C, Graff M, Michaud A, Bischoff T, de Vevey M, Studer JP, Herzig L, Chapuis C, Tissot J, Pecoud A, Favrat B.; 2003 May 24; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=156009
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No Evidence of Active Infection with Human Herpesvirus 6 (HHV-6) or HHV-8 in Chronic Fatigue Syndrome. by Enbom M, Linde A.; 2000 Jun; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=86845
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Randomised controlled trial of patient education to encourage graded exercise in chronic fatigue syndrome. by Powell P, Bentall RP, Nye FJ, Edwards RH.; 2001 Feb 17; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=26565
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Retroviral Sequences Related to Human T-Lymphotropic Virus Type II in Patients with Chronic Fatigue Immune Dysfunction Syndrome. by DeFreitas E, Hilliard B, Cheney PR, Bell DS, Kiggundu E, Sankey D, Wroblewska Z, Palladino M, P.Woodward J, Koprowski H.; 1991 Apr 1; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=51352
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RNase L Levels in Peripheral Blood Mononuclear Cells: 37-Kilodalton/83-Kilodalton Isoform Ratio Is a Potential Test for Chronic Fatigue Syndrome. by Tiev KP, Demettre E, Ercolano P, Bastide L, Lebleu B, Cabane J.; 2003 Mar; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=150526
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The "glycogen shunt" in exercising muscle: A role for glycogen in muscle energetics and fatigue. by Shulman RG, Rothman DL.; 2001 Jan 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=14608
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The effect of massage on localized lumbar muscle fatigue. by Tanaka TH, Leisman G, Mori H, Nishijo K.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=134459
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 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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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 fatigue, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “fatigue” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for fatigue (hyperlinks lead to article summaries): •
A 60-year-old man with progressive malaise, fatigue and decreased libido. Author(s): Chaudhry MU. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2003 September 2; 169(5): 445. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12952809&dopt=Abstract
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A comparison of three fatigue measures in veterans with cancer. Author(s): Hwang SS, Chang VT, Kasimis BS. Source: Cancer Investigation. 2003 June; 21(3): 363-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12901282&dopt=Abstract
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A measure of heart rate variability is sensitive to orthostatic challenge in women with chronic fatigue syndrome. Author(s): Yamamoto Y, LaManca JJ, Natelson BH. Source: Experimental Biology and Medicine (Maywood, N.J.). 2003 February; 228(2): 167-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12563023&dopt=Abstract
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A pilot randomized controlled trial of dexamphetamine in patients with chronic fatigue syndrome. Author(s): Olson LG, Ambrogetti A, Sutherland DC. Source: Psychosomatics. 2003 January-February; 44(1): 38-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12515836&dopt=Abstract
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A program to reduce fatigue in convalescing elderly adults. Author(s): Robinson S, Vollmer C, Hermes B. Source: Journal of Gerontological Nursing. 2003 May; 29(5): 47-53; Quiz 54-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765011&dopt=Abstract
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A qualitative investigation of fatigue among healthy working adults. Author(s): Aaronson LS, Pallikkathayil L, Crighton F. Source: Western Journal of Nursing Research. 2003 June; 25(4): 419-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12790057&dopt=Abstract
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A six-month trial of valacyclovir in the Epstein-Barr virus subset of chronic fatigue syndrome: improvement in left ventricular function. Author(s): Lerner AM, Beqaj SH, Deeter RG, Dworkin HJ, Zervos M, Chang CH, Fitzgerald JT, Goldstein J, O'Neill W. Source: Drugs Today (Barc). 2002 August; 38(8): 549-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12582420&dopt=Abstract
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A survivor's journey: one woman's experience with cancer-related fatigue. Author(s): Gilbert M. Source: The Oncologist. 2003; 8 Suppl 1: 3-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626780&dopt=Abstract
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Abnormal impedance cardiography predicts symptom severity in chronic fatigue syndrome. Author(s): Peckerman A, LaManca JJ, Dahl KA, Chemitiganti R, Qureishi B, Natelson BH. Source: The American Journal of the Medical Sciences. 2003 August; 326(2): 55-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12920435&dopt=Abstract
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Adherence, sleep, and fatigue outcomes after adjuvant breast cancer chemotherapy: results of a feasibility intervention study. Author(s): Berger AM, VonEssen S, Kuhn BR, Piper BF, Agrawal S, Lynch JC, Higginbotham P. Source: Oncology Nursing Forum. 2003 May-June; 30(3): 513-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719750&dopt=Abstract
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Advocate fatigue. Author(s): Beck JM 2nd. Source: J Ark Med Soc. 2000 November; 97(5): 149. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12876816&dopt=Abstract
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Aerobic capacity of Gulf War veterans with chronic fatigue syndrome. Author(s): Nagelkirk PR, Cook DB, Peckerman A, Kesil W, Sakowski T, Natelson BH, LaManca JJ. Source: Military Medicine. 2003 September; 168(9): 750-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14529252&dopt=Abstract
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Amantadine for fatigue in multiple sclerosis. Author(s): Taus C, Giuliani G, Pucci E, D'Amico R, Solari A. Source: Cochrane Database Syst Rev. 2003; (2): Cd002818. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804439&dopt=Abstract
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An approach to chronic fatigue syndrome in adults. Author(s): Sabin TD. Source: The Neurologist. 2003 January; 9(1): 28-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12801429&dopt=Abstract
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An epidemiological approach to study fatigue in the working population: the Maastricht Cohort Study. Author(s): Kant IJ, Bultmann U, Schroer KA, Beurskens AJ, Van Amelsvoort LG, Swaen GM. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I32-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782745&dopt=Abstract
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An on-road study to investigate fatigue in local/short haul trucking. Author(s): Hanowski RJ, Wierwille WW, Dingus TA. Source: Accident; Analysis and Prevention. 2003 March; 35(2): 153-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504135&dopt=Abstract
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An overview of chronic fatigue syndrome. Author(s): Jackson E. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2002 December 11-17; 17(13): 45-53; Quiz 54-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12572221&dopt=Abstract
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Applicability, validity, and reliability of the Piper Fatigue Scale in postpolio patients. Author(s): Strohschein FJ, Kelly CG, Clarke AG, Westbury CF, Shuaib A, Chan KM. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 2003 February; 82(2): 122-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544758&dopt=Abstract
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Are pilots at risk of accidents due to fatigue? Author(s): Goode JH. Source: Journal of Safety Research. 2003; 34(3): 309-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12963077&dopt=Abstract
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Are you a help-aholic? How to avoid compassion fatigue. Author(s): Wilson KE. Source: J Christ Nurs. 2003 Spring; 20(2): 23-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12683150&dopt=Abstract
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Assessing chronic fatigue. Author(s): Baschetti R. Source: Qjm : Monthly Journal of the Association of Physicians. 2003 June; 96(6): 454. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12788966&dopt=Abstract
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Assessment and management of cancer-related fatigue in adults. Author(s): Ahlberg K, Ekman T, Gaston-Johansson F, Mock V. Source: Lancet. 2003 August 23; 362(9384): 640-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12944066&dopt=Abstract
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Assessment of cortisol response with low-dose and high-dose ACTH in patients with chronic fatigue syndrome and healthy comparison subjects. Author(s): Gaab J, Huster D, Peisen R, Engert V, Heitz V, Schad T, Schurmeyer T, Ehlert U. Source: Psychosomatics. 2003 March-April; 44(2): 113-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618533&dopt=Abstract
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Assessment of fatigue among working people: a comparison of six questionnaires. Author(s): De Vries J, Michielsen HJ, Van Heck GL. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I10-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782741&dopt=Abstract
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Assessment of low back muscle fatigue by surface EMG signal analysis: methodological aspects. Author(s): Farina D, Gazzoni M, Merletti R. Source: Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology. 2003 August; 13(4): 319-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12832163&dopt=Abstract
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Assessment of muscle fatigue during biking. Author(s): Knaflitz M, Molinari F. Source: Ieee Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the Ieee Engineering in Medicine and Biology Society. 2003 March; 11(1): 17-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12797721&dopt=Abstract
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Associations between bronchial hyperresponsiveness and immune cell parameters in patients with chronic fatigue syndrome. Author(s): Nijs J, De Becker P, De Meirleir K, Demanet C, Vincken W, Schuermans D, McGregor N. Source: Chest. 2003 April; 123(4): 998-1007. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684286&dopt=Abstract
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Associations between fatigue attributions and fatigue, health, and psychosocial work characteristics: a study among employees visiting a physician with fatigue. Author(s): Andrea H, Kant IJ, Beurskens AJ, Metsemakers JF, Van Schayck CP. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I99-104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782755&dopt=Abstract
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Associations between infections and fatigue in a Dutch working population: results of the Maastricht Cohort Study on Fatigue at Work. Author(s): Mohren DC, Swaen GM, Kant IJ, Borm PJ, Galama JM. Source: European Journal of Epidemiology. 2001; 17(12): 1081-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530766&dopt=Abstract
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Autoantibodies against muscarinic cholinergic receptor in chronic fatigue syndrome. Author(s): Tanaka S, Kuratsune H, Hidaka Y, Hakariya Y, Tatsumi KI, Takano T, Kanakura Y, Amino N. Source: International Journal of Molecular Medicine. 2003 August; 12(2): 225-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12851722&dopt=Abstract
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Between-days reliability of electromyographic measures of paraspinal muscle fatigue at 40, 50 and 60% levels of maximal voluntary contractile force. Author(s): Arnall FA, Koumantakis GA, Oldham JA, Cooper RG. Source: Clinical Rehabilitation. 2002 November; 16(7): 761-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12428825&dopt=Abstract
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Biaxial flex-fatigue and viral penetration of natural rubber latex gloves before and after artificial aging. Author(s): Schwerin MR, Walsh DL, Coleman Richardson D, Kisielewski RW, Kotz RM, Routson LB, David Lytle C. Source: Journal of Biomedical Materials Research. 2002; 63(6): 739-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12418018&dopt=Abstract
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Biochemical markers for post-operative fatigue after major surgery. Author(s): McGuire J, Ross GL, Price H, Mortensen N, Evans J, Castell LM. Source: Brain Research Bulletin. 2003 April 15; 60(1-2): 125-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12725900&dopt=Abstract
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Birth order and its association with the onset of chronic fatigue syndrome. Author(s): Brimacombe M, Helmer DA, Natelson BH. Source: Human Biology; an International Record of Research. 2002 August; 74(4): 615-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12371687&dopt=Abstract
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Blood flow and muscle fatigue in SCI individuals during electrical stimulation. Author(s): Olive JL, Slade JM, Dudley GA, McCully KK. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 2003 February; 94(2): 7018. Epub 2002 October 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12391070&dopt=Abstract
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Blood flow and muscle metabolism in chronic fatigue syndrome. Author(s): McCully KK, Smith S, Rajaei S, Leigh JS Jr, Natelson BH. Source: Clinical Science (London, England : 1979). 2003 June; 104(6): 641-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12589704&dopt=Abstract
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Brain regions involved in fatigue sensation: reduced acetylcarnitine uptake into the brain. Author(s): Kuratsune H, Yamaguti K, Lindh G, Evengard B, Hagberg G, Matsumura K, Iwase M, Onoe H, Takahashi M, Machii T, Kanakura Y, Kitani T, Langstrom B, Watanabe Y. Source: Neuroimage. 2002 November; 17(3): 1256-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12414265&dopt=Abstract
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Can continuous physical training counteract aging effect on myoelectric fatigue? A surface electromyography study application. Author(s): Casale R, Rainoldi A, Nilsson J, Bellotti P. Source: Archives of Physical Medicine and Rehabilitation. 2003 April; 84(4): 513-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12690589&dopt=Abstract
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Cancer fatigue and its impact on patients: knowledge within the cancer care team. Author(s): Hammick M, Stone P; Cancer Fatigue Forum. Source: Journal of Interprofessional Care. 2003 May; 17(2): 183-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745294&dopt=Abstract
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Cancer fatigue: the way forward. Author(s): Curt G, Johnston PG. Source: The Oncologist. 2003; 8 Suppl 1: 27-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626786&dopt=Abstract
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Cancer, fatigue and the return of patients to work-a prospective cohort study. Author(s): Spelten ER, Verbeek JH, Uitterhoeve AL, Ansink AC, van der Lelie J, de Reijke TM, Kammeijer M, de Haes JC, Sprangers MA. Source: European Journal of Cancer (Oxford, England : 1990). 2003 July; 39(11): 1562-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12855263&dopt=Abstract
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Cancer-related fatigue in patients attending oncological rehabilitation programs: prevalence, patterns and predictors. Author(s): Bartsch HH, Weis J, Moser MT. Source: Onkologie. 2003 February; 26(1): 51-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12624518&dopt=Abstract
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Cancer-related fatigue: can exercise physiology assist oncologists? Author(s): Lucia A, Earnest C, Perez M. Source: The Lancet Oncology. 2003 October; 4(10): 616-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14554239&dopt=Abstract
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Cancer-related fatigue: evolving concepts in evaluation and treatment. Author(s): Stasi R, Abriani L, Beccaglia P, Terzoli E, Amadori S. Source: Cancer. 2003 November 1; 98(9): 1786-801. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14584059&dopt=Abstract
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Cancer-related fatigue--a difference of opinion? Results of a multicentre survey of healthcare professionals, patients and caregivers. Author(s): Stone P, Ream E, Richardson A, Thomas H, Andrews P, Campbell P, Dawson T, Edwards J, Goldie T, Hammick M, Kearney N, Lean M, Rapley D, Smith AG, Teague C, Young A. Source: European Journal of Cancer Care. 2003 March; 12(1): 20-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12641553&dopt=Abstract
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Cerebral and systemic hemodynamics changes during upright tilt in chronic fatigue syndrome. Author(s): Razumovsky AY, DeBusk K, Calkins H, Snader S, Lucas KE, Vyas P, Hanley DF, Rowe PC. Source: Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging. 2003 January; 13(1): 57-67. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12593133&dopt=Abstract
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Chronic fatigue and organophosphate pesticides in sheep farming: a retrospective study amongst people reporting to a UK pharmacovigilance scheme. Author(s): Tahmaz N, Soutar A, Cherrie JW. Source: The Annals of Occupational Hygiene. 2003 June; 47(4): 261-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12765866&dopt=Abstract
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Chronic fatigue syndrome and Addison's disease. Author(s): Baschetti R. Source: The Journal of Pediatrics. 2003 February; 142(2): 217; Author Reply 217-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12584556&dopt=Abstract
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Chronic fatigue syndrome and eating disorders: concurrence or coincidence? Author(s): Fisher M, Krilov LR, Ovadia M. Source: Int J Adolesc Med Health. 2002 October-December; 14(4): 307-16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12613112&dopt=Abstract
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Chronic fatigue syndrome in children: a cross sectional survey. Author(s): Patel MX, Smith DG, Chalder T, Wessely S. Source: Archives of Disease in Childhood. 2003 October; 88(10): 894-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14500310&dopt=Abstract
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Chronic fatigue syndrome, fibromyalgia, and complex regional pain syndrome type I. Author(s): Van Houdenhove B. Source: Psychosomatics. 2003 March-April; 44(2): 173-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12618538&dopt=Abstract
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Chronic fatigue syndrome: new evidence for a central fatigue disorder. Author(s): Georgiades E, Behan WM, Kilduff LP, Hadjicharalambous M, Mackie EE, Wilson J, Ward SA, Pitsiladis YP. Source: Clinical Science (London, England : 1979). 2003 August; 105(2): 213-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708966&dopt=Abstract
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Chronic fatigue syndrome: symptom subtypes in a community based sample. Author(s): Jason LA, Taylor RR, Kennedy CL, Jordan KM, Song S, Johnson D, TorresHarding S. Source: Women & Health. 2003; 37(1): 1-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12627607&dopt=Abstract
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Chronic fatigue syndrome: the nurse's role. Author(s): Aylett E, Fawcett TN. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2003 May 14-20; 17(35): 33-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12772385&dopt=Abstract
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Clinical correlates to muscle biopsy findings in HIV patients experiencing fatigue: a case series. Author(s): Zell SC, Nielsen S. Source: J Int Assoc Physicians Aids Care (Chic Ill). 2002 Summer; 1(3): 90-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12942681&dopt=Abstract
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Clinical neurophysiological approaches to neuromuscular fatigue. Author(s): Troger M, Vollestad N, Dengler R, Mills KR. Source: Suppl Clin Neurophysiol. 2000; 53: 433-42. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12741031&dopt=Abstract
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Combination therapy with hydrocortisone and fludrocortisone does not improve symptoms in chronic fatigue syndrome: a randomized, placebo-controlled, doubleblind, crossover study. Author(s): Blockmans D, Persoons P, Van Houdenhove B, Lejeune M, Bobbaers H. Source: The American Journal of Medicine. 2003 June 15; 114(9): 736-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12829200&dopt=Abstract
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Comparative study of anxiety, depression, somatization, functional disability, and illness attribution in adolescents with chronic fatigue or migraine. Author(s): Smith MS, Martin-Herz SP, Womack WM, Marsigan JL. Source: Pediatrics. 2003 April; 111(4 Pt 1): E376-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671155&dopt=Abstract
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Comparison of subjective and objective measures of insomnia in monozygotic twins discordant for chronic fatigue syndrome. Author(s): Watson NF, Kapur V, Arguelles LM, Goldberg J, Schmidt DF, Armitage R, Buchwald D. Source: Sleep. 2003 May 1; 26(3): 324-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749553&dopt=Abstract
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Compassion fatigue: who cares for the caregivers? The key to recovery. Author(s): Stevens-Guille B. Source: Alta Rn. 2003 July; 59(7): 18-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13677678&dopt=Abstract
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Compassion satisfaction, compassion fatigue, and critical incident stress management. Author(s): Wee D, Myers D. Source: Int J Emerg Ment Health. 2003 Winter; 5(1): 33-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12722488&dopt=Abstract
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Complement activation in a model of chronic fatigue syndrome. Author(s): Sorensen B, Streib JE, Strand M, Make B, Giclas PC, Fleshner M, Jones JF. Source: The Journal of Allergy and Clinical Immunology. 2003 August; 112(2): 397-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12897748&dopt=Abstract
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Contractile leg fatigue after cycle exercise: a factor limiting exercise in patients with chronic obstructive pulmonary disease. Author(s): Saey D, Debigare R, LeBlanc P, Mador MJ, Cote CH, Jobin J, Maltais F. Source: American Journal of Respiratory and Critical Care Medicine. 2003 August 15; 168(4): 425-30. Epub 2003 April 24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12714348&dopt=Abstract
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Correlates of illness worry in chronic fatigue syndrome. Author(s): Taillefer SS, Kirmayer LJ, Robbins JM, Lasry JC. Source: Journal of Psychosomatic Research. 2003 April; 54(4): 331-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670610&dopt=Abstract
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Costs, correlates and consequences of fatigue in children and adults. Author(s): White PD. Source: Psychological Medicine. 2003 February; 33(2): 197-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622299&dopt=Abstract
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Could fatigue become the sixth vital sign? Author(s): Biedrzycki BA. Source: Ons News / Oncology Nursing Society. 2003 April; 18(4): 1, 4-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12703243&dopt=Abstract
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Cross-cultural differences in the epidemiology of unexplained fatigue syndromes in primary care. Author(s): Skapinakis P, Lewis G, Mavreas V. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 March; 182: 205-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12611782&dopt=Abstract
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Deficit in motor performance correlates with changed corticospinal excitability in patients with chronic fatigue syndrome. Author(s): Davey NJ, Puri BK, Catley M, Main J, Nowicky AV, Zaman R. Source: Int J Clin Pract. 2003 May; 57(4): 262-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12800454&dopt=Abstract
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Depression, fatigue, and health-related quality of life among people with advanced multiple sclerosis: results from an exploratory telerehabilitation study. Author(s): Egner A, Phillips VL, Vora R, Wiggers E. Source: Neurorehabilitation. 2003; 18(2): 125-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12867675&dopt=Abstract
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Development of an algorithm for an EEG-based driver fatigue countermeasure. Author(s): Lal SK, Craig A, Boord P, Kirkup L, Nguyen H. Source: Journal of Safety Research. 2003; 34(3): 321-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12963079&dopt=Abstract
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Diagnosing chronic fatigue syndrome: comparison of a protocol and computerised questionnaires. Author(s): Prins JB, Elving LD, Koning H, Bleijenberg G, van der Meer JW. Source: The Netherlands Journal of Medicine. 2003 April; 61(4): 120-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12852720&dopt=Abstract
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Diaphragm pacing during prolonged mechanical ventilation of the lungs could prevent from respiratory muscle fatigue. Author(s): Pavlovic D, Wendt M. Source: Medical Hypotheses. 2003 March; 60(3): 398-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12581619&dopt=Abstract
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Differences between patients with chronic fatigue syndrome and with chronic fatigue at an infectious disease clinic in Stockholm, Sweden. Author(s): Evengard B, Jonzon E, Sandberg A, Theorell T, Lindh G. Source: Psychiatry and Clinical Neurosciences. 2003 August; 57(4): 361-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839515&dopt=Abstract
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Differential diagnosis and management of fatigue in multiple sclerosis: considerations for the nurse. Author(s): Costello K, Harris C. Source: The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses. 2003 June; 35(3): 139-48. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830661&dopt=Abstract
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Differential diagnosis for chronic fatigue syndrome. Author(s): Nelsen DA Jr. Source: American Family Physician. 2003 January 15; 67(2): 252; Author Reply 252. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562147&dopt=Abstract
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Discussion on the true impact of fatigue in primary biliary cirrhosis: a population study. Author(s): Kingham JG. Source: Gastroenterology. 2003 February; 124(2): 582; Author Reply 582. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12557171&dopt=Abstract
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Displaced fatigue fractures of the femoral shaft. Author(s): Salminen ST, Pihlajamaki HK, Visuri TI, Bostman OM. Source: Clinical Orthopaedics and Related Research. 2003 April; (409): 250-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671509&dopt=Abstract
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Distinguishing between excessive daytime sleepiness and fatigue: toward improved detection and treatment. Author(s): Pigeon WR, Sateia MJ, Ferguson RJ. Source: Journal of Psychosomatic Research. 2003 January; 54(1): 61-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505556&dopt=Abstract
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Distinguishing patients with chronic fatigue from those with chronic fatigue syndrome: a diagnostic study in UK primary care. Author(s): Darbishire L, Ridsdale L, Seed PT. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 2003 June; 53(491): 441-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12939888&dopt=Abstract
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Diverse etiologies for chronic fatigue syndrome. Author(s): Chia JK, Chia A. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 March 1; 36(5): 671-2; Author Reply 672-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12594650&dopt=Abstract
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Does graded activity increase activity? A case study of chronic fatigue syndrome. Author(s): Friedberg F. Source: Journal of Behavior Therapy and Experimental Psychiatry. 2002 SeptemberDecember; 33(3-4): 203-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12628637&dopt=Abstract
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Does the human heart fatigue subsequent to prolonged exercise? Author(s): Dawson E, George K, Shave R, Whyte G, Ball D. Source: Sports Medicine (Auckland, N.Z.). 2003; 33(5): 365-80. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12696984&dopt=Abstract
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Dyspnea on exertion, fatigue, and pallor in a 50-year-old active duty soldier. Author(s): Vermna PS, Gallagher CM. Source: Military Medicine. 2003 July; 168(7): 587-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12901473&dopt=Abstract
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Effect of a selected amino acid mixture on the recovery from muscle fatigue during and after eccentric contraction exercise training. Author(s): Sugita M, Ohtani M, Ishii N, Maruyama K, Kobayashi K. Source: Bioscience, Biotechnology, and Biochemistry. 2003 February; 67(2): 372-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729001&dopt=Abstract
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Effect of fatigue on torque output and electromyographic measures of trunk muscles during isometric axial rotation. Author(s): Ng JK, Parnianpour M, Richardson CA, Kippers V. Source: Archives of Physical Medicine and Rehabilitation. 2003 March; 84(3): 374-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638105&dopt=Abstract
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Effect of fatigue testing on core integrity and post microleakage of teeth restored with different post systems. Author(s): Reid LC, Kazemi RB, Meiers JC. Source: Journal of Endodontics. 2003 February; 29(2): 125-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597713&dopt=Abstract
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Effect of force level and training status on contractile properties following fatigue. Author(s): Garland SJ, Walton D, Ivanova TD. Source: Canadian Journal of Applied Physiology = Revue Canadienne De Physiologie Appliquee. 2003 February; 28(1): 93-101. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12671198&dopt=Abstract
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Effect of hydration and vocal rest on the vocal fatigue in amateur karaoke singers. Author(s): Yiu EM, Chan RM. Source: Journal of Voice : Official Journal of the Voice Foundation. 2003 June; 17(2): 21627. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12825654&dopt=Abstract
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Effect of rescuer fatigue on performance of continuous external chest compressions over 3 min. Author(s): Ashton A, McCluskey A, Gwinnutt CL, Keenan AM. Source: Resuscitation. 2002 November; 55(2): 151-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413752&dopt=Abstract
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Effects of a pulsed electromagnetic therapy on multiple sclerosis fatigue and quality of life: a double-blind, placebo controlled trial. Author(s): Lappin MS, Lawrie FW, Richards TL, Kramer ED. Source: Alternative Therapies in Health and Medicine. 2003 July-August; 9(4): 38-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12868251&dopt=Abstract
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Effects of an energy conservation course on fatigue impact for persons with progressive multiple sclerosis. Author(s): Vanage SM, Gilbertson KK, Mathiowetz V. Source: Am J Occup Ther. 2003 May-June; 57(3): 315-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785670&dopt=Abstract
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Effects of exercise-induced fatigue with and without hydration on static postural control in adult human subjects. Author(s): Gauchard GC, Gangloff P, Vouriot A, Mallie JP, Perrin PP. Source: The International Journal of Neuroscience. 2002 October; 112(10): 1191-206. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587522&dopt=Abstract
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Effects of fatigue on physical activity and function in patients with Parkinson's disease. Author(s): Garber CE, Friedman JH. Source: Neurology. 2003 April 8; 60(7): 1119-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682317&dopt=Abstract
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Effects of fatigue on the torque-velocity relation in muscle. Author(s): Spendiff O, Longford NT, Winter EM. Source: British Journal of Sports Medicine. 2002 December; 36(6): 431-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12453837&dopt=Abstract
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Effects of local fatigue of the lower limbs on postural control and postural stability in standing posture. Author(s): Caron O. Source: Neuroscience Letters. 2003 April 10; 340(2): 83-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12668242&dopt=Abstract
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Effects of muscle fatigue on 3-dimensional scapular kinematics. Author(s): Tsai NT, McClure PW, Karduna AR. Source: Archives of Physical Medicine and Rehabilitation. 2003 July; 84(7): 1000-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12881824&dopt=Abstract
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Effects of muscle glycogen on performance of repeated sprints and mechanisms of fatigue. Author(s): Rockwell MS, Rankin JW, Dixon H. Source: International Journal of Sport Nutrition and Exercise Metabolism. 2003 March; 13(1): 1-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660402&dopt=Abstract
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Electromyographic fatigue threshold of erector spinae muscle induced by a muscular endurance test in health men. Author(s): Cardozo AC, Goncalves M. Source: Electromyogr Clin Neurophysiol. 2003 September; 43(6): 377-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14535051&dopt=Abstract
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Embedded assumptions in qualitative studies of fatigue. Author(s): Paterson B, Canam C, Joachim G, Thorne S. Source: Western Journal of Nursing Research. 2003 March; 25(2): 119-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666639&dopt=Abstract
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EMG frequency content changes with increasing force and during fatigue in the quadriceps femoris muscle of men and women. Author(s): Bilodeau M, Schindler-Ivens S, Williams DM, Chandran R, Sharma SS. Source: Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology. 2003 February; 13(1): 83-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488090&dopt=Abstract
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Engine-driven preparation of curved root canals: measuring cyclic fatigue and other physical parameters. Author(s): Peters OA, Kappeler S, Bucher W, Barbakow F. Source: Aust Endod J. 2002 April; 28(1): 11-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12360676&dopt=Abstract
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Ensure that funding for fatigue research is money well spent. Author(s): Wujcik D. Source: Ons News / Oncology Nursing Society. 2003 April; 18(4): 2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12703244&dopt=Abstract
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Enterovirus related metabolic myopathy: a postviral fatigue syndrome. Author(s): Lane RJ, Soteriou BA, Zhang H, Archard LC. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 October; 74(10): 13826. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14570830&dopt=Abstract
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Enteroviruses in chronic fatigue syndrome: “now you see them, now you don't”. Author(s): Dalakas MC. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 October; 74(10): 13612. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14570825&dopt=Abstract
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Epidemiology of chronic fatigue syndrome and self reported myalgic encephalomyelitis in 5-15 year olds: cross sectional study. Author(s): Chalder T, Goodman R, Wessely S, Hotopf M, Meltzer H. Source: Bmj (Clinical Research Ed.). 2003 September 20; 327(7416): 654-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14500438&dopt=Abstract
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Ergonomics: muscle fatigue, posture, magnification, and illumination. Author(s): Andrews N, Vigoren G. Source: Compend Contin Educ Dent. 2002 March; 23(3): 261-6, 268, 270 Passim; Quiz 274. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785139&dopt=Abstract
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Evaluating adolescents with fatigue: ever get tired of it? Author(s): Cavanaugh RM Jr. Source: Pediatrics in Review / American Academy of Pediatrics. 2002 October; 23(10): 337-48. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12359868&dopt=Abstract
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Examining the influence of biological and psychological factors on cognitive performance in chronic fatigue syndrome: a randomized, double-blind, placebocontrolled, crossover study. Author(s): Smith S, Sullivan K. Source: International Journal of Behavioral Medicine. 2003; 10(2): 162-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12763708&dopt=Abstract
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Excitation-contraction coupling and fatigue mechanisms in skeletal muscle: studies with mechanically skinned fibres. Author(s): Lamb GD. Source: Journal of Muscle Research and Cell Motility. 2002; 23(1): 81-91. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12363289&dopt=Abstract
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Exercise reduces fatigue in chronic fatigued Hodgkins disease survivors--results from a pilot study. Author(s): Oldervoll LM, Kaasa S, Knobel H, Loge JH. Source: European Journal of Cancer (Oxford, England : 1990). 2003 January; 39(1): 57-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504659&dopt=Abstract
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Exercise training and skeletal muscle inflammation in chronic heart failure: feeling better about fatigue. Author(s): Mann DL, Reid MB. Source: Journal of the American College of Cardiology. 2003 September 3; 42(5): 869-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12957434&dopt=Abstract
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Exhausting fatigue influences F-wave and peripheral conduction velocity, following lumbar radiculopathy. Author(s): Tsur A, Glass I, Solzi P. Source: Disability and Rehabilitation. 2002 September 10; 24(13): 647-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12296980&dopt=Abstract
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Experimental evidence for interpretive but not attention biases towards somatic information in patients with chronic fatigue syndrome. Author(s): Moss-Morris R, Petrie KJ. Source: British Journal of Health Psychology. 2003 May; 8(Pt 2): 195-208. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804333&dopt=Abstract
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Fatigue analysis of the surface EMG signal in isometric constant force contractions using the averaged instantaneous frequency. Author(s): Georgakis A, Stergioulas LK, Giakas G. Source: Ieee Transactions on Bio-Medical Engineering. 2003 February; 50(2): 262-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12665043&dopt=Abstract
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Fatigue and exposure to cigarette smoke. Author(s): Hicks RA, Fernandez C, Hicks GJ. Source: Psychological Reports. 2003 June; 92(3 Pt 1): 1040-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841482&dopt=Abstract
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Fatigue and sleep disturbance in patients with cancer, patients with clinical depression, and community-dwelling adults. Author(s): Anderson KO, Getto CJ, Mendoza TR, Palmer SN, Wang XS, Reyes-Gibby CC, Cleeland CS. Source: Journal of Pain and Symptom Management. 2003 April; 25(4): 307-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691682&dopt=Abstract
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Fatigue as a predictor of sickness absence: results from the Maastricht cohort study on fatigue at work. Author(s): Janssen N, Kant IJ, Swaen GM, Janssen PP, Schroer CA. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I71-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782750&dopt=Abstract
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Fatigue as a risk factor for being injured in an occupational accident: results from the Maastricht Cohort Study. Author(s): Swaen GM, Van Amelsvoort LG, Bultmann U, Kant IJ. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I88-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782753&dopt=Abstract
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Fatigue at work. Author(s): Van Dijk FJ, Swaen GM. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782739&dopt=Abstract
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Fatigue behavior of the resin-resin bond of partially replaced resin-based composite restorations. Author(s): Frankenberger R, Kramer N, Ebert J, Lohbauer U, Kappel S, ten Weges S, Petschelt A. Source: Am J Dent. 2003 February; 16(1): 17-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12744407&dopt=Abstract
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Fatigue complaints among female shift workers in a computer factory of Japan. Author(s): Sudo N, Ohtsuka R. Source: J Hum Ergol (Tokyo). 2002 December; 31(1-2): 41-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12908334&dopt=Abstract
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Fatigue crack propagation path across the dentinoenamel junction complex in human teeth. Author(s): Dong XD, Ruse ND. Source: Journal of Biomedical Materials Research. 2003 July 1; 66A(1): 103-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833436&dopt=Abstract
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Fatigue in a community sample of twins. Author(s): Sullivan PF, Kovalenko P, York TP, Prescott CA, Kendler KS. Source: Psychological Medicine. 2003 February; 33(2): 263-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622305&dopt=Abstract
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Fatigue in adults with cerebral palsy in Norway compared with the general population. Author(s): Jahnsen R, Villien L, Stanghelle JK, Holm I. Source: Developmental Medicine and Child Neurology. 2003 May; 45(5): 296-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729142&dopt=Abstract
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Fatigue in employees with diabetes: its relation with work characteristics and diabetes related burden. Author(s): Weijman I, Ros WJ, Rutten GE, Schaufeli WB, Schabracq MJ, Winnubst JA. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I93-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782754&dopt=Abstract
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Fatigue in HIV/AIDS is associated with depression and subjective neurocognitive complaints but not neuropsychological functioning. Author(s): Millikin CP, Rourke SB, Halman MH, Power C. Source: J Clin Exp Neuropsychol. 2003 April; 25(2): 201-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12754678&dopt=Abstract
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Fatigue in multiple sclerosis: definition, pathophysiology and treatment. Author(s): Krupp LB. Source: Cns Drugs. 2003; 17(4): 225-34. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12665396&dopt=Abstract
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Fatigue in Myasthenia Gravis patients. Author(s): Kittiwatanapaisan W, Gauthier DK, Williams AM, Oh SJ. Source: The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses. 2003 April; 35(2): 87-93, 106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795035&dopt=Abstract
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Fatigue in systemic lupus erythematosus: a randomized controlled trial of exercise. Author(s): Tench CM, McCarthy J, McCurdie I, White PD, D'Cruz DP. Source: Rheumatology (Oxford, England). 2003 September; 42(9): 1050-4. Epub 2003 April 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12730519&dopt=Abstract
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Fatigue in the general population. Author(s): Schwarz R, Krauss O, Hinz A. Source: Onkologie. 2003 April; 26(2): 140-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771522&dopt=Abstract
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Fatigue is associated with high circulating leptin levels in chronic hepatitis C. Author(s): Romero-Gomez M, Sanchez-Munoz D, Cruz M. Source: Gut. 2003 June; 52(6): 915. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12740359&dopt=Abstract
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Fatigue load of teeth restored with bonded direct composite and indirect ceramic inlays in MOD class II cavity preparations. Author(s): Shor A, Nicholls JI, Phillips KM, Libman WJ. Source: Int J Prosthodont. 2003 January-February; 16(1): 64-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12675458&dopt=Abstract
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Fatigue of paralyzed and control thenar muscles induced by variable or constant frequency stimulation. Author(s): Thomas CK, Griffin L, Godfrey S, Ribot-Ciscar E, Butler JE. Source: Journal of Neurophysiology. 2003 April; 89(4): 2055-64. Epub 2002 December 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12611940&dopt=Abstract
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Fatigue resistance of removable orthodontic appliance reinforced with glass fibre weave. Author(s): Rantala LI, Lastumaki TM, Peltomaki T, Vallittu PK. Source: Journal of Oral Rehabilitation. 2003 May; 30(5): 501-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752930&dopt=Abstract
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Fatigue strength of a wire passing through a cannulated screw: implications for closure of the sternum following cardiac surgery. Author(s): Jutley RS, Shepherd DE, Hukins DW. Source: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine. 2003; 217(3): 221-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12807163&dopt=Abstract
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Fatigue testing and performance of acrylic bone-cement materials: state-of-the-art review. Author(s): Lewis G. Source: Journal of Biomedical Materials Research. 2003 July 15; 66B(1): 457-86. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12808608&dopt=Abstract
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Fatigue testing of a proximal femoral hip component. Author(s): Macdonald W, Carlsson LV, Gathercole N, Jacobsson CM. Source: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine. 2003; 217(2): 137-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12666781&dopt=Abstract
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Fatigue, burnout, and chronic fatigue syndrome among employees on sick leave: do attributions make the difference? Author(s): Huibers MJ, Beurskens AJ, Prins JB, Kant IJ, Bazelmans E, Van Schayck CP, Knottnerus JA, Bleijenberg G. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I26-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782744&dopt=Abstract
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Fatigue, sleep restriction, and performance in automobile drivers: a controlled study in a natural environment. Author(s): Philip P, Sagaspe P, Taillard J, Moore N, Guilleminault C, Sanchez-Ortuno M, Akerstedt T, Bioulac B. Source: Sleep. 2003 May 1; 26(3): 277-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749545&dopt=Abstract
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Fighting fatigue. More than just a resident issue? Author(s): Schaffner M. Source: Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates. 2003 March-April; 26(2): 82-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682529&dopt=Abstract
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Financial, occupational, and personal consequences of disability in patients with chronic fatigue syndrome and fibromyalgia compared to other fatiguing conditions. Author(s): Assefi NP, Coy TV, Uslan D, Smith WR, Buchwald D. Source: The Journal of Rheumatology. 2003 April; 30(4): 804-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12672203&dopt=Abstract
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Fludrocortisone and chronic fatigue syndrome. Author(s): Baschetti R. Source: N Z Med J. 2003 August 8; 116(1179): U549. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14513090&dopt=Abstract
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Functional status, neuropsychological functioning, and mood in chronic fatigue syndrome (CFS): relationship to psychiatric disorder. Author(s): Tiersky LA, Matheis RJ, Deluca J, Lange G, Natelson BH. Source: The Journal of Nervous and Mental Disease. 2003 May; 191(5): 324-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12819552&dopt=Abstract
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Gender-specific knee extensor torque, flexor torque, and muscle fatigue responses during maximal effort contractions. Author(s): Pincivero DM, Gandaio CM, Ito Y. Source: European Journal of Applied Physiology. 2003 April; 89(2): 134-41. Epub 2003 January 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12665976&dopt=Abstract
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Grading autonomic dysfunction in chronic fatigue syndrome. Author(s): Ferreira AC, de Marchena E. Source: Seminars in Arthritis and Rheumatism. 2002 December; 32(3): 137-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12528076&dopt=Abstract
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Heat stress evaluation and worker fatigue in a steel plant. Author(s): Chen ML, Chen CJ, Yeh WY, Huang JW, Mao IF. Source: Aiha Journal : a Journal for the Science of Occupational and Environmental Health and Safety. 2003 May-June; 64(3): 352-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12809541&dopt=Abstract
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Hemodynamic and neurohumoral responses to head-up tilt in patients with chronic fatigue syndrome. Author(s): Timmers HJ, Wieling W, Soetekouw PM, Bleijenberg G, Van Der Meer JW, Lenders JW. Source: Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society. 2002 August; 12(4): 273-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12357281&dopt=Abstract
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Hemodynamics instability score in chronic fatigue syndrome and in non-chronic fatigue syndrome. Author(s): Naschitz JE, Sabo E, Naschitz S, Rosner I, Rozenbaum M, Fields M, Isseroff H, Priselac RM, Gaitini L, Eldar S, Zukerman E, Yeshurun D, Madelain F, Isseroff H. Source: Seminars in Arthritis and Rheumatism. 2002 December; 32(3): 141-8. Erratum In: Semin Arthritis Rheum. 2003 April; 32(5): 343. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12528078&dopt=Abstract
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High prevalence of fatigue in quiescent inflammatory bowel disease is not related to adrenocortical insufficiency. Author(s): Minderhoud IM, Oldenburg B, van Dam PS, van Berge Henegouwen GP. Source: The American Journal of Gastroenterology. 2003 May; 98(5): 1088-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12809832&dopt=Abstract
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High prevalence of Mycoplasma infections among European chronic fatigue syndrome patients. Examination of four Mycoplasma species in blood of chronic fatigue syndrome patients. Author(s): Nijs J, Nicolson GL, De Becker P, Coomans D, De Meirleir K. Source: Fems Immunology and Medical Microbiology. 2002 November 15; 34(3): 209-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12423773&dopt=Abstract
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High rates of autoimmune and endocrine disorders, fibromyalgia, chronic fatigue syndrome and atopic diseases among women with endometriosis: a survey analysis. Author(s): Sinaii N, Cleary SD, Ballweg ML, Nieman LK, Stratton P. Source: Human Reproduction (Oxford, England). 2002 October; 17(10): 2715-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12351553&dopt=Abstract
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Homeopathic treatment of Chronic Fatigue Syndrome: three case studies using Jan Scholten's methodology. Author(s): Geraghty J. Source: Homeopathy. 2002 April; 91(2): 99-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12371465&dopt=Abstract
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How sleep is related to fatigue. Author(s): Lavidor M, Weller A, Babkoff H. Source: British Journal of Health Psychology. 2003 February; 8(Pt 1): 95-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643819&dopt=Abstract
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Human brain activation during sustained and intermittent submaximal fatigue muscle contractions: an FMRI study. Author(s): Liu JZ, Shan ZY, Zhang LD, Sahgal V, Brown RW, Yue GH. Source: Journal of Neurophysiology. 2003 July; 90(1): 300-12. Epub 2003 March 12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12634278&dopt=Abstract
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Human skeletal muscle responses vary with age and gender during fatigue due to incremental isometric exercise. Author(s): Kent-Braun JA, Ng AV, Doyle JW, Towse TF. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 2002 November; 93(5): 1813-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12381770&dopt=Abstract
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Hypothalamic-pituitary-adrenal axis reactivity in chronic fatigue syndrome and health under psychological, physiological, and pharmacological stimulation. Author(s): Gaab J, Huster D, Peisen R, Engert V, Heitz V, Schad T, Schurmeyer TH, Ehlert U. Source: Psychosomatic Medicine. 2002 November-December; 64(6): 951-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12461200&dopt=Abstract
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Ideal versus reality: physicians perspectives on patients with chronic fatigue syndrome (CFS) and fibromyalgia. Author(s): Asbring P, Narvanen AL. Source: Social Science & Medicine (1982). 2003 August; 57(4): 711-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12821018&dopt=Abstract
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Immunological variables mediate cognitive dysfunction in gulf war veterans but not civilians with chronic fatigue syndrome. Author(s): Brimacombe M, Zhang Q, Lange G, Natelson BH. Source: Neuroimmunomodulation. 2002-2003; 10(2): 93-100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12372983&dopt=Abstract
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In vitro fatigue behavior of human dentin with implications for life prediction. Author(s): Nalla RK, Imbeni V, Kinney JH, Staninec M, Marshall SJ, Ritchie RO. Source: Journal of Biomedical Materials Research. 2003 July 1; 66A(1): 10-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833426&dopt=Abstract
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In vitro training program to improve ambidextrous skill and reduce physical fatigue during laparoscopic surgery: preliminary experience. Author(s): Gupta R, Guillonneau B, Cathelineau X, Baumert H, Vallencien G. Source: Journal of Endourology / Endourological Society. 2003 June; 17(5): 323-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12885359&dopt=Abstract
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Increased metabolic muscle fatigue is caused by some but not all mitochondrial mutations. Author(s): Schulte-Mattler WJ, Muller T, Deschauer M, Gellerich FN, Iaizzo PA, Zierz S. Source: Archives of Neurology. 2003 January; 60(1): 50-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12533088&dopt=Abstract
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Influence of different stimulation frequencies on power output and fatigue during FES-cycling in recently injured SCI people. Author(s): Eser PC, Donaldson Nde N, Knecht H, Stussi E. Source: Ieee Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the Ieee Engineering in Medicine and Biology Society. 2003 September; 11(3): 236-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14518786&dopt=Abstract
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Inspiratory muscle fatigue in swimmers after a single 200 m swim. Author(s): Lomax ME, McConnell AK. Source: Journal of Sports Sciences. 2003 August; 21(8): 659-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12875316&dopt=Abstract
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Interaction of fibre type, potentiation and fatigue in human knee extensor muscles. Author(s): Hamada T, Sale DG, MacDougall JD, Tarnopolsky MA. Source: Acta Physiologica Scandinavica. 2003 June; 178(2): 165-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12780391&dopt=Abstract
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Interpretation of EMG changes with fatigue: facts, pitfalls, and fallacies. Author(s): Dimitrova NA, Dimitrov GV. Source: Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology. 2003 February; 13(1): 13-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12488084&dopt=Abstract
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Interventions for the treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis. Author(s): Bagnall AM, Whiting P, Richardson R, Sowden AJ. Source: Quality & Safety in Health Care. 2002 September; 11(3): 284-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12486997&dopt=Abstract
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Introduction: All Ireland Fatigue Coalition. Author(s): Daly PA. Source: The Oncologist. 2003; 8 Suppl 1: 1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626779&dopt=Abstract
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Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. Author(s): Verdon F, Burnand B, Stubi CL, Bonard C, Graff M, Michaud A, Bischoff T, de Vevey M, Studer JP, Herzig L, Chapuis C, Tissot J, Pecoud A, Favrat B. Source: Bmj (Clinical Research Ed.). 2003 May 24; 326(7399): 1124. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12763985&dopt=Abstract
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Iron supplementation improves progressive fatigue resistance during dynamic knee extensor exercise in iron-depleted, nonanemic women. Author(s): Brutsaert TD, Hernandez-Cordero S, Rivera J, Viola T, Hughes G, Haas JD. Source: The American Journal of Clinical Nutrition. 2003 February; 77(2): 441-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540406&dopt=Abstract
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Is the significance of postpartum fatigue being overlooked in the lives of women? Author(s): Troy NW. Source: Mcn. the American Journal of Maternal Child Nursing. 2003 July-August; 28(4): 252-7; Quiz 258-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12840692&dopt=Abstract
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Is weaning failure caused by low-frequency fatigue of the diaphragm? Author(s): Laghi F, Cattapan SE, Jubran A, Parthasarathy S, Warshawsky P, Choi YS, Tobin MJ. Source: American Journal of Respiratory and Critical Care Medicine. 2003 January 15; 167(2): 120-7. Epub 2002 October 31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12411288&dopt=Abstract
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Item banking to improve, shorten and computerize self-reported fatigue: an illustration of steps to create a core item bank from the FACIT-Fatigue Scale. Author(s): Lai JS, Cella D, Chang CH, Bode RK, Heinemann AW. Source: Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation. 2003 August; 12(5): 485-501. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13677494&dopt=Abstract
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L-carnitine decreases severity and type of fatigue induced by interferon-alpha in the treatment of patients with hepatitis C. Author(s): Neri S, Pistone G, Saraceno B, Pennisi G, Luca S, Malaguarnera M. Source: Neuropsychobiology. 2003; 47(2): 94-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12707492&dopt=Abstract
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Mark Twain and his family's health: Livy Clemens' neurasthenia in the gilded age and chronic fatigue syndrome of today. Author(s): Arcari R, Crombie HD. Source: Conn Med. 2003 May; 67(5): 293-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12802844&dopt=Abstract
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Match performance of high-standard soccer players with special reference to development of fatigue. Author(s): Mohr M, Krustrup P, Bangsbo J. Source: Journal of Sports Sciences. 2003 July; 21(7): 519-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12848386&dopt=Abstract
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Measuring fatigue in patients with Parkinson's disease - the Fatigue Severity Scale. Author(s): Herlofson K, Larsen JP. Source: European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies. 2002 November; 9(6): 595-600. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12453074&dopt=Abstract
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Measuring fatigue in people with multiple sclerosis. Author(s): Chipchase SY, Lincoln NB, Radford KA. Source: Disability and Rehabilitation. 2003 July 22; 25(14): 778-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12959358&dopt=Abstract
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Measuring fatigue severity in primary care patients. Author(s): Hartz A, Bentler S, Watson D. Source: Journal of Psychosomatic Research. 2003 June; 54(6): 515-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12781305&dopt=Abstract
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Mechanical strength, fatigue life, and failure analysis of two prototypes and five conventional tibial locking screws. Author(s): Hou SM, Wang JL, Lin J. Source: Journal of Orthopaedic Trauma. 2002 November-December; 16(10): 701-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12439193&dopt=Abstract
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Mental fatigue and the control of cognitive processes: effects on perseveration and planning. Author(s): van der Linden D, Frese M, Meijman TF. Source: Acta Psychologica. 2003 May; 113(1): 45-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12679043&dopt=Abstract
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Microdialysis and electromyography of experimental muscle fatigue in healthy volunteers and patients with mitochondrial myopathy. Author(s): Axelson HW, Melberg A, Ronquist G, Askmark H. Source: Muscle & Nerve. 2002 October; 26(4): 520-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12362418&dopt=Abstract
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Mild versus severe fatigue in polio survivors: special characteristics. Author(s): Schanke AK, Stanghelle JK, Andersson S, Opheim A, Strom V, Solbakk AK. Source: Journal of Rehabilitation Medicine : Official Journal of the Uems European Board of Physical and Rehabilitation Medicine. 2002 May; 34(3): 134-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12395941&dopt=Abstract
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Modeling fatigue. Author(s): Sumner W 2nd, Xu JZ. Source: Proceedings / Amia. Annual Symposium. Amia Symposium. 2002; : 747-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12463924&dopt=Abstract
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Modification of the functional capacity of sarcoplasmic reticulum membranes in patients suffering from chronic fatigue syndrome. Author(s): Fulle S, Belia S, Vecchiet J, Morabito C, Vecchiet L, Fano G. Source: Neuromuscular Disorders : Nmd. 2003 August; 13(6): 479-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12899875&dopt=Abstract
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Monotonic flexure and fatigue strength of composites for provisional and definitive restorations. Author(s): Scherrer SS, Wiskott AH, Coto-Hunziker V, Belser UC. Source: The Journal of Prosthetic Dentistry. 2003 June; 89(6): 579-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12815352&dopt=Abstract
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Monotony of road environment and driver fatigue: a simulator study. Author(s): Thiffault P, Bergeron J. Source: Accident; Analysis and Prevention. 2003 May; 35(3): 381-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12643955&dopt=Abstract
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Moral fatigue--a nursing perspective. Author(s): Taylor S. Source: Bioethics Forum. 2002; 18(1-2): 37-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12956173&dopt=Abstract
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Motor fatigue and cognitive task performance in humans. Author(s): Lorist MM, Kernell D, Meijman TF, Zijdewind I. Source: The Journal of Physiology. 2002 November 15; 545(Pt 1): 313-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12433971&dopt=Abstract
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Mouth pressure twitches induced by cervical magnetic stimulation to assess inspiratory muscle fatigue. Author(s): Delpech N, Jonville S, Denjean A. Source: Respiratory Physiology & Neurobiology. 2003 March 28; 134(3): 231-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660102&dopt=Abstract
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Multidimensional independent predictors of cancer-related fatigue. Author(s): Hwang SS, Chang VT, Rue M, Kasimis B. Source: Journal of Pain and Symptom Management. 2003 July; 26(1): 604-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12850643&dopt=Abstract
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Multiple co-infections (Mycoplasma, Chlamydia, human herpes virus-6) in blood of chronic fatigue syndrome patients: association with signs and symptoms. Author(s): Nicolson GL, Gan R, Haier J. Source: Apmis : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica. 2003 May; 111(5): 557-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12887507&dopt=Abstract
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Muscle recovery from a short fatigue test and consequence on the reliability of EMG indices of fatigue. Author(s): Lariviere C, Gravel D, Arsenault AB, Gagnon D, Loisel P. Source: European Journal of Applied Physiology. 2003 April; 89(2): 171-6. Epub 2003 February 01. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12665981&dopt=Abstract
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Myoelectric manifestations of sternocleidomastoid and anterior scalene muscle fatigue in chronic neck pain patients. Author(s): Falla D, Rainoldi A, Merletti R, Jull G. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2003 March; 114(3): 488-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705429&dopt=Abstract
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N-acetylcysteine infusion alters blood redox status but not time to fatigue during intense exercise in humans. Author(s): Medved I, Brown MJ, Bjorksten AR, Leppik JA, Sostaric S, McKenna MJ. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 2003 April; 94(4): 1572-82. Epub 2002 December 20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12496140&dopt=Abstract
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Nail pigmentation and fatigue in a 39-year-old woman. Author(s): Rizos E, Drosos AA, Ioannidis JP. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 February 1; 36(3): 348, 378-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12539085&dopt=Abstract
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National Institutes of Health State-of-the-Science Conference Statement: Symptom Management in Cancer: Pain, Depression, and Fatigue, July 15-17, 2002. Author(s): Patrick DL, Ferketich SL, Frame PS, Harris JJ, Hendricks CB, Levin B, Link MP, Lustig C, McLaughlin J, Ried LD, Turrisi AT 3rd, Unutzer J, Vernon SW; National Institutes of Health State-of-the-Science Panel. Source: Journal of the National Cancer Institute. 2003 August 6; 95(15): 1110-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12902440&dopt=Abstract
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Need for recovery from work related fatigue and its role in the development and prediction of subjective health complaints. Author(s): Sluiter JK, de Croon EM, Meijman TF, Frings-Dresen MH. Source: Occupational and Environmental Medicine. 2003 June; 60 Suppl 1: I62-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12782749&dopt=Abstract
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Need for recovery in the working population: description and associations with fatigue and psychological distress. Author(s): Jansen NW, Kant IJ, van den Brandt PA. Source: International Journal of Behavioral Medicine. 2002; 9(4): 322-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12512472&dopt=Abstract
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Neuromuscular fatigue after a ski skating marathon. Author(s): Millet GY, Martin V, Maffiuletti NA, Martin A. Source: Canadian Journal of Applied Physiology = Revue Canadienne De Physiologie Appliquee. 2003 June; 28(3): 434-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12955870&dopt=Abstract
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NIH releases statement on managing pain, depression, and fatigue in cancer. Author(s): Ressel GW; National Institutes of Health. Source: American Family Physician. 2003 January 15; 67(2): 423-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562162&dopt=Abstract
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No excess fatigue in young adult survivors of childhood cancer. Author(s): Langeveld NE, Grootenhuis MA, Voute PA, de Haan RJ, van den Bos C. Source: European Journal of Cancer (Oxford, England : 1990). 2003 January; 39(2): 20414. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12509953&dopt=Abstract
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Nonlinear cortical modulation of muscle fatigue: a functional MRI study. Author(s): Liu JZ, Dai TH, Sahgal V, Brown RW, Yue GH. Source: Brain Research. 2002 December 13; 957(2): 320-9. Erratum In: Brain Res. 2003 May 30; 973(2): 307. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12445974&dopt=Abstract
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Normal production of inflammatory cytokines in chronic fatigue and fibromyalgia syndromes determined by intracellular cytokine staining in short-term cultured blood mononuclear cells. Author(s): Amel Kashipaz MR, Swinden D, Todd I, Powell RJ. Source: Clinical and Experimental Immunology. 2003 May; 132(2): 360-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699429&dopt=Abstract
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Nursing leads the way in cancer-related fatigue on the Web. Author(s): Gomez E. Source: Ons News / Oncology Nursing Society. 2003 April; 18(4): 7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12703246&dopt=Abstract
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Nutrition intervention in an all-star basketball player with fatigue. Author(s): Kleiner SM. Source: Curr Sports Med Rep. 2003 August; 2(4): 187-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834572&dopt=Abstract
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Observer independent analysis of cerebral glucose metabolism in patients with chronic fatigue syndrome. Author(s): Siessmeier T, Nix WA, Hardt J, Schreckenberger M, Egle UT, Bartenstein P. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 July; 74(7): 922-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12810781&dopt=Abstract
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Obstructive sleep apnoea as a cause of fatigue in ankylosing spondylitis. Author(s): Erb N, Karokis D, Delamere JP, Cushley MJ, Kitas GD. Source: Annals of the Rheumatic Diseases. 2003 February; 62(2): 183-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12525393&dopt=Abstract
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One-year outcome of unexplained fatigue syndromes in primary care: results from an international study. Author(s): Skapinakis P, Lewis G, Mavreas V. Source: Psychological Medicine. 2003 July; 33(5): 857-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12877400&dopt=Abstract
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Oral antioxidant supplementation for fatigue associated with primary biliary cirrhosis: results of a multicentre, randomized, placebo-controlled, cross-over trial. Author(s): Prince MI, Mitchison HC, Ashley D, Burke DA, Edwards N, Bramble MG, James OF, Jones DE. Source: Alimentary Pharmacology & Therapeutics. 2003 January; 17(1): 137-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492743&dopt=Abstract
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Pathologic quiz case: a 72-year-old man with fatigue and proteinuria. Angiotropic (intravascular) large B-cell lymphoma. Author(s): Ozolek J, Nodit L, Bastacky S, Craig F, Nalesnik M. Source: Archives of Pathology & Laboratory Medicine. 2003 October; 127(10): 1380-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14521449&dopt=Abstract
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Patient-related barriers to fatigue communication: initial validation of the fatigue management barriers questionnaire. Author(s): Passik SD, Kirsh KL, Donaghy K, Holtsclaw E, Theobald D, Cella D, Breitbart W; Fatigue Coalition. Source: Journal of Pain and Symptom Management. 2002 November; 24(5): 481-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12547048&dopt=Abstract
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Perceived exertion is elevated in old age during an isometric fatigue task. Author(s): Allman BL, Rice CL. Source: European Journal of Applied Physiology. 2003 April; 89(2): 191-7. Epub 2003 February 28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12665984&dopt=Abstract
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Perception and predictability of travel fatigue after long-haul flights: a retrospective study. Author(s): Flower DJ, Irvine D, Folkard S. Source: Aviation, Space, and Environmental Medicine. 2003 February; 74(2): 173-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12602450&dopt=Abstract
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Pergolide mesilate may improve fatigue in patients with Parkinson's disease. Author(s): Abe K, Takanashi M, Yanagihara T, Sakoda S. Source: Behavioural Neurology. 2001-2002; 13(3-4): 117-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12446951&dopt=Abstract
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Personality traits in multiple sclerosis (MS) patients with and without fatigue experience. Author(s): Merkelbach S, Konig J, Sittinger H. Source: Acta Neurologica Scandinavica. 2003 March; 107(3): 195-201. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12614312&dopt=Abstract
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Phantom lymphadenopathy. An association with chronic fatigue syndrome. Author(s): Baschetti R. Source: Postgraduate Medical Journal. 2003 March; 79(929): 185. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12697934&dopt=Abstract
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Phantom lymphadenopathy. An association with chronic fatigue syndrome. Author(s): Shee CD. Source: Postgraduate Medical Journal. 2003 January; 79(927): 59-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12566557&dopt=Abstract
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Physical activity and perception of energy and fatigue in obstructive sleep apnea. Author(s): Hong S, Dimsdale JE. Source: Medicine and Science in Sports and Exercise. 2003 July; 35(7): 1088-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12840627&dopt=Abstract
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Physiological and psychological influences on postoperative fatigue. Author(s): Hall GM, Salmon P. Source: Anesthesia and Analgesia. 2002 November; 95(5): 1446-50, Table of Contents. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12401642&dopt=Abstract
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Physiological and psychological markers associated with HIV-related fatigue. Author(s): Barroso J, Carlson JR, Meynell J. Source: Clinical Nursing Research. 2003 February; 12(1): 49-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12583499&dopt=Abstract
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Position sense acuity is diminished following repetitive low-intensity work to fatigue in a simulated occupational setting: a critical comment. Author(s): Bjorklund M, Crenshaw AG, Djupsjobacka M, Johansson H. Source: European Journal of Applied Physiology. 2003 January; 88(4-5): 485-6. Epub 2002 November 15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12527983&dopt=Abstract
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Possible influence of defenses and negative life events on patients with chronic fatigue syndrome: a pilot study. Author(s): Sundbom E, Henningsson M, Holm U, Soderbergh S, Evengard B. Source: Psychological Reports. 2002 December; 91(3 Pt 1): 963-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530752&dopt=Abstract
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Post-partal sacral fatigue fracture. Author(s): Narvaez J, Narvaez JA. Source: Rheumatology (Oxford, England). 2003 February; 42(2): 384-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12595643&dopt=Abstract
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Post-traumatic stress disorder and chronic fatigue syndrome-like illness among Gulf War veterans: a population-based survey of 30,000 veterans. Author(s): Kang HK, Natelson BH, Mahan CM, Lee KY, Murphy FM. Source: American Journal of Epidemiology. 2003 January 15; 157(2): 141-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12522021&dopt=Abstract
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Postural sway under muscle vibration and muscle fatigue in humans. Author(s): Vuillerme N, Danion F, Forestier N, Nougier V. Source: Neuroscience Letters. 2002 November 22; 333(2): 131-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12419498&dopt=Abstract
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Posture, muscle activity and muscle fatigue in prolonged VDT work at different screen height settings. Author(s): Seghers J, Jochem A, Spaepen A. Source: Ergonomics. 2003 June 10; 46(7): 714-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745683&dopt=Abstract
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Predictors of fatigue following the onset of infectious mononucleosis. Author(s): Candy B, Chalder T, Cleare AJ, Peakman A, Skowera A, Wessely S, Weinman J, Zuckerman M, Hotopf M. Source: Psychological Medicine. 2003 July; 33(5): 847-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12877399&dopt=Abstract
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Predictors of outcome in a fatigued population in primary care following a randomized controlled trial. Author(s): Chalder T, Godfrey E, Ridsdale L, King M, Wessely S. Source: Psychological Medicine. 2003 February; 33(2): 283-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622306&dopt=Abstract
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Premature labor and birth: influence of rank and perception of fatigue in active duty military women. Author(s): Stinson JC, Lee KA. Source: Military Medicine. 2003 May; 168(5): 385-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12775174&dopt=Abstract
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Prevalence and correlates of fatigue among persons with HIV infection. Author(s): Sullivan PS, Dworkin MS; Adult and Adolescent Spectrum of HIV Disease Investigators. Source: Journal of Pain and Symptom Management. 2003 April; 25(4): 329-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691684&dopt=Abstract
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Prevalence and incidence of chronic fatigue syndrome in Wichita, Kansas. Author(s): Reyes M, Nisenbaum R, Hoaglin DC, Unger ER, Emmons C, Randall B, Stewart JA, Abbey S, Jones JF, Gantz N, Minden S, Reeves WC. Source: Archives of Internal Medicine. 2003 July 14; 163(13): 1530-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860574&dopt=Abstract
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Primary haemochromatosis: a missed cause of chronic fatigue syndrome? Author(s): Swinkels DW, Aalbers N, Elving LD, Bleijenberg G, Swanink CM, van der Meer JW. Source: The Netherlands Journal of Medicine. 2002 December; 60(11): 429-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12685490&dopt=Abstract
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Proton magnetic resonance spectroscopy of basal ganglia in chronic fatigue syndrome. Author(s): Chaudhuri A, Condon BR, Gow JW, Brennan D, Hadley DM. Source: Neuroreport. 2003 February 10; 14(2): 225-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12598734&dopt=Abstract
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Psychiatric adjustment in chronic fatigue syndrome of childhood and in juvenile idiopathic arthritis. Author(s): Rangel L, Garralda ME, Hall A, Woodham S. Source: Psychological Medicine. 2003 February; 33(2): 289-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622307&dopt=Abstract
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Psychological correlates of functional status in chronic fatigue syndrome. Author(s): Taillefer SS, Kirmayer LJ, Robbins JM, Lasry JC. Source: Journal of Psychosomatic Research. 2002 December; 53(6): 1097-106. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12479992&dopt=Abstract
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Psychometric properties of the Dutch Chronic Fatigue Syndrome--Activities and Participation Questionnaire (CFS-APQ). Author(s): Nijs J, Vaes P, McGregor N, Van Hoof E, De Meirleir K. Source: Physical Therapy. 2003 May; 83(5): 444-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12718710&dopt=Abstract
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Psychometric qualities of a brief self-rated fatigue measure: The Fatigue Assessment Scale. Author(s): Michielsen HJ, De Vries J, Van Heck GL. Source: Journal of Psychosomatic Research. 2003 April; 54(4): 345-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670612&dopt=Abstract
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Psychosocial characteristics and immunological functions in patients with postinfectious chronic fatigue syndrome and noninfectious chronic fatigue syndrome. Author(s): Masuda A, Munemoto T, Yamanaka T, Takei M, Tei C. Source: Journal of Behavioral Medicine. 2002 October; 25(5): 477-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12442562&dopt=Abstract
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Psychosocial factors related to nausea, vomiting, and fatigue in early pregnancy. Author(s): Chou FH, Lin LL, Cooney AT, Walker LO, Riggs MW. Source: Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau. 2003; 35(2): 119-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12854291&dopt=Abstract
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Quadriceps fatigue after cycle exercise in patients with COPD compared with healthy control subjects. Author(s): Mador MJ, Bozkanat E, Kufel TJ. Source: Chest. 2003 April; 123(4): 1104-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684300&dopt=Abstract
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Quality and efficacy of educational materials on cancer-related fatigue: views of patients from two European countries. Author(s): Ream E, Browne N, Glaus A, Knipping C, Frei IA. Source: European Journal of Oncology Nursing : the Official Journal of European Oncology Nursing Society. 2003 June; 7(2): 99-109. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12849563&dopt=Abstract
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Quality of life in patients with multiple sclerosis: the impact of fatigue and depression. Author(s): Janardhan V, Bakshi R. Source: Journal of the Neurological Sciences. 2002 December 15; 205(1): 51-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409184&dopt=Abstract
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Quantification of cumulated physical fatigue at the workplace. Author(s): Pichot V, Bourin E, Roche F, Garet M, Gaspoz JM, Duverney D, Antoniadis A, Lacour JR, Barthelemy JC. Source: Pflugers Archiv : European Journal of Physiology. 2002 November; 445(2): 26772. Epub 2002 September 18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12457247&dopt=Abstract
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Recent advances in the understanding of skeletal muscle fatigue. Author(s): Westerblad H, Allen DG. Source: Current Opinion in Rheumatology. 2002 November; 14(6): 648-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12410085&dopt=Abstract
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Recovery of electromyograph median frequency after lumbar muscle fatigue analysed using an exponential time dependence model. Author(s): Elfving B, Liljequist D, Dedering A, Nemeth G. Source: European Journal of Applied Physiology. 2002 November; 88(1-2): 85-93. Epub 2002 September 06. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436274&dopt=Abstract
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Relatedness theory as a framework for the treatment of fatigued women. Author(s): Patusky KL. Source: Archives of Psychiatric Nursing. 2002 October; 16(5): 224-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12434328&dopt=Abstract
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Relation of rated fatigue and changes in energy after exercise and over 14 weeks in previously sedentary women exercisers. Author(s): Annesi JJ. Source: Percept Mot Skills. 2002 December; 95(3 Pt 1): 719-27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12509165&dopt=Abstract
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Relations between fatigue, neuropsychological functioning, and physical activity after treatment for breast carcinoma: daily self-report and objective behavior. Author(s): Servaes P, Verhagen CA, Bleijenberg G. Source: Cancer. 2002 November 1; 95(9): 2017-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404297&dopt=Abstract
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Relationship between musculoskeletal symptoms and blood markers of oxidative stress in patients with chronic fatigue syndrome. Author(s): Vecchiet J, Cipollone F, Falasca K, Mezzetti A, Pizzigallo E, Bucciarelli T, De Laurentis S, Affaitati G, De Cesare D, Giamberardino MA. Source: Neuroscience Letters. 2003 January 2; 335(3): 151-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12531455&dopt=Abstract
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Review: Beta-blockers increase fatigue and sexual dysfunction but not depression after myocardial infarction. Author(s): Ko DT, Hebert PR, Krumholz HM. Source: Acp Journal Club. 2003 January-February; 138(1): 30; Author Reply 30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12511138&dopt=Abstract
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RNase L levels in peripheral blood mononuclear cells: 37-kilodalton/83-kilodalton isoform ratio is a potential test for chronic fatigue syndrome. Author(s): Tiev KP, Demettre E, Ercolano P, Bastide L, Lebleu B, Cabane J. Source: Clinical and Diagnostic Laboratory Immunology. 2003 March; 10(2): 315-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626460&dopt=Abstract
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Role of fatigue in limiting physical activities in humans with neuromuscular diseases. Author(s): Miller RG. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 2002 November; 81(11 Suppl): S99-107. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12409815&dopt=Abstract
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Self-reported sleep quality and fatigue correlates with actigraphy in midlife women with fibromyalgia. Author(s): Landis CA, Frey CA, Lentz MJ, Rothermel J, Buchwald D, Shaver JL. Source: Nursing Research. 2003 May-June; 52(3): 140-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12792254&dopt=Abstract
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Sex differences in human skeletal muscle fatigue are eliminated under ischemic conditions. Author(s): Russ DW, Kent-Braun JA. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 2003 June; 94(6): 2414-22. Epub 2003 January 31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562681&dopt=Abstract
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Shortening-induced depression of voluntary force in unfatigued and fatigued human adductor pollicis muscle. Author(s): de Ruiter CJ, de Haan A. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 2003 January; 94(1): 69-74. Epub 2002 September 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12391074&dopt=Abstract
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Sleep EEG patterns and fatigue of middle-aged and older female family caregivers providing routine nighttime care for elderly persons at home. Author(s): Sato R, Kanda K, Anan M, Watanuki S. Source: Percept Mot Skills. 2002 December; 95(3 Pt 1): 815-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12509180&dopt=Abstract
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Sleep, fatigue, and medical training: setting an agenda for optimal learning and patient care. Author(s): Buysse DJ, Barzansky B, Dinges D, Hogan E, Hunt CE, Owens J, Rosekind M, Rosen R, Simon F, Veasey S, Wiest F. Source: Sleep. 2003 March 15; 26(2): 218-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12683483&dopt=Abstract
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Subclassifying chronic fatigue syndrome through exercise testing. Author(s): Vanness JM, Snell CR, Strayer DR, Dempsey L 4th, Stevens SR. Source: Medicine and Science in Sports and Exercise. 2003 June; 35(6): 908-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12783037&dopt=Abstract
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Successful intravenous immunoglobulin therapy in 3 cases of parvovirus B19associated chronic fatigue syndrome. Author(s): Kerr JR, Cunniffe VS, Kelleher P, Bernstein RM, Bruce IN. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 May 1; 36(9): E100-6. Epub 2003 April 22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12715326&dopt=Abstract
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Successful treatment of chronic fatigue syndrome with midodrine: a pilot study. Author(s): Naschitz JE, Rosner I, Rozenbaum M, Musafia-Priselac R, Sabo E, Gaitini L, Eldar S, Zukerman E, Yeshurun D. Source: Clin Exp Rheumatol. 2003 May-June; 21(3): 416-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12846081&dopt=Abstract
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Surveillance for chronic fatigue syndrome--four U.S. cities, September 1989 through August 1993. Author(s): Reyes M, Gary HE Jr, Dobbins JG, Randall B, Steele L, Fukuda K, Holmes GP, Connell DG, Mawle AC, Schmid DS, Stewart JA, Schonberger LB, Gunn WJ, Reeves WC. Source: Mmwr. Cdc Surveillance Summaries : Morbidity and Mortality Weekly Report. Cdc Surveillance Summaries / Centers for Disease Control. 1997 February 21; 46(2): 113. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12412768&dopt=Abstract
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Symptoms of rhinosinusitis in patients with unexplained chronic fatigue or bodily pain: a pilot study. Author(s): Chester AC. Source: Archives of Internal Medicine. 2003 August 11-25; 163(15): 1832-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12912720&dopt=Abstract
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T-cell homeostasis in breast cancer survivors with persistent fatigue. Author(s): Bower JE, Ganz PA, Aziz N, Fahey JL, Cole SW. Source: Journal of the National Cancer Institute. 2003 August 6; 95(15): 1165-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12902446&dopt=Abstract
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The assessment of fatigue in primary Sjogren's syndrome. Author(s): Lwin CT, Bishay M, Platts RG, Booth DA, Bowman SJ. Source: Scandinavian Journal of Rheumatology. 2003; 32(1): 33-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12635943&dopt=Abstract
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The association between chronic diseases and fatigue in the working population. Author(s): Franssen PM, Bultmann U, Kant I, van Amelsvoort LG. Source: Journal of Psychosomatic Research. 2003 April; 54(4): 339-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670611&dopt=Abstract
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The cognitive performance of patients with multiple sclerosis during periods of high and low fatigue. Author(s): Parmenter BA, Denney DR, Lynch SG. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2003 March; 9(2): 111-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708805&dopt=Abstract
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The conscious perception of the sensation of fatigue. Author(s): St Clair Gibson A, Baden DA, Lambert MI, Lambert EV, Harley YX, Hampson D, Russell VA, Noakes TD. Source: Sports Medicine (Auckland, N.Z.). 2003; 33(3): 167-76. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12656638&dopt=Abstract
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The economic cost of chronic fatigue and chronic fatigue syndrome in UK primary care. Author(s): McCrone P, Darbishire L, Ridsdale L, Seed P. Source: Psychological Medicine. 2003 February; 33(2): 253-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622304&dopt=Abstract
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The effect of a contralateral contraction on maximal voluntary activation and central fatigue in elbow flexor muscles. Author(s): Todd G, Petersen NT, Taylor JL, Gandevia SC. Source: Experimental Brain Research. Experimentelle Hirnforschung. Experimentation Cerebrale. 2003 June; 150(3): 308-13. Epub 2003 April 03. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12677313&dopt=Abstract
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The effect of fatigue on abnormal vibration induced illusion of movement in idiopathic focal dystonia. Author(s): Frima N, Rome SM, Grunewald RA. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 August; 74(8): 1154-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12876261&dopt=Abstract
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The effect of induced muscle tension and fatigue on the oculocardiac reflex. Author(s): Machida CJ, Arnold RW. Source: Binocul Vis Strabismus Q. 2003 Spring-Summer; 18(2): 81-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12785319&dopt=Abstract
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The effectiveness of a self-care intervention for the management of postpartum fatigue. Author(s): Troy NW, Dalgas-Pelish P. Source: Applied Nursing Research : Anr. 2003 February; 16(1): 38-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12624861&dopt=Abstract
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The effectiveness of citalopram for idiopathic chronic fatigue. Author(s): Hartz AJ, Bentler SE, Brake KA, Kelly MW. Source: The Journal of Clinical Psychiatry. 2003 August; 64(8): 927-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927008&dopt=Abstract
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The effects of acute stretching on hamstring muscle fatigue and perceived exertion. Author(s): Laur DJ, Anderson T, Geddes G, Crandall A, Pincivero DM. Source: Journal of Sports Sciences. 2003 March; 21(3): 163-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12703846&dopt=Abstract
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The effects of health state, hemoglobin, global symptom distress, mood disturbance, and treatment site on fatigue onset, duration, and distress in patients receiving radiation therapy. Author(s): Magnan MA, Mood DW. Source: Oncology Nursing Forum. 2003 March-April; 30(2): E33-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12692668&dopt=Abstract
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The head-up tilt test for diagnosing chronic fatigue syndrome. Author(s): Ghosh AK, Ghosh K. Source: Qjm : Monthly Journal of the Association of Physicians. 2003 May; 96(5): 379-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12702788&dopt=Abstract
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The influence of mental fatigue on facial EMG activity during a simulated workday. Author(s): Veldhuizen IJ, Gaillard AW, de Vries J. Source: Biological Psychology. 2003 April; 63(1): 59-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12706964&dopt=Abstract
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The neuroendocrinology of chronic fatigue syndrome. Author(s): Cleare AJ. Source: Endocrine Reviews. 2003 April; 24(2): 236-52. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700181&dopt=Abstract
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The radicalized self: the impact on the self of the contested nature of the diagnosis of chronic fatigue syndrome. Author(s): Clarke JN, James S. Source: Social Science & Medicine (1982). 2003 October; 57(8): 1387-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927469&dopt=Abstract
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The relationship between illness attributions and attributional style in Chronic Fatigue Syndrome. Author(s): Creswell C, Chalder T. Source: The British Journal of Clinical Psychology / the British Psychological Society. 2003 March; 42(Pt 1): 101-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12675983&dopt=Abstract
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The relationship between psychologic distress and cancer-related fatigue. Author(s): Tchekmedyian NS, Kallich J, McDermott A, Fayers P, Erder MH. Source: Cancer. 2003 July 1; 98(1): 198-203. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12833472&dopt=Abstract
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The role of helplessness as mediator between neurological disability, emotional instability, experienced fatigue and depression in patients with multiple sclerosis. Author(s): van der Werf SP, Evers A, Jongen PJ, Bleijenberg G. Source: Multiple Sclerosis (Houndmills, Basingstoke, England). 2003 February; 9(1): 8994. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12617274&dopt=Abstract
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Three instruments to assess fatigue in children with cancer: the child, parent and staff perspectives. Author(s): Hockenberry MJ, Hinds PS, Barrera P, Bryant R, Adams-McNeill J, Hooke C, Rasco-Baggott C, Patterson-Kelly K, Gattuso JS, Manteuffel B. Source: Journal of Pain and Symptom Management. 2003 April; 25(4): 319-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691683&dopt=Abstract
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Tiredness and fatigue in the postnatal period. Author(s): McQueen A, Mander R. Source: Journal of Advanced Nursing. 2003 June; 42(5): 463-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752866&dopt=Abstract
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Truck driver fatigue risk assessment and management: a multinational survey. Author(s): Adams-Guppy J, Guppy A. Source: Ergonomics. 2003 June 20; 46(8): 763-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12745978&dopt=Abstract
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Unconscious amygdalar fear conditioning in a subset of chronic fatigue syndrome patients. Author(s): Gupta A. Source: Medical Hypotheses. 2002 December; 59(6): 727-35. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12445517&dopt=Abstract
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Unexplained fatigue syndromes in a multinational primary care sample: specificity of definition and prevalence and distinctiveness from depression and generalized anxiety. Author(s): Skapinakis P, Lewis G, Mavreas V. Source: The American Journal of Psychiatry. 2003 April; 160(4): 785-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12668371&dopt=Abstract
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Update on chronic fatigue syndrome and Epstein-Barr virus. Author(s): Katz BZ. Source: Pediatric Annals. 2002 November; 31(11): 741-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12455482&dopt=Abstract
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Using self-regulation theory to develop an intervention for cancer-related fatigue. Author(s): Reuille KM. Source: Clinical Nurse Specialist Cns. 2002 November; 16(6): 312-9; Quiz 320-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464847&dopt=Abstract
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Utility of the blood for gene expression profiling and biomarker discovery in chronic fatigue syndrome. Author(s): Vernon SD, Unger ER, Dimulescu IM, Rajeevan M, Reeves WC. Source: Disease Markers. 2002; 18(4): 193-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590173&dopt=Abstract
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Validation evidence for the French Canadian adaptation of the Multidimensional Fatigue Inventory as a measure of cancer-related fatigue. Author(s): Fillion L, Gelinas C, Simard S, Savard J, Gagnon P. Source: Cancer Nursing. 2003 April; 26(2): 143-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660563&dopt=Abstract
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Validation of a telephone cognitive assessment test battery for use in chronic fatigue syndrome. Author(s): McCue P, Scholey AB, Herman C, Wesnes KA. Source: Journal of Telemedicine and Telecare. 2002; 8(6): 337-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12537921&dopt=Abstract
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Validation of the French 'multidimensional fatigue inventory' (MFI 20). Author(s): Gentile S, Delaroziere JC, Favre F, Sambuc R, San Marco JL. Source: European Journal of Cancer Care. 2003 March; 12(1): 58-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12641557&dopt=Abstract
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Validation of the German version of the brief fatigue inventory. Author(s): Radbruch L, Sabatowski R, Elsner F, Everts J, Mendoza T, Cleeland C. Source: Journal of Pain and Symptom Management. 2003 May; 25(5): 449-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12727043&dopt=Abstract
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Validation study of the Japanese version of the brief fatigue inventory. Author(s): Okuyama T, Wang XS, Akechi T, Mendoza TR, Hosaka T, Cleeland CS, Uchitomi Y. Source: Journal of Pain and Symptom Management. 2003 February; 25(2): 106-17. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12590026&dopt=Abstract
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Validity of cancer-related fatigue instruments. Author(s): Schwartz AH. Source: Pharmacotherapy. 2002 November; 22(11): 1433-41. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12432970&dopt=Abstract
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Variability in diagnostic criteria for chronic fatigue syndrome may result in substantial differences in patterns of symptoms and disability. Author(s): Jason LA, Helgerson J, Torres-Harding SR, Carrico AW, Taylor RR. Source: Evaluation & the Health Professions. 2003 March; 26(1): 3-22. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12629919&dopt=Abstract
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Variation in immune response genes and chronic Q fever. Concepts: preliminary test with post-Q fever fatigue syndrome. Author(s): Helbig KJ, Heatley SL, Harris RJ, Mullighan CG, Bardy PG, Marmion BP. Source: Genes and Immunity. 2003 January; 4(1): 82-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12595908&dopt=Abstract
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Vibration-induced muscle fatigue, a possible contribution to musculoskeletal injury. Author(s): Adamo DE, Martin BJ, Johnson PW. Source: European Journal of Applied Physiology. 2002 November; 88(1-2): 134-40. Epub 2002 August 27. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12436281&dopt=Abstract
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Vocal fatigue: current knowledge and future directions. Author(s): Welham NV, Maclagan MA. Source: Journal of Voice : Official Journal of the Voice Foundation. 2003 March; 17(1): 2130. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12705816&dopt=Abstract
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CHAPTER 2. NUTRITION AND FATIGUE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and fatigue.
Finding Nutrition Studies on Fatigue 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 “fatigue” (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.
116 Fatigue
The following is a typical result when searching for recently indexed consumer information on fatigue: •
A double-blind pilot study of the effect of Prokarin on fatigue in multiple sclerosis. Author(s): Life Diagnostics, Calgary, Alberta, Canada. Source: Gillson, G Richard, T L Smith, R B Wright, J V Mult-Scler. 2002 February; 8(1): 30-5 1352-4585
•
A six-month trial of valacyclovir in the Epstein-Barr virus subset of chronic fatigue syndrome: improvement in left ventricular function. Author(s): School of Medicine, Wayne State University, Detroit, MI, USA.
[email protected] Source: Lerner, A M Beqaj, S H Deeter, R G Dworkin, H J Zervos, M Chang, C H Fitzgerald, J T Goldstein, J O'Neill, W Drugs-Today-(Barc). 2002 August; 38(8): 549-61 0025-7656
•
Amino acids and central fatigue. Source: Blomstrand, E. Amino-acids. Wien; New York : Springer-Verlag, c1991-. 2001. volume 20 (1) page 25-34. 0939-4451
•
Assessment and treatment of HIV-related fatigue. Author(s): Duke University School of Nursing, Division of Infectious Diseases, Department of Medicine, USA. Source: Adinolfi, A J-Assoc-Nurses-AIDS-Care. 2001; 12 Suppl: 29-34; quiz 35-8 10553290
•
Brain regions involved in fatigue sensation: reduced acetylcarnitine uptake into the brain. Author(s): Department of Molecular Medicine, Hematology and Oncology, Osaka University Graduate School of Medicine, C9, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
[email protected] Source: Kuratsune, H Yamaguti, K Lindh, G Evengard, B Hagberg, G Matsumura, K Iwase, M Onoe, H Takahashi, M Machii, T Kanakura, Y Kitani, T Langstrom, B Watanabe, Y Neuroimage. 2002 November; 17(3): 1256-65 1053-8119
•
Capsaicin-sensitive muscle afferents modulate the monosynaptic reflex in response to muscle ischemia and fatigue in the rat. Author(s): Dipartimento di Medicina Interna, Sezione di Fisiologia Umana, Universita di Perugia, I-06100 Perugia, Italy. Source: Della Torre, G Brunetti, O Pettorossi, V E Arch-Ital-Biol. 2002 January; 140(1): 5165 0003-9829
•
Chronic fatigue disorders: an inappropriate response to arginine vasopressin? Author(s): Spectra Biomedical, Inc., Menlo Park, CA 94025, USA. Source: Peroutka, S J Med-Hypotheses. 1998 June; 50(6): 521-3 0306-9877
•
Contractile properties, fatigue and recovery are not influenced by short-term creatine supplementation in human muscle. Author(s): Centre for Activity and Ageing, Lawson Research Institute, Faculties of Health Science and Medicine, The University of Western Ontario, London, ON, Canada N6G 2M3. Source: Jakobi, J M Rice, C L Curtin, S V Marsh, G D Exp-Physiol. 2000 July; 85(4): 451-60 0958-0670
Nutrition
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Cyclic fatigue of endodontic nickel titanium rotary instruments: static and dynamic tests. Author(s): Graduate Institute of Clinical Dentistry, College of Medicine, National Taiwan University, Taipei, ROC. Source: Li, U M Lee, B S Shih, C T Lan, W H Lin, C P J-Endod. 2002 June; 28(6): 448-51 0099-2399
•
Defining and managing chronic fatigue syndrome. Source: Anonymous Evid-Rep-Technol-Assess-(Summ). 2001 September; (42): 1-4 1530440x
•
Effect of creatine supplementation during high resistance training on mass, strength, and fatigue resistance in rat skeletal muscle. Author(s): Department of Biological Sciences, California State University, Bakersfield 93311, USA. Source: McBride, T A Gregory, M A J-Strength-Cond-Res. 2002 August; 16(3): 335-42 1064-8011
•
Effect of garlic intake on the antifatigue and fatigue recovery during prolonged exercise. Author(s): Pusan National University, Pusan (Korea Republic). Department of Physical Education Source: Baek, Y.H. Journal-of-The-Korean-Society-of-Food-and-Nutrition (Korea Republic). (December 1995). volume 24(6) page 970-977. 0253-3154
•
Effect of growth hormone treatment in patients with chronic fatigue syndrome: a preliminary study. Author(s): Department of Internal Medicine, University Hospital Antwerp, Belgium. Source: Moorkens, G Wynants, H Abs, R Growth-Horm-IGF-Res. 1998 April; 8 Suppl B131-3 1096-6374
•
Effects of vitamin E deficiency on fatigue and muscle contractile properties. Author(s): School of Human Movement Studies, Rm 520, Connell Building, University of Queensland, St Lucia, QLD 4072, Australia.
[email protected] Source: Coombes, J S Rowell, B Dodd, S L Demirel, H A Naito, H Shanely, R A Powers, S K Eur-J-Appl-Physiol. 2002 July; 87(3): 272-7 1439-6319
•
Elevated levels of tumor necrosis factor alpha in postdialysis fatigue. Author(s): Department of Medicine, United Health Services Hospitals, Binghamton, New York, USA. Source: Dreisbach, A W Hendrickson, T Beezhold, D Riesenberg, L A Sklar, A H Int-JArtif-Organs. 1998 February; 21(2): 83-6 0391-3988
•
Engine-driven preparation of curved root canals: measuring cyclic fatigue and other physical parameters. Author(s): Department of Preventive Dentistry, Periodontology and Cardiology, Zurich University, Switzerland. Source: Peters, O A Kappeler, S Bucher, W Barbakow, F Aust-Endod-J. 2002 April; 28(1): 11-7 1329-1947
•
Fatigue associated with obstructive sleep apnea in a patient with sarcoidosis. Author(s): Department of Pulmonology, University Hospital Maastricht, The Netherlands.
[email protected] Source: Drent, M Verbraecken, J van der Grinten, C Wouters, E Respiration. 2000; 67(3): 337-40 0025-7931
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Homeopathic treatment of Chronic Fatigue Syndrome: three case studies using Jan Scholten's methodology. Author(s):
[email protected] Source: Geraghty, J Homeopathy. 2002 April; 91(2): 99-105 1475-4916
•
Hyperprolactinaemia during prolonged exercise in the heat: evidence for a centrally mediated component of fatigue in trained cyclists. Author(s): Department of Biomedical Sciences, University Medical School, Aberdeen AB25 2ZD, UK. Source: Pitsiladis, Y P Strachan, A T Davidson, I Maughan, R J Exp-Physiol. 2002 March; 87(2): 215-26 0958-0670
•
Low levels of serum acylcarnitine in chronic fatigue syndrome and chronic hepatitis type C, but not seen in other diseases. Author(s): Hematology and Oncology, Osaka University Medical School, Suita, Osaka 565, Japan. Source: Kuratsune, H Yamaguti, K Lindh, G Evengard, B Takahashi, M Machii, T Matsumura, K Takaishi, J Kawata, S Langstrom, B Kanakura, Y Kitani, T Watanabe, Y Int-J-Mol-Med. 1998 July; 2(1): 51-6 1107-3756
•
Neuromuscular properties and fatigue in older men following acute creatine supplementation. Author(s): Canadian Centre for Activity and Aging, School of Kinesiology, Faculty of Health Science, The University of Western Ontario, London, Canada, N6G 2M3. Source: Jakobi, J M Rice, C L Curtin, S V Marsh, G D Eur-J-Appl-Physiol. 2001 April; 84(4): 321-8 1439-6319
•
Nutritional strategies for treating chronic fatigue syndrome. Author(s): UCLA School of Medicine, California, USA. Source: Werbach, M R Altern-Med-Revolume 2000 April; 5(2): 93-108 1089-5159
•
Potential role of levocarnitine supplementation for the treatment of chemotherapyinduced fatigue in non-anaemic cancer patients. Author(s): Medical Oncology Unit, Hospital of Urbino, Via Bonconte da Montefeltro, 61029 Urbino, Italy.
[email protected] Source: Graziano, F Bisonni, R Catalano, V Silva, R Rovidati, S Mencarini, E Ferraro, B Canestrari, F Baldelli, A M De Gaetano, A Giordani, P Testa, E Lai, V Br-J-Cancer. 2002 June 17; 86(12): 1854-7 0007-0920
•
Self-care for fatigue in patients With HIV. Author(s): MGH Institute of Health Professions in Boston, MA, USA.
[email protected] Source: Corless, Inge B Bunch, Eli Haugen Kemppainen, Jeanne K Holzemer, William L Nokes, Kathleen M Eller, Lucille Sanzero Portillo, Carmen J Butensky, Ellen Nicholas, Patrice K Bain, Catherine A Davis, Sheila Kirksey, Kenn M Chou, Fang Yu Oncol-NursForum. 2002 June; 29(5): E60-9 1538-0688
•
Studies on ayurvedic drugs. I. Evaluation of antifatigue effect of the ayurvedic drug “Alert” in rats. Source: Kakrani, H.K. Nair, G.V. Kalyani, G.A. Satyanarayana, D. Fitoterapia. Milano : Inverni della Beffa. 1985. volume 56 (5) page 293-295. 0367-326X
•
The challenge of evaluating fatigue. Author(s): University of Texas Health Science Center, Houston, Texas, USA. Source: Rodriguez, T J-Am-Acad-Nurse-Pract. 2000 August; 12(8): 329-38; quiz 339-41 1041-2972
Nutrition
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The characteristics of fatigue symptoms and their association with the life style and the health status in school children. Author(s): Department of Hygiene, Faculty of Medicine, Tottori University, Yonago, Japan. Source: Okamoto, M Tan, F Suyama, A Okada, H Miyamoto, T Kishimoto, T JEpidemiol. 2000 July; 10(4): 241-8 0917-5040
•
The effect of a polynutrient supplement on fatigue and physical activity of patients with chronic fatigue syndrome: a double-blind randomized controlled trial. Author(s): Departments of. General Internal Medicine and. Medical Psychology, University Medical Center Nijmegen, The Netherlands. Source: Brouwers, F M Van Der Werf, S Bleijenberg, G Van Der Zee, L Van Der Meer, J W QJM. 2002 October; 95(10): 677-83 1460-2725
•
The in vitro immunomodulatory effects of glyconutrients on peripheral blood mononuclear cells of patients with chronic fatigue syndrome. Author(s): University of California, Irvine, Department of Medicine, Orange 92668, USA. Source: See, D M Cimoch, P Chou, S Chang, J Tilles, J Integr-Physiol-Behav-Sci. 1998 JulSeptember; 33(3): 280-7 1053-881X
•
The trajectory of fatigue in adult patients with breast and ovarian cancer receiving chemotherapy. Author(s): College of Nursing, Wayne State University, Detroit, MI, USA.
[email protected] Source: Payne, J K Oncol-Nurs-Forum. 2002 October; 29(9): 1334-40 1538-0688
•
Treatment of chronic fatigue syndrome by dietary supplementation with omega-3 fatty acids--a good idea? Author(s): Department of Research, Isfahan University of Medical Sciences, Shahrekord, Isfahan, Iran.
[email protected] Source: Tamizi far, B Tamizi, B Med-Hypotheses. 2002 March; 58(3): 249-50 0306-9877
The following information is typical of that found when using the “Full IBIDS Database” to search for “fatigue” (or a synonym): •
Chronic fatigue syndrome (CFS) associated with Staphylococcus spp. bacteremia, responsive to thiacetarsamide sodium in 7 dogs. Author(s): (Clinica Veterinaria Airone de Nus, Aoste (Italie)) Source: Tarello, W. Revue-de-Medecine-Veterinaire (France). (November 2002). volume 152 (11) p. 785-792.
Additional physician-oriented references include: •
A double-blind pilot study of the effect of Prokarin on fatigue in multiple sclerosis. Author(s): Life Diagnostics, Calgary, Alberta, Canada. Source: Gillson, G Richard, T L Smith, R B Wright, J V Mult-Scler. 2002 February; 8(1): 30-5 1352-4585
•
A six-month trial of valacyclovir in the Epstein-Barr virus subset of chronic fatigue syndrome: improvement in left ventricular function. Author(s): School of Medicine, Wayne State University, Detroit, MI, USA.
[email protected] Source: Lerner, A M Beqaj, S H Deeter, R G Dworkin, H J Zervos, M Chang, C H Fitzgerald, J T Goldstein, J O'Neill, W Drugs-Today-(Barc). 2002 August; 38(8): 549-61 0025-7656
120 Fatigue
•
Amino acids and central fatigue. Source: Blomstrand, E. Amino-acids. Wien; New York : Springer-Verlag, c1991-. 2001. volume 20 (1) page 25-34. 0939-4451
•
Assessment and treatment of HIV-related fatigue. Author(s): Duke University School of Nursing, Division of Infectious Diseases, Department of Medicine, USA. Source: Adinolfi, A J-Assoc-Nurses-AIDS-Care. 2001; 12 Suppl: 29-34; quiz 35-8 10553290
•
Brain regions involved in fatigue sensation: reduced acetylcarnitine uptake into the brain. Author(s): Department of Molecular Medicine, Hematology and Oncology, Osaka University Graduate School of Medicine, C9, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan.
[email protected] Source: Kuratsune, H Yamaguti, K Lindh, G Evengard, B Hagberg, G Matsumura, K Iwase, M Onoe, H Takahashi, M Machii, T Kanakura, Y Kitani, T Langstrom, B Watanabe, Y Neuroimage. 2002 November; 17(3): 1256-65 1053-8119
•
Capsaicin-sensitive muscle afferents modulate the monosynaptic reflex in response to muscle ischemia and fatigue in the rat. Author(s): Dipartimento di Medicina Interna, Sezione di Fisiologia Umana, Universita di Perugia, I-06100 Perugia, Italy. Source: Della Torre, G Brunetti, O Pettorossi, V E Arch-Ital-Biol. 2002 January; 140(1): 5165 0003-9829
•
Chronic fatigue disorders: an inappropriate response to arginine vasopressin? Author(s): Spectra Biomedical, Inc., Menlo Park, CA 94025, USA. Source: Peroutka, S J Med-Hypotheses. 1998 June; 50(6): 521-3 0306-9877
•
Contractile properties, fatigue and recovery are not influenced by short-term creatine supplementation in human muscle. Author(s): Centre for Activity and Ageing, Lawson Research Institute, Faculties of Health Science and Medicine, The University of Western Ontario, London, ON, Canada N6G 2M3. Source: Jakobi, J M Rice, C L Curtin, S V Marsh, G D Exp-Physiol. 2000 July; 85(4): 451-60 0958-0670
•
Cyclic fatigue of endodontic nickel titanium rotary instruments: static and dynamic tests. Author(s): Graduate Institute of Clinical Dentistry, College of Medicine, National Taiwan University, Taipei, ROC. Source: Li, U M Lee, B S Shih, C T Lan, W H Lin, C P J-Endod. 2002 June; 28(6): 448-51 0099-2399
•
Defining and managing chronic fatigue syndrome. Source: Anonymous Evid-Rep-Technol-Assess-(Summ). 2001 September; (42): 1-4 1530440x
•
Effect of creatine supplementation during high resistance training on mass, strength, and fatigue resistance in rat skeletal muscle. Author(s): Department of Biological Sciences, California State University, Bakersfield 93311, USA. Source: McBride, T A Gregory, M A J-Strength-Cond-Res. 2002 August; 16(3): 335-42 1064-8011
Nutrition
121
•
Effect of garlic intake on the antifatigue and fatigue recovery during prolonged exercise. Author(s): Pusan National University, Pusan (Korea Republic). Department of Physical Education Source: Baek, Y.H. Journal-of-The-Korean-Society-of-Food-and-Nutrition (Korea Republic). (December 1995). volume 24(6) page 970-977. 0253-3154
•
Effect of growth hormone treatment in patients with chronic fatigue syndrome: a preliminary study. Author(s): Department of Internal Medicine, University Hospital Antwerp, Belgium. Source: Moorkens, G Wynants, H Abs, R Growth-Horm-IGF-Res. 1998 April; 8 Suppl B131-3 1096-6374
•
Effects of vitamin E deficiency on fatigue and muscle contractile properties. Author(s): School of Human Movement Studies, Rm 520, Connell Building, University of Queensland, St Lucia, QLD 4072, Australia.
[email protected] Source: Coombes, J S Rowell, B Dodd, S L Demirel, H A Naito, H Shanely, R A Powers, S K Eur-J-Appl-Physiol. 2002 July; 87(3): 272-7 1439-6319
•
Elevated levels of tumor necrosis factor alpha in postdialysis fatigue. Author(s): Department of Medicine, United Health Services Hospitals, Binghamton, New York, USA. Source: Dreisbach, A W Hendrickson, T Beezhold, D Riesenberg, L A Sklar, A H Int-JArtif-Organs. 1998 February; 21(2): 83-6 0391-3988
•
Engine-driven preparation of curved root canals: measuring cyclic fatigue and other physical parameters. Author(s): Department of Preventive Dentistry, Periodontology and Cardiology, Zurich University, Switzerland. Source: Peters, O A Kappeler, S Bucher, W Barbakow, F Aust-Endod-J. 2002 April; 28(1): 11-7 1329-1947
•
Fatigue associated with obstructive sleep apnea in a patient with sarcoidosis. Author(s): Department of Pulmonology, University Hospital Maastricht, The Netherlands.
[email protected] Source: Drent, M Verbraecken, J van der Grinten, C Wouters, E Respiration. 2000; 67(3): 337-40 0025-7931
•
Homeopathic treatment of Chronic Fatigue Syndrome: three case studies using Jan Scholten's methodology. Author(s):
[email protected] Source: Geraghty, J Homeopathy. 2002 April; 91(2): 99-105 1475-4916
•
Hyperprolactinaemia during prolonged exercise in the heat: evidence for a centrally mediated component of fatigue in trained cyclists. Author(s): Department of Biomedical Sciences, University Medical School, Aberdeen AB25 2ZD, UK. Source: Pitsiladis, Y P Strachan, A T Davidson, I Maughan, R J Exp-Physiol. 2002 March; 87(2): 215-26 0958-0670
•
Low levels of serum acylcarnitine in chronic fatigue syndrome and chronic hepatitis type C, but not seen in other diseases. Author(s): Hematology and Oncology, Osaka University Medical School, Suita, Osaka 565, Japan.
122 Fatigue
Source: Kuratsune, H Yamaguti, K Lindh, G Evengard, B Takahashi, M Machii, T Matsumura, K Takaishi, J Kawata, S Langstrom, B Kanakura, Y Kitani, T Watanabe, Y Int-J-Mol-Med. 1998 July; 2(1): 51-6 1107-3756 •
Neuromuscular properties and fatigue in older men following acute creatine supplementation. Author(s): Canadian Centre for Activity and Aging, School of Kinesiology, Faculty of Health Science, The University of Western Ontario, London, Canada, N6G 2M3. Source: Jakobi, J M Rice, C L Curtin, S V Marsh, G D Eur-J-Appl-Physiol. 2001 April; 84(4): 321-8 1439-6319
•
Nutritional strategies for treating chronic fatigue syndrome. Author(s): UCLA School of Medicine, California, USA. Source: Werbach, M R Altern-Med-Revolume 2000 April; 5(2): 93-108 1089-5159
•
Potential role of levocarnitine supplementation for the treatment of chemotherapyinduced fatigue in non-anaemic cancer patients. Author(s): Medical Oncology Unit, Hospital of Urbino, Via Bonconte da Montefeltro, 61029 Urbino, Italy.
[email protected] Source: Graziano, F Bisonni, R Catalano, V Silva, R Rovidati, S Mencarini, E Ferraro, B Canestrari, F Baldelli, A M De Gaetano, A Giordani, P Testa, E Lai, V Br-J-Cancer. 2002 June 17; 86(12): 1854-7 0007-0920
•
Self-care for fatigue in patients With HIV. Author(s): MGH Institute of Health Professions in Boston, MA, USA.
[email protected] Source: Corless, Inge B Bunch, Eli Haugen Kemppainen, Jeanne K Holzemer, William L Nokes, Kathleen M Eller, Lucille Sanzero Portillo, Carmen J Butensky, Ellen Nicholas, Patrice K Bain, Catherine A Davis, Sheila Kirksey, Kenn M Chou, Fang Yu Oncol-NursForum. 2002 June; 29(5): E60-9 1538-0688
•
Studies on ayurvedic drugs. I. Evaluation of antifatigue effect of the ayurvedic drug “Alert” in rats. Source: Kakrani, H.K. Nair, G.V. Kalyani, G.A. Satyanarayana, D. Fitoterapia. Milano : Inverni della Beffa. 1985. volume 56 (5) page 293-295. 0367-326X
•
The challenge of evaluating fatigue. Author(s): University of Texas Health Science Center, Houston, Texas, USA. Source: Rodriguez, T J-Am-Acad-Nurse-Pract. 2000 August; 12(8): 329-38; quiz 339-41 1041-2972
•
The characteristics of fatigue symptoms and their association with the life style and the health status in school children. Author(s): Department of Hygiene, Faculty of Medicine, Tottori University, Yonago, Japan. Source: Okamoto, M Tan, F Suyama, A Okada, H Miyamoto, T Kishimoto, T JEpidemiol. 2000 July; 10(4): 241-8 0917-5040
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The effect of a polynutrient supplement on fatigue and physical activity of patients with chronic fatigue syndrome: a double-blind randomized controlled trial. Author(s): Departments of. General Internal Medicine and. Medical Psychology, University Medical Center Nijmegen, The Netherlands. Source: Brouwers, F M Van Der Werf, S Bleijenberg, G Van Der Zee, L Van Der Meer, J W QJM. 2002 October; 95(10): 677-83 1460-2725
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The in vitro immunomodulatory effects of glyconutrients on peripheral blood mononuclear cells of patients with chronic fatigue syndrome. Author(s): University of California, Irvine, Department of Medicine, Orange 92668, USA. Source: See, D M Cimoch, P Chou, S Chang, J Tilles, J Integr-Physiol-Behav-Sci. 1998 JulSeptember; 33(3): 280-7 1053-881X
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The trajectory of fatigue in adult patients with breast and ovarian cancer receiving chemotherapy. Author(s): College of Nursing, Wayne State University, Detroit, MI, USA.
[email protected] Source: Payne, J K Oncol-Nurs-Forum. 2002 October; 29(9): 1334-40 1538-0688
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Treatment of chronic fatigue syndrome by dietary supplementation with omega-3 fatty acids--a good idea? Author(s): Department of Research, Isfahan University of Medical Sciences, Shahrekord, Isfahan, Iran.
[email protected] Source: Tamizi far, B Tamizi, B Med-Hypotheses. 2002 March; 58(3): 249-50 0306-9877
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMD®Health: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
The following is a specific Web list relating to fatigue; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Vitamins Pantothenic Acid Source: Integrative Medicine Communications; www.drkoop.com Pantothenic Acid Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,882,00.html Vitamin A Source: Healthnotes, Inc.; www.healthnotes.com Vitamin A Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin a Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10066,00.html Vitamin B Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10067,00.html Vitamin B Complex Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,962,00.html Vitamin B1 Source: Healthnotes, Inc.; www.healthnotes.com
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Vitamin B12 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B2 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B5 (pantothenic Acid) Source: Integrative Medicine Communications; www.drkoop.com Vitamin B6 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin C Source: Healthnotes, Inc.; www.healthnotes.com •
Minerals Carnitine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10012,00.html Carnitine (l-carnitine) Source: Integrative Medicine Communications; www.drkoop.com Chromium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10018,00.html Cisplatin Source: Healthnotes, Inc.; www.healthnotes.com Copper Source: Integrative Medicine Communications; www.drkoop.com Copper Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,886,00.html Creatine Source: Integrative Medicine Communications; www.drkoop.com Creatine Source: Prima Communications, Inc.www.personalhealthzone.com Creatine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10020,00.html
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Creatine Monohydrate Source: Healthnotes, Inc.; www.healthnotes.com Fluoxetine Source: Healthnotes, Inc.; www.healthnotes.com Gabapentin Source: Healthnotes, Inc.; www.healthnotes.com Iodine Source: Integrative Medicine Communications; www.drkoop.com Iodine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,888,00.html Iron Source: Healthnotes, Inc.; www.healthnotes.com Iron Source: Prima Communications, Inc.www.personalhealthzone.com L-carnitine Source: Healthnotes, Inc.; www.healthnotes.com L-carnitine Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: Healthnotes, Inc.; www.healthnotes.com Magnesium Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: Prima Communications, Inc.www.personalhealthzone.com Magnesium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html Paroxetine Source: Healthnotes, Inc.; www.healthnotes.com Phosphocreatine Source: Integrative Medicine Communications; www.drkoop.com Potassium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com
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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10086,00.html Retinol Source: Integrative Medicine Communications; www.drkoop.com Selenium Source: Integrative Medicine Communications; www.drkoop.com Selenium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10055,00.html Sulfur Source: Integrative Medicine Communications; www.drkoop.com Vitamin a (retinol) Source: Integrative Medicine Communications; www.drkoop.com Zinc Source: Healthnotes, Inc.; www.healthnotes.com •
Food and Diet Athletic Performance Source: Healthnotes, Inc.; www.healthnotes.com Carbo-loading Diet Source: Healthnotes, Inc.; www.healthnotes.com Gluten-free Diet Source: Healthnotes, Inc.; www.healthnotes.com Homeopathic Remedies for Athletic Performance Source: Healthnotes, Inc.; www.healthnotes.com Hypoglycemia Source: Healthnotes, Inc.; www.healthnotes.com Low-salt Diet Source: Healthnotes, Inc.; www.healthnotes.com Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Omega-3 Fatty Acids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,992,00.html
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The Zone Diet Source: Healthnotes, Inc.; www.healthnotes.com Turkey Source: Healthnotes, Inc.; www.healthnotes.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND FATIGUE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to fatigue. 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 fatigue 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 “fatigue” (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 fatigue: •
A population-based study of the clinical course of chronic fatigue syndrome. Author(s): Nisenbaum R, Jones JF, Unger ER, Reyes M, Reeves WC. Source: Health and Quality of Life Outcomes [electronic Resource]. 2003 October 3; 1(1): 49. Epub 2003 Oct 03. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14613572&dopt=Abstract
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Adaptive control of cyclic movements as muscles fatigue using functional neuromuscular stimulation. Author(s): Riess J, Abbas JJ. Source: IEEE Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the Ieee Engineering in Medicine and Biology Society. 2001 September; 9(3): 326-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11561670&dopt=Abstract
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Adherence, sleep, and fatigue outcomes after adjuvant breast cancer chemotherapy: results of a feasibility intervention study. Author(s): Berger AM, VonEssen S, Kuhn BR, Piper BF, Agrawal S, Lynch JC, Higginbotham P. Source: Oncology Nursing Forum. 2003 May-June; 30(3): 513-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12719750&dopt=Abstract
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An interdisciplinary therapeutic approach for dealing with patients attributing chronic fatigue and functional memory disorders to environmental poisoning--a pilot study. Author(s): Lacour M, Zunder T, Dettenkofer M, Schonbeck S, Ludtke R, Scheidt C. Source: International Journal of Hygiene and Environmental Health. 2002 February; 204(5-6): 339-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11885358&dopt=Abstract
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An overview of chronic fatigue syndrome. Author(s): Jackson E. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2002 December 11-17; 17(13): 45-53; Quiz 54-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12572221&dopt=Abstract
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Antifatigue effect of fresh royal jelly in mice. Author(s): Kamakura M, Mitani N, Fukuda T, Fukushima M. Source: J Nutr Sci Vitaminol (Tokyo). 2001 December; 47(6): 394-401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11922114&dopt=Abstract
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Anti-stress and anti-fatigue effect of fermented rice bran. Author(s): Kim KM, Yu KW, Kang DH, Suh HJ. Source: Phytotherapy Research : Ptr. 2002 November; 16(7): 700-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12410560&dopt=Abstract
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Chronic fatigue syndrome - medical fact or artifact. Author(s): Eidelman D. Source: Medical Hypotheses. 2003 June; 60(6): 840-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699708&dopt=Abstract
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Chronic fatigue syndrome and fibromyalgia: clinical assessment and treatment. Author(s): Friedberg F, Jason LA. Source: Journal of Clinical Psychology. 2001 April; 57(4): 433-55. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255201&dopt=Abstract
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Chronic fatigue syndrome. Clinical practice guidelines--2002. Author(s): Working Group of the Royal Australasian College of Physicians.
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Source: The Medical Journal of Australia. 2002 May 6; 176 Suppl: S23-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12056987&dopt=Abstract •
Chronic fatigue syndrome: a review. Author(s): Afari N, Buchwald D. Source: The American Journal of Psychiatry. 2003 February; 160(2): 221-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562565&dopt=Abstract
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Chronic fatigue syndrome: oxidative stress and dietary modifications. Author(s): Logan AC, Wong C. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 2001 October; 6(5): 450-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11703165&dopt=Abstract
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Chronic fatigue syndrome: successful outcome of an intensive inpatient programme. Author(s): Lim A, Lubitz L. Source: Journal of Paediatrics and Child Health. 2002 June; 38(3): 295-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12047700&dopt=Abstract
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Cognitive behaviour therapy for chronic fatigue syndrome: a multicentre randomised controlled trial. Author(s): Prins JB, Bleijenberg G, Bazelmans E, Elving LD, de Boo TM, Severens JL, van der Wilt GJ, Spinhoven P, van der Meer JW. Source: Lancet. 2001 March 17; 357(9259): 841-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11265953&dopt=Abstract
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Colforsin daropate improves contractility in fatigued canine diaphragm. Author(s): Fujii Y, Hoshi T, Toyooka H. Source: Anesthesia and Analgesia. 2001 March; 92(3): 762-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11226115&dopt=Abstract
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Concept analysis: chronic fatigue. Author(s): Trendall J. Source: Journal of Advanced Nursing. 2000 November; 32(5): 1126-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11114997&dopt=Abstract
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Cure of lifelong fatigue by calcium supplementation. Author(s): Alscher DM, Mettang T, Kuhlmann U. Source: Lancet. 2001 September 15; 358(9285): 888. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11567706&dopt=Abstract
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Cytokines and chronic fatigue syndrome. Author(s): Patarca R. Source: Annals of the New York Academy of Sciences. 2001 March; 933: 185-200. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12000020&dopt=Abstract
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Dietary and supplement treatment of iron deficiency results in improvements in general health and fatigue in Australian women of childbearing age. Author(s): Patterson AJ, Brown WJ, Roberts DC. Source: Journal of the American College of Nutrition. 2001 August; 20(4): 337-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11506061&dopt=Abstract
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Effect of aspartate and asparagine supplementation on fatigue determinants in intense exercise. Author(s): Marquezi ML, Roschel HA, dos Santa Costa A, Sawada LA, Lancha AH Jr. Source: International Journal of Sport Nutrition and Exercise Metabolism. 2003 March; 13(1): 65-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12660406&dopt=Abstract
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Effect of creatine supplementation during high resistance training on mass, strength, and fatigue resistance in rat skeletal muscle. Author(s): McBride TA, Gregory MA. Source: Journal of Strength and Conditioning Research / National Strength & Conditioning Association. 2002 August; 16(3): 335-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12173946&dopt=Abstract
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Effect of fatigue on torque output and electromyographic measures of trunk muscles during isometric axial rotation. Author(s): Ng JK, Parnianpour M, Richardson CA, Kippers V. Source: Archives of Physical Medicine and Rehabilitation. 2003 March; 84(3): 374-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638105&dopt=Abstract
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Effect of natural and synthetic antioxidants in a mouse model of chronic fatigue syndrome. Author(s): Singh A, Naidu PS, Gupta S, Kulkarni SK. Source: Journal of Medicinal Food. 2002 Winter; 5(4): 211-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12639396&dopt=Abstract
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Effect of rescuer fatigue on performance of continuous external chest compressions over 3 min. Author(s): Ashton A, McCluskey A, Gwinnutt CL, Keenan AM.
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Source: Resuscitation. 2002 November; 55(2): 151-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413752&dopt=Abstract •
Effects of a pulsed electromagnetic therapy on multiple sclerosis fatigue and quality of life: a double-blind, placebo controlled trial. Author(s): Lappin MS, Lawrie FW, Richards TL, Kramer ED. Source: Alternative Therapies in Health and Medicine. 2003 July-August; 9(4): 38-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12868251&dopt=Abstract
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Effects of seasonal allergic rhinitis on fatigue levels and mood. Author(s): Marshall PS, O'Hara C, Steinberg P. Source: Psychosomatic Medicine. 2002 July-August; 64(4): 684-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12140359&dopt=Abstract
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Failure of activation of spinal motoneurones after muscle fatigue in healthy subjects studied by transcranial magnetic stimulation. Author(s): Andersen B, Westlund B, Krarup C. Source: The Journal of Physiology. 2003 August 15; 551(Pt 1): 345-56. Epub 2003 June 24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824449&dopt=Abstract
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Fatigue in multiple sclerosis. Author(s): Krupp LB, Christodoulou C. Source: Curr Neurol Neurosci Rep. 2001 May; 1(3): 294-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11898532&dopt=Abstract
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Fatigue in systemic lupus erythematosus: a randomized controlled trial of exercise. Author(s): Tench CM, McCarthy J, McCurdie I, White PD, D'Cruz DP. Source: Rheumatology (Oxford, England). 2003 September; 42(9): 1050-4. Epub 2003 April 16. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12730519&dopt=Abstract
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Fatigue of anemia. Author(s): Eichner ER. Source: Nutrition Reviews. 2001 January; 59(1 Pt 2): S17-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11255796&dopt=Abstract
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Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome. Author(s): Buskila D. Source: Current Opinion in Rheumatology. 2001 March; 13(2): 117-27. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11224736&dopt=Abstract
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From a lived body to a medicalized body: diagnostic transformation and chronic fatigue syndrome. Author(s): Sachs L. Source: Medical Anthropology. 2001; 19(4): 299-317. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11800317&dopt=Abstract
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Gammalinolenic acid treatment of fatigue associated with primary Sjogren's syndrome. Author(s): Theander E, Horrobin DF, Jacobsson LT, Manthorpe R. Source: Scandinavian Journal of Rheumatology. 2002; 31(2): 72-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12109650&dopt=Abstract
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High fibre breakfast cereals reduce fatigue. Author(s): Smith A, Bazzoni C, Beale J, Elliott-Smith J, Tiley M. Source: Appetite. 2001 December; 37(3): 249-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11895326&dopt=Abstract
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Homeopathic treatment of Chronic Fatigue Syndrome: three case studies using Jan Scholten's methodology. Author(s): Geraghty J. Source: Homeopathy. 2002 April; 91(2): 99-105. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12371465&dopt=Abstract
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Hyperbaric oxygen therapy to relieve chronic fatigue associated with HIV/AIDS [letter] Author(s): Reillo M, Altieri R, Neubauer R. Source: Aids Patient Care. 1994 June; 8(3): 106-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11362128&dopt=Abstract
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Information processing in chronic fatigue syndrome: a preliminary investigation of suggestibility. Author(s): DiClementi JD, Schmaling KB, Jones JF. Source: Journal of Psychosomatic Research. 2001 November; 51(5): 679-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11728509&dopt=Abstract
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Interventions for the treatment and management of chronic fatigue syndrome: a systematic review. Author(s): Whiting P, Bagnall AM, Sowden AJ, Cornell JE, Mulrow CD, Ramirez G. Source: Jama : the Journal of the American Medical Association. 2001 September 19; 286(11): 1360-8. Review. Erratum In: Jama 2002 March 20; 287(11): 1401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11560542&dopt=Abstract
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Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. Author(s): Verdon F, Burnand B, Stubi CL, Bonard C, Graff M, Michaud A, Bischoff T, de Vevey M, Studer JP, Herzig L, Chapuis C, Tissot J, Pecoud A, Favrat B. Source: Bmj (Clinical Research Ed.). 2003 May 24; 326(7399): 1124. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12763985&dopt=Abstract
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Iron supplementation improves progressive fatigue resistance during dynamic knee extensor exercise in iron-depleted, nonanemic women. Author(s): Brutsaert TD, Hernandez-Cordero S, Rivera J, Viola T, Hughes G, Haas JD. Source: The American Journal of Clinical Nutrition. 2003 February; 77(2): 441-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12540406&dopt=Abstract
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Long-term outcome of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome: a 5-year follow-up study. Author(s): Deale A, Husain K, Chalder T, Wessely S. Source: The American Journal of Psychiatry. 2001 December; 158(12): 2038-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11729022&dopt=Abstract
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Monitoring of muscle fatigue during isokinetic exercise. Author(s): Airaksinen O, Rantanen P, Sihvonen T, Airaksinen K, Hanninen O, Herno A. Source: Acupuncture & Electro-Therapeutics Research. 2001; 26(4): 253-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11841110&dopt=Abstract
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Moral fatigue--a nursing perspective. Author(s): Taylor S. Source: Bioethics Forum. 2002; 18(1-2): 37-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12956173&dopt=Abstract
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Motor cortex excitability in chronic fatigue syndrome. Author(s): Starr A, Scalise A, Gordon R, Michalewski HJ, Caramia MD. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2000 November; 111(11): 2025-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11068238&dopt=Abstract
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Motor fatigue and cognitive task performance in humans. Author(s): Lorist MM, Kernell D, Meijman TF, Zijdewind I. Source: The Journal of Physiology. 2002 November 15; 545(Pt 1): 313-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12433971&dopt=Abstract
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Neuromuscular properties and fatigue in older men following acute creatine supplementation. Author(s): Jakobi JM, Rice CL, Curtin SV, Marsh GD.
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Source: European Journal of Applied Physiology. 2001 April; 84(4): 321-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11374116&dopt=Abstract •
Nutrition intervention in an all-star basketball player with fatigue. Author(s): Kleiner SM. Source: Curr Sports Med Rep. 2003 August; 2(4): 187-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834572&dopt=Abstract
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Nutritional strategies for treating chronic fatigue syndrome. Author(s): Logan AC. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 2001 February; 6(1): 4-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11207453&dopt=Abstract
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Oral antioxidant supplementation for fatigue associated with primary biliary cirrhosis: results of a multicentre, randomized, placebo-controlled, cross-over trial. Author(s): Prince MI, Mitchison HC, Ashley D, Burke DA, Edwards N, Bramble MG, James OF, Jones DE. Source: Alimentary Pharmacology & Therapeutics. 2003 January; 17(1): 137-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12492743&dopt=Abstract
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Origin of cubic difference tones generated by high-intensity stimuli: effect of ischemia and auditory fatigue on the gerbil cochlea. Author(s): Mom T, Bonfils P, Gilain L, Avan P. Source: The Journal of the Acoustical Society of America. 2001 September; 110(3 Pt 1): 1477-88. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11572358&dopt=Abstract
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Postoperative fatigue negatively impacts the daily lives of patients recovering from hysterectomy. Author(s): DeCherney AH, Bachmann G, Isaacson K, Gall S. Source: Obstetrics and Gynecology. 2002 January; 99(1): 51-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11777510&dopt=Abstract
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Potential role of levocarnitine supplementation for the treatment of chemotherapyinduced fatigue in non-anaemic cancer patients. Author(s): Graziano F, Bisonni R, Catalano V, Silva R, Rovidati S, Mencarini E, Ferraro B, Canestrari F, Baldelli AM, De Gaetano A, Giordani P, Testa E, Lai V. Source: British Journal of Cancer. 2002 June 17; 86(12): 1854-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12085175&dopt=Abstract
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Predictors of response to treatment for chronic fatigue syndrome. Author(s): Bentall RP, Powell P, Nye FJ, Edwards RH.
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Source: The British Journal of Psychiatry; the Journal of Mental Science. 2002 September; 181: 248-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12204931&dopt=Abstract •
Preventing fatigue of fast striated muscles of the pelvic floor and slow striated muscles of the limb by manipulating the on-off time of electric stimulation. Author(s): Poortmans A, Wyndaele JJ. Source: Archives of Physical Medicine and Rehabilitation. 2002 April; 83(4): 550-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11932860&dopt=Abstract
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Radiotherapy-related fatigue. Author(s): Jereczek-Fossa BA, Marsiglia HR, Orecchia R. Source: Critical Reviews in Oncology/Hematology. 2002 March; 41(3): 317-25. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11880207&dopt=Abstract
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Radiotherapy-related fatigue: how to assess and how to treat the symptom. A commentary. Author(s): Jereczek-Fossa BA, Marsiglia HR, Orecchia R. Source: Tumori. 2001 May-June; 87(3): 147-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11504369&dopt=Abstract
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Reducing fatigue of athletes following oral administration of huangqi jianzhong tang. Author(s): Chen KT, Su CH, Hsin LH, Su YC, Su YP, Lin JG. Source: Acta Pharmacologica Sinica. 2002 August; 23(8): 757-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12147200&dopt=Abstract
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Rhodiola rosea in stress induced fatigue--a double blind cross-over study of a standardized extract SHR-5 with a repeated low-dose regimen on the mental performance of healthy physicians during night duty. Author(s): Darbinyan V, Kteyan A, Panossian A, Gabrielian E, Wikman G, Wagner H. Source: Phytomedicine : International Journal of Phytotherapy and Phytopharmacology. 2000 October; 7(5): 365-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11081987&dopt=Abstract
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Role of antioxidants in chronic fatigue syndrome in mice. Author(s): Singh A, Garg V, Gupta S, Kulkarni SK. Source: Indian J Exp Biol. 2002 November; 40(11): 1240-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=13677625&dopt=Abstract
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Self-care for fatigue in patients With HIV. Author(s): Corless IB, Bunch EH, Kemppainen JK, Holzemer WL, Nokes KM, Eller LS, Portillo CJ, Butensky E, Nicholas PK, Bain CA, Davis S, Kirksey KM, Chou FY.
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Source: Oncology Nursing Forum. 2002 June; 29(5): E60-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12064325&dopt=Abstract •
Stress state during fixation determines susceptibility to fatigue-linked biodegradation in bioprosthetic heart valve materials. Author(s): Margueratt SD, Lee JM. Source: Biomed Sci Instrum. 2002; 38: 145-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12085592&dopt=Abstract
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The effect of a polynutrient supplement on fatigue and physical activity of patients with chronic fatigue syndrome: a double-blind randomized controlled trial. Author(s): Brouwers FM, Van Der Werf S, Bleijenberg G, Van Der Zee L, Van Der Meer JW. Source: Qjm : Monthly Journal of the Association of Physicians. 2002 October; 95(10): 677-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12324640&dopt=Abstract
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The effect of massage on localized lumbar muscle fatigue. Author(s): Tanaka TH, Leisman G, Mori H, Nishijo K. Source: Bmc Complementary and Alternative Medicine [electronic Resource]. 2002 October 14; 2(1): 9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12377105&dopt=Abstract
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The prognosis after multidisciplinary treatment for patients with postinfectious chronic fatigue syndrome and noninfectious chronic fatigue syndrome. Author(s): Masuda A, Nakayama T, Yamanaka T, Koga Y, Tei C. Source: Journal of Behavioral Medicine. 2002 October; 25(5): 487-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12442563&dopt=Abstract
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Treatment of chronic fatigue syndrome by dietary supplementation with omega-3 fatty acids--a good idea? Author(s): Tamizi far B, Tamizi B. Source: Medical Hypotheses. 2002 March; 58(3): 249-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12018979&dopt=Abstract
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Treatment of chronic fatigue with neurofeedback and self-hypnosis. Author(s): Hammond DC. Source: Neurorehabilitation. 2001; 16(4): 295-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11790917&dopt=Abstract
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Treatments for fatigue in multiple sclerosis: a rapid and systematic review. Author(s): Branas P, Jordan R, Fry-Smith A, Burls A, Hyde C.
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Source: Health Technology Assessment (Winchester, England). 2000; 4(27): 1-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11074395&dopt=Abstract •
Using the bedside wellness system during chemotherapy decreases fatigue and emesis in cancer patients. Author(s): Oyama H, Kaneda M, Katsumata N, Akechi T, Ohsuga M. Source: Journal of Medical Systems. 2000 June; 24(3): 173-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10984871&dopt=Abstract
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMD®Health: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to fatigue; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview AIDS and HIV Source: Integrative Medicine Communications; www.drkoop.com Alcoholism Source: Integrative Medicine Communications; www.drkoop.com
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Allergies and Sensitivities Source: Healthnotes, Inc.; www.healthnotes.com Anemia Source: Integrative Medicine Communications; www.drkoop.com Anxiety Source: Healthnotes, Inc.; www.healthnotes.com Anxiety Source: Integrative Medicine Communications; www.drkoop.com Bipolar Disorder Source: Healthnotes, Inc.; www.healthnotes.com Bone Cancer Source: Integrative Medicine Communications; www.drkoop.com Bone Infection Source: Integrative Medicine Communications; www.drkoop.com Bone Marrow Disorders Source: Integrative Medicine Communications; www.drkoop.com Breast Cancer Source: Healthnotes, Inc.; www.healthnotes.com Bronchitis Source: Healthnotes, Inc.; www.healthnotes.com Bronchitis Source: Integrative Medicine Communications; www.drkoop.com Candida/yeast Hypersensitivity Syndrome Source: Prima Communications, Inc.www.personalhealthzone.com Canker Sores Source: Healthnotes, Inc.; www.healthnotes.com Cardiomyopathy Source: Healthnotes, Inc.; www.healthnotes.com Cardiovascular Disease Overview Source: Healthnotes, Inc.; www.healthnotes.com Celiac Disease Source: Healthnotes, Inc.; www.healthnotes.com Chickenpox and Shingles Source: Integrative Medicine Communications; www.drkoop.com
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Chronic Candidiasis Source: Healthnotes, Inc.; www.healthnotes.com Chronic Fatigue Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Chronic Fatigue Syndrome Source: Integrative Medicine Communications; www.drkoop.com Chronic Myelogenous Leukemia Source: Integrative Medicine Communications; www.drkoop.com Chronic Obstructive Pulmonary Disease Source: Healthnotes, Inc.; www.healthnotes.com Colds and Flus Source: Prima Communications, Inc.www.personalhealthzone.com Colorectal Cancer Source: Integrative Medicine Communications; www.drkoop.com Common Cold Source: Integrative Medicine Communications; www.drkoop.com Congestive Heart Failure Source: Healthnotes, Inc.; www.healthnotes.com Congestive Heart Failure Source: Integrative Medicine Communications; www.drkoop.com Congestive Heart Failure Source: Prima Communications, Inc.www.personalhealthzone.com Crohn's Disease Source: Integrative Medicine Communications; www.drkoop.com Cystic Fibrosis Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Healthnotes, Inc.; www.healthnotes.com Depression Source: Integrative Medicine Communications; www.drkoop.com Depression (Mild to Moderate) Source: Prima Communications, Inc.www.personalhealthzone.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com
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Dysphagia Source: Integrative Medicine Communications; www.drkoop.com Epilepsy Source: Integrative Medicine Communications; www.drkoop.com Epstein-barr Virus Source: Integrative Medicine Communications; www.drkoop.com Erythema Source: Integrative Medicine Communications; www.drkoop.com Fainting Source: Integrative Medicine Communications; www.drkoop.com Fibromyalgia Source: Healthnotes, Inc.; www.healthnotes.com Fibromyalgia Source: Integrative Medicine Communications; www.drkoop.com Flu Source: Integrative Medicine Communications; www.drkoop.com Food Poisoning Source: Integrative Medicine Communications; www.drkoop.com Gastroesophageal Reflux Disease Source: Integrative Medicine Communications; www.drkoop.com Heartburn Source: Integrative Medicine Communications; www.drkoop.com Heat Exhaustion Source: Integrative Medicine Communications; www.drkoop.com Hepatitis Source: Healthnotes, Inc.; www.healthnotes.com Herpes Zoster and Varicella Viruses Source: Integrative Medicine Communications; www.drkoop.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Support Source: Healthnotes, Inc.; www.healthnotes.com Hyperkalemia Source: Integrative Medicine Communications; www.drkoop.com
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Hypertension Source: Integrative Medicine Communications; www.drkoop.com Hypoglycemia Source: Integrative Medicine Communications; www.drkoop.com Hypothermia Source: Integrative Medicine Communications; www.drkoop.com Hypothyroidism Source: Healthnotes, Inc.; www.healthnotes.com Hypothyroidism Source: Integrative Medicine Communications; www.drkoop.com Immune Function Source: Healthnotes, Inc.; www.healthnotes.com Infection Source: Healthnotes, Inc.; www.healthnotes.com Influenza Source: Healthnotes, Inc.; www.healthnotes.com Influenza Source: Integrative Medicine Communications; www.drkoop.com Insomnia Source: Integrative Medicine Communications; www.drkoop.com Insomnia Source: Prima Communications, Inc.www.personalhealthzone.com Intermittent Claudication Source: Healthnotes, Inc.; www.healthnotes.com Iron-deficiency Anemia Source: Healthnotes, Inc.; www.healthnotes.com Irritable Bowel Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Jet Lag Source: Healthnotes, Inc.; www.healthnotes.com Laryngitis Source: Integrative Medicine Communications; www.drkoop.com Leukemia Source: Integrative Medicine Communications; www.drkoop.com
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Low Back Pain Source: Integrative Medicine Communications; www.drkoop.com Low Blood Sugar Source: Integrative Medicine Communications; www.drkoop.com Lung Cancer Source: Integrative Medicine Communications; www.drkoop.com Lupus Source: Integrative Medicine Communications; www.drkoop.com Lyme Disease Source: Integrative Medicine Communications; www.drkoop.com Malabsorption Source: Healthnotes, Inc.; www.healthnotes.com Meningitis Source: Integrative Medicine Communications; www.drkoop.com Menopausal Symptoms (Other Than Osteoporosis) Source: Prima Communications, Inc.www.personalhealthzone.com Menorrhagia Source: Healthnotes, Inc.; www.healthnotes.com Migraine Headaches Source: Prima Communications, Inc.www.personalhealthzone.com Mitral Valve Prolapse Source: Healthnotes, Inc.; www.healthnotes.com Mononucleosis Source: Integrative Medicine Communications; www.drkoop.com Morning Sickness Source: Healthnotes, Inc.; www.healthnotes.com Motion Sickness Source: Healthnotes, Inc.; www.healthnotes.com Motion Sickness Source: Integrative Medicine Communications; www.drkoop.com Multiple Sclerosis Source: Healthnotes, Inc.; www.healthnotes.com Multiple Sclerosis Source: Integrative Medicine Communications; www.drkoop.com
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Myelofibrosis Source: Integrative Medicine Communications; www.drkoop.com Myeloproliferative Disorders Source: Integrative Medicine Communications; www.drkoop.com Osteoarthritis Source: Healthnotes, Inc.; www.healthnotes.com Osteoarthritis Source: Integrative Medicine Communications; www.drkoop.com Osteomyelitis Source: Integrative Medicine Communications; www.drkoop.com Pain Source: Healthnotes, Inc.; www.healthnotes.com Pericarditis Source: Integrative Medicine Communications; www.drkoop.com Peripheral Vascular Disease Source: Healthnotes, Inc.; www.healthnotes.com Phenylketonuria Source: Healthnotes, Inc.; www.healthnotes.com PMS Source: Integrative Medicine Communications; www.drkoop.com PMS Alternative names: Premenstrual Stress Syndrome Source: Prima Communications, Inc.www.personalhealthzone.com Polycythemia Vera Source: Integrative Medicine Communications; www.drkoop.com Premenstrual Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Premenstrual Syndrome Source: Integrative Medicine Communications; www.drkoop.com Proctitis Source: Integrative Medicine Communications; www.drkoop.com Prostate Cancer Source: Healthnotes, Inc.; www.healthnotes.com Prostate Cancer Source: Integrative Medicine Communications; www.drkoop.com
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Pyloric Stenosis Source: Integrative Medicine Communications; www.drkoop.com Rectal Inflammation Source: Integrative Medicine Communications; www.drkoop.com Rheumatoid Arthritis Source: Healthnotes, Inc.; www.healthnotes.com Rubella Source: Integrative Medicine Communications; www.drkoop.com Sarcoidosis Source: Integrative Medicine Communications; www.drkoop.com Seasonal Affective Disorder Source: Healthnotes, Inc.; www.healthnotes.com Seizure Disorders Source: Integrative Medicine Communications; www.drkoop.com Shingles and Chickenpox Source: Integrative Medicine Communications; www.drkoop.com Sickle Cell Anemia Source: Healthnotes, Inc.; www.healthnotes.com Sleeplessness Source: Integrative Medicine Communications; www.drkoop.com Syncope Source: Integrative Medicine Communications; www.drkoop.com Systemic Lupus Erythematosus Source: Integrative Medicine Communications; www.drkoop.com Tension Headache Source: Healthnotes, Inc.; www.healthnotes.com Thrombocytosis Source: Integrative Medicine Communications; www.drkoop.com Tuberculosis Source: Integrative Medicine Communications; www.drkoop.com Ulcerative Colitis Source: Healthnotes, Inc.; www.healthnotes.com Urinary Tract Infection Source: Healthnotes, Inc.; www.healthnotes.com
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Varicella and Herpes Zoster Viruses Source: Integrative Medicine Communications; www.drkoop.com Vertigo Source: Healthnotes, Inc.; www.healthnotes.com Viral Hepatitis Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B12 Deficiency Source: Healthnotes, Inc.; www.healthnotes.com Wilson's Disease Source: Healthnotes, Inc.; www.healthnotes.com •
Alternative Therapy Acupressure Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,662,00.html Apitherapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,669,00.html Ayurveda Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,672,00.html Bach Flower Remedies Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,673,00.html Colon Therapy Source: Healthnotes, Inc.; www.healthnotes.com Colon Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,682,00.html Detoxification Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10119,00.html Fasting Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com
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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,694,00.html Feldenkrais Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,695,00.html Guided Imagery Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,699,00.html Homeopathy Source: Integrative Medicine Communications; www.drkoop.com Jin Shin Jyutsu Alternative names: jin shin jitsu Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/j.html Macrobiotics Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,714,00.html Massage Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,716,00.html Meditation Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,717,00.html Mind & Body Medicine Source: Integrative Medicine Communications; www.drkoop.com Myotherapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,931,00.html Osteopathy Source: Integrative Medicine Communications; www.drkoop.com Osteopathy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,724,00.html
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Polarity Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,727,00.html Thai Massage-Reflex Yoga with Mettatouch Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/t.html Traditional Chinese Medicine Source: Integrative Medicine Communications; www.drkoop.com •
Chinese Medicine Jiawei Xiaoyao Wan Alternative names: Jiawei Xiaoyao Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China
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Herbs and Supplements 5-htp (5-hydroxytryptophan) Source: Prima Communications, Inc.www.personalhealthzone.com Acanthopanax Senticosus Source: Integrative Medicine Communications; www.drkoop.com Acidophilus and Other Probiotics Source: Prima Communications, Inc.www.personalhealthzone.com Adrenal Complex Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,994,00.html Adrenal Extract Source: Healthnotes, Inc.; www.healthnotes.com Aesculus Alternative names: Horse Chestnut; Aesculus hippocastanum L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Aloe Alternative names: Aloe vera L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Alpha-lipoic Acid Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com
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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10002,00.html American Ginseng Source: Healthnotes, Inc.; www.healthnotes.com Amino Acids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10003,00.html Amino Acids Overview Source: Healthnotes, Inc.; www.healthnotes.com Aminoglycosides Source: Integrative Medicine Communications; www.drkoop.com Andrographis Alternative names: Andrographis paniculata Source: Healthnotes, Inc.; www.healthnotes.com Anticonvulsants Source: Healthnotes, Inc.; www.healthnotes.com Asian Ginseng Alternative names: Panax ginseng Source: Healthnotes, Inc.; www.healthnotes.com Astragalus Alternative names: Astragalus membranaceus Source: Healthnotes, Inc.; www.healthnotes.com Astragalus Alternative names: Astragalus membranaceus, Astragalus membranaceus var. mongholicus, Huang-qi, Milk-Vetch Root Source: Integrative Medicine Communications; www.drkoop.com Astragalus Membranaceus Source: Integrative Medicine Communications; www.drkoop.com Astragalus Mongholicus Alternative names: Astragalus membranaceus, Astragalus membranaceus var. mongholicus, Huang-qi, Milk-Vetch Root Source: Integrative Medicine Communications; www.drkoop.com Astragalus Sp Alternative names: Vetch, Rattlepod, Locoweed; Astragalus sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Barberry Alternative names: Berberis vulgaris Source: Healthnotes, Inc.; www.healthnotes.com
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Bee Products Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,756,00.html Beta-carotene Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10103,00.html Bile Acid Sequestrants Source: Integrative Medicine Communications; www.drkoop.com Black Cohosh Source: Prima Communications, Inc.www.personalhealthzone.com Branched-chain Amino Acids Source: Healthnotes, Inc.; www.healthnotes.com Brewer's Yeast Alternative names: Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Caffeine Source: Healthnotes, Inc.; www.healthnotes.com Caprylic Acid Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10111,00.html Cardiac Glycosides Source: Integrative Medicine Communications; www.drkoop.com Carotenoids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,763,00.html Cat's Claw Alternative names: Uncaria tomentosa Source: Integrative Medicine Communications; www.drkoop.com Chasteberry Source: Prima Communications, Inc.www.personalhealthzone.com Chemotherapy Source: Healthnotes, Inc.; www.healthnotes.com Coenzyme Q Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com
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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,768,00.html Corydalis Alternative names: Corydalis turtschaninovii, Corydalis yanhusuo Source: Healthnotes, Inc.; www.healthnotes.com Cyclophosphamide Source: Healthnotes, Inc.; www.healthnotes.com Dandelion Source: Prima Communications, Inc.www.personalhealthzone.com Dehydroepiandrosterone (dhea) Source: Healthnotes, Inc.; www.healthnotes.com Dehydroepiandrosterone (dhea) Source: Integrative Medicine Communications; www.drkoop.com Dhea Source: Integrative Medicine Communications; www.drkoop.com Dhea Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10022,00.html Docetaxel Source: Healthnotes, Inc.; www.healthnotes.com Dong Quai (Angelica) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,774,00.html Echinacea Alternative names: Echinacea purpurea, Echinacea angustifolia, Echinacea pallida Source: Healthnotes, Inc.; www.healthnotes.com Echinacea Source: Prima Communications, Inc.www.personalhealthzone.com Echinacea Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,775,00.html Eleuthero Source: Healthnotes, Inc.; www.healthnotes.com Eleuthero Source: Integrative Medicine Communications; www.drkoop.com
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Eleutherococcus Senticosus Source: Integrative Medicine Communications; www.drkoop.com Eyebright Alternative names: Euphrasia officinalis Source: Healthnotes, Inc.; www.healthnotes.com Fluorouracil Source: Healthnotes, Inc.; www.healthnotes.com Fluvoxamine Source: Healthnotes, Inc.; www.healthnotes.com Forskolin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10025,00.html Ginseng (panax) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10029,00.html GLA (Gamma-Linolenic Acid) Source: Prima Communications, Inc.www.personalhealthzone.com Glutamic Acid Source: Healthnotes, Inc.; www.healthnotes.com Glutamine Source: Integrative Medicine Communications; www.drkoop.com Glutamine Source: Prima Communications, Inc.www.personalhealthzone.com Glycyrrhiza Glabra Source: Integrative Medicine Communications; www.drkoop.com Goldenseal Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,791,00.html Guaraná Alternative names: Paullinia cupana Source: Healthnotes, Inc.; www.healthnotes.com Hawthorn Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10035,00.html
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Histamine H2 Antagonists Source: Integrative Medicine Communications; www.drkoop.com Huang-qi Source: Integrative Medicine Communications; www.drkoop.com Hydantoin Derivatives Source: Integrative Medicine Communications; www.drkoop.com Hypericum Perforatum Source: Integrative Medicine Communications; www.drkoop.com Indapamide Source: Healthnotes, Inc.; www.healthnotes.com Ip-6 Source: Healthnotes, Inc.; www.healthnotes.com Kava Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,798,00.html Klamathweed Source: Integrative Medicine Communications; www.drkoop.com Lavender Alternative names: Lavandula officinalis Source: Healthnotes, Inc.; www.healthnotes.com Lavender Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,799,00.html Licorice Alternative names: Glycyrrhiza glabra, Glycyrrhiza uralensis Source: Healthnotes, Inc.; www.healthnotes.com Licorice Alternative names: Glycyrrhiza glabra, Spanish Licorice Source: Integrative Medicine Communications; www.drkoop.com Licorice Source: Prima Communications, Inc.www.personalhealthzone.com Licorice Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,801,00.html
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Loop Diuretics Source: Integrative Medicine Communications; www.drkoop.com Melatonin Source: Healthnotes, Inc.; www.healthnotes.com Melatonin Source: Integrative Medicine Communications; www.drkoop.com Melatonin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,804,00.html Methotrexate Source: Healthnotes, Inc.; www.healthnotes.com Methylsulfonylmethane Source: Healthnotes, Inc.; www.healthnotes.com Milk Thistle Source: Prima Communications, Inc.www.personalhealthzone.com Milk-vetch Root Source: Integrative Medicine Communications; www.drkoop.com Miscellaneous Preparations Source: Integrative Medicine Communications; www.drkoop.com NADH Source: Healthnotes, Inc.; www.healthnotes.com NADH Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10047,00.html Nonsteroidal Anti-inflammatory Drugs (nsaids) Source: Integrative Medicine Communications; www.drkoop.com OPCS (Oligomeric Proanthocyanidins) Source: Prima Communications, Inc.www.personalhealthzone.com Paclitaxel Source: Healthnotes, Inc.; www.healthnotes.com Panax Alternative names: Ginseng; Panax ginseng Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Pau D'arco Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com
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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,811,00.html Peppermint Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,812,00.html Phosphorus Source: Integrative Medicine Communications; www.drkoop.com Phyllanthus/ayurvedic Liver Support Combination Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10050,00.html Pregnenolone Source: Prima Communications, Inc.www.personalhealthzone.com Reishi Alternative names: Ganoderma lucidum Source: Healthnotes, Inc.; www.healthnotes.com S-Adenosylmethionine (SAMe) Source: Integrative Medicine Communications; www.drkoop.com Salicylates Source: Integrative Medicine Communications; www.drkoop.com Schisandra Source: Healthnotes, Inc.; www.healthnotes.com Sertraline Source: Healthnotes, Inc.; www.healthnotes.com Siberian Ginseng Alternative names: Eleutherococcus senticosus, Acanthopanax senticosus, Eleuthero Source: Integrative Medicine Communications; www.drkoop.com Siberian Ginseng Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,821,00.html Spanish Licorice Source: Integrative Medicine Communications; www.drkoop.com St. John’s Wort Alternative names: Hypericum perforatum Source: Healthnotes, Inc.; www.healthnotes.com
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St. John's Wort Alternative names: Hypericum perforatum, Klamathweed Source: Integrative Medicine Communications; www.drkoop.com Stimulant Laxatives Source: Integrative Medicine Communications; www.drkoop.com Suma Source: Healthnotes, Inc.; www.healthnotes.com Suma Source: Prima Communications, Inc.www.personalhealthzone.com Symphytum Alternative names: Comfrey; Symphytum officinale L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Thiazide Diuretics Source: Integrative Medicine Communications; www.drkoop.com Tyrosine Source: Integrative Medicine Communications; www.drkoop.com Tyrosine Source: Prima Communications, Inc.www.personalhealthzone.com Uncaria Tomentosa Source: Integrative Medicine Communications; www.drkoop.com Uricosuric Agents Source: Integrative Medicine Communications; www.drkoop.com Valerian Alternative names: Valeriana officinalis Source: Healthnotes, Inc.; www.healthnotes.com Valerian Source: Prima Communications, Inc.www.personalhealthzone.com Valproic Acid Derivatives Source: Integrative Medicine Communications; www.drkoop.com Yohimbe Source: Prima Communications, Inc.www.personalhealthzone.com
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html.
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This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON FATIGUE Overview In this chapter, we will give you a bibliography on recent dissertations relating to fatigue. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “fatigue” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on fatigue, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Fatigue ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to fatigue. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A Biomechanical and Physiological Evaluation of Fatigue in Distance Running by Evans, Sharon Ann, PhD from Michigan State University, 1988, 110 pages http://wwwlib.umi.com/dissertations/fullcit/8912573
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A Controlled Study of the Effects of Chemical and Psychological Stress on Persian Gulf War Veterans with Chronic Fatigue by Giardino, Nicholas David; PhD from Rutgers the State University of New Jersey - New Brunswick, 2002, 64 pages http://wwwlib.umi.com/dissertations/fullcit/3066709
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A Descriptive Case Study Analysis of the Basketball Jump Shot and the Effect of Fatigue on the Jump Shot by Bryant, James Edward, Edd from University of Missouri Columbia, 1969, 380 pages http://wwwlib.umi.com/dissertations/fullcit/7002966
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A Method of Fatigue Damage Analysis by Wetzel, R. M; PhD from University of Waterloo (Canada), 1972 http://wwwlib.umi.com/dissertations/fullcit/NK12256
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A Phenomenological Study of Six Chronic Fatigue Immune Dysfunction Syndrome Survivors by Aikman, Linda Poling, PhD from Ohio University, 1994, 173 pages http://wwwlib.umi.com/dissertations/fullcit/9511005
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A Preliminary Investigation to Determine the Effects of a Crosslinking Reagent on the Fatigue Resistance of the Posterior Annulus of the Intervertebral Disc by Gray, Dean Michael; Ms from University of Southern California, 2002, 120 pages http://wwwlib.umi.com/dissertations/fullcit/1411786
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A Stochastic Approach for Estimating Fatigue Life of Equipment Located at Topside of Fpso Offshore Systems by Wang, Juan; Ms from Rice University, 2002, 60 pages http://wwwlib.umi.com/dissertations/fullcit/1408717
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A Study of Fatigue Crack Initiation and Early Propagation by Zhai, Zhen-hua; PhD from Mcgill University (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL52246
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A Study of the Effect of Mechanical Variables on Fatigue Crack Closure and Propagation by Ibrahim, Faisal Khalil; PhD from University of Waterloo (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL29583
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A Study of the Growth of Short Fatigue Cracks Based on Fracture Mechanics by Elhaddad, M. H; PhD from University of Waterloo (Canada), 1978 http://wwwlib.umi.com/dissertations/fullcit/NK39857
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A Study on Fatigue of Welded Structures: Predictive Modeling Based on Automatic Learning, Numerical Analysis, and Experimental Results by Huang, Jun; PhD from University of California, San Diego, 2002, 182 pages http://wwwlib.umi.com/dissertations/fullcit/3071054
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A Thermodynamic Damage Mechanics Theory and Experimental Verification for Thermomechanical Fatigue Life Prediction of Microelectronics Solder Joints by Tang, Hong; PhD from State University of New York at Buffalo, 2003, 289 pages http://wwwlib.umi.com/dissertations/fullcit/3076534
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A Three Phase Approach to Solving the Bidline Generation Problem with an Emphasis on Mitigating Pilot Fatigue Through Circadian Rule Enforcement by Weir, Jeffery David; PhD from Georgia Institute of Technology, 2002, 87 pages http://wwwlib.umi.com/dissertations/fullcit/3072370
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Acknowledging the Elusive: the Dilemma of Defining Chronic Fatigue Syndrome by Macdonald, Goldie, PhD from University of Florida, 1998, 168 pages http://wwwlib.umi.com/dissertations/fullcit/9919607
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Aerobic Exercise Training Effects on Physical Function, Fatigue and Mood, Immune Status, and Oxidative Stress in Subjects Undergoing Radiation Treatment for Breast Cancer by Drouin, Jacqueline; PhD from Wayne State University, 2002, 142 pages http://wwwlib.umi.com/dissertations/fullcit/3047549
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Ammonia Production and Anaerobic Glycolysis during Intermittent High-intensity Exercise: Mechanism for Muscular Fatigue (exercise) by Michael, Timothy James, PhD from University of Pittsburgh, 1992, 82 pages http://wwwlib.umi.com/dissertations/fullcit/9226502
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An Analysis of Changes in Affect and Changes in Both Computational Power and Computational Stamina Occurring in Primary and Elementary School Children after Instruction in Hutchings' Low Fatigue Addition Algorithm, Practice with Unusually Large Examples, by Dashiell, William Henry, PhD from University of Maryland College Park, 1974, 331 pages http://wwwlib.umi.com/dissertations/fullcit/7429066
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An Electromyographic Analysis of Skeletal Neuromuscular Fatigue with Special Reference to Age by Evans, Steven Joe, PhD from University of Southern California, 1971, 235 pages http://wwwlib.umi.com/dissertations/fullcit/7127919
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An Electromyographic Analysis of the Action of Therapeutic Cold on Neuromuscular Fatigue by Moore, Robert John, PhD from University of Oregon, 1972, 81 pages http://wwwlib.umi.com/dissertations/fullcit/7313754
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An Evaluation of Selected Methods of Recovery from Fatigue. by Swanson, Harlan Leroy, Edd from Utah State University, 1973, 94 pages http://wwwlib.umi.com/dissertations/fullcit/7413263
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An Examination of Variable Amplitude Histories in Fatigue by Conle, Friedrich Albrecht; PhD from University of Waterloo (Canada), 1979 http://wwwlib.umi.com/dissertations/fullcit/NK39853
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An Exploratory Study of Musical Stimuli and Inducement of Auditory Fatigue by Comella, Frank Peter, PhD from The University of Iowa, 1972, 163 pages http://wwwlib.umi.com/dissertations/fullcit/7313514
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An Investigation into the Fatigue Crack Growth Behaviour of an Imi 829 Titanium Rotating Disc Material by Hull, David Allan; PhD from University of Toronto (Canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL54605
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An Investigation into the Fatigue Crack Growth Characteristics of a Single Crystal Nickel-base Superalloy by Wu, David Chong; PhD from University of Toronto (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL34128
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An Investigation of Sleep and Fatigue in Transit Bus Operators on Different Work Schedules by Howarth, Heidi Dawn; PhD from The University of Connecticut, 2002, 126 pages http://wwwlib.umi.com/dissertations/fullcit/3071209
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An Investigation of the Diagonal Failure of Reinforced Concrete Beams under Fatigue Loading by Suter, Gerhard T; Advdeg from University of Toronto (Canada), 1967 http://wwwlib.umi.com/dissertations/fullcit/NK01092
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An Investigation of the Fatigue Crack Growth Rate Characteristics of Titanium Alloy Imi829 by Sooley, Patrick Michael; PhD from University of Toronto (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NL23447
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Anaerobic Fatigue and Its Effect on Kinematic and Kinetic Variables Associated with Impact during Vertical Jumping by Robinson, Russell Edward, PhD from Texas Woman's University, 1996, 143 pages http://wwwlib.umi.com/dissertations/fullcit/9716589
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Analytical and Experimental Investigation on the Fatigue Behaviour of Tubular Joints for Offshore Monopod Structures by Gowda, Siddappa Shankare; PhD from Memorial University of Newfoundland (Canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK65569
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Bending Moment Approximation Analysis for Use in Fatigue Life Evaluation of Steel Railway Girder Bridges by Dick, Stephen Mark; PhD from University of Kansas, 2002, 297 pages http://wwwlib.umi.com/dissertations/fullcit/3067081
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Biostability of Polyurethane Elastomers: Pacemaker Leads, Effect of Fatigue, and Novel Antioxidant Stabilizers by Wiggins, Michael John; PhD from Case Western Reserve University, 2002, 166 pages http://wwwlib.umi.com/dissertations/fullcit/3058378
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Built-in Diagnostics for Monitoring Fatigue Crack Growth in Aircraft Structures by Ihn, Jeong-beom; PhD from Stanford University, 2003, 106 pages http://wwwlib.umi.com/dissertations/fullcit/3085192
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Caffeine Increases Time to Fatigue by Potentiating Force and Not by Altering Firing Rates in a Submaximal Isometric Task by Meyers, Brandon Matthew; Msc from York University (Canada), 2002, 116 pages http://wwwlib.umi.com/dissertations/fullcit/MQ75406
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Cancer-related Fatigue and Functional Status in Men and Women Receiving Chemotherapy for the Treatment of Lung or Colon Cancer by Warne, Catherine Paterson; Msn from Texas Tech University, 2002, 106 pages http://wwwlib.umi.com/dissertations/fullcit/1409783
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Central and Peripheral Fatigue in Isometric Contractions with Distinct Rates of Force Development by Ugrinowitsch, Carlos; PhD from Brigham Young University, 2003, 105 pages http://wwwlib.umi.com/dissertations/fullcit/3091445
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Changes in Electromyographic Activity in Human Muscle Fatigue by Garland, S. Jayne; PhD from Mcmaster University (Canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL52150
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Characterization of Microstructural Evolution of Crept, Aged and Thermomechanically Fatigued Eutectic Tin-silver Solder Joints Using Orientation Imaging Microscopy by Telang, Adwait Uday; Ms from Michigan State University, 2002, 161 pages http://wwwlib.umi.com/dissertations/fullcit/1411987
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Circadian Rhythms and the Experience of Fatigue in Women before and after Surgery for Breast Cancer by Dean, Grace Ellen; PhD from University of California, Los Angeles, 2002, 123 pages http://wwwlib.umi.com/dissertations/fullcit/3058500
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Cohesive Models of Fatigue Crack Growth and Stress-corrosion Cracking by Nguyen, Olivier Thanh; PhD from California Institute of Technology, 2002, 91 pages http://wwwlib.umi.com/dissertations/fullcit/3052843
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Compassion Fatigue: a Study of Its Potential Risks among Health Care Professionals by Jackson, Erika Denise; Msw from California State University, Long Beach, 2002, 68 pages http://wwwlib.umi.com/dissertations/fullcit/1407702
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Compassion Fatigue: an Investigation of Audience Burnout toward Social Problems by Kinnick, Katherine Neil, PhD from University of Georgia, 1994, 236 pages http://wwwlib.umi.com/dissertations/fullcit/9520833
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Comportement Du Titane Et Du Zirconium En Fatigue Oligocyclique by Handfield, Louis; PhD from Ecole Polytechnique, Montreal (Canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK65366
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Comportement En Fatigue Des Joints Soudes Automatiques by Verreman, Yves; PhD from Institut National De La Recherche Scientifique (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NL27140
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Computer Prediction and Experimental Determination of Fatigue Life Probability Distributions by Elmaraghy, Hoda Abdel-kader; PhD from Mcmaster University (Canada), 1976 http://wwwlib.umi.com/dissertations/fullcit/NK29581
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Contact Fatigue: Life Prediction and Palliatives by Conner, Brett P.; PhD from Massachusetts Institute of Technology, 2002 http://wwwlib.umi.com/dissertations/fullcit/f663393
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Contribution a L'etude Du Comportement Electrochimique, De La Corrosion Sous Tension Et De La Corrosion Sous Fatigue De Certains Alliages D'aluminium by Elboujda Mimoun; PhD from Universite Laval (Canada), 1990 http://wwwlib.umi.com/dissertations/fullcit/NL57465
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Coping with Chronic Fatigue by Jensen, Susan Lynne; PhD from Western Michigan University, 2000, 141 pages http://wwwlib.umi.com/dissertations/fullcit/9984612
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Correlates of Fatigue in Critical Care Nurses by Ruggiero, Jeanne; PhD from Rutgers the State University of New Jersey - Newark, 2002, 133 pages http://wwwlib.umi.com/dissertations/fullcit/3043635
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Corrosion and Corrosion Fatigue of Aluminum Alloys by Alyousif, Osama M.; PhD from Lehigh University, 2002, 133 pages http://wwwlib.umi.com/dissertations/fullcit/3048945
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Corrosion Fatigue and Pitting Behaviour of Duplex Stainless Steels in Chloride Solutions by Sriram, Rajagopal; PhD from The University of British Columbia (Canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL55214
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Creep-fatigue of Inconel Alloy X-750 at High Temperature by Venkiteswaran, P. K; PhD from University of Waterloo (Canada), 1973 http://wwwlib.umi.com/dissertations/fullcit/NK14165
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Cumulated Steady-state Fatigue and Recovery by Svoboda, Milan David, Edd from University of California, Berkeley, 1970, 57 pages http://wwwlib.umi.com/dissertations/fullcit/7109748
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Dangers in Paradise: the Battle against Combat Fatigue in the Pacific War by Bresnahan, Josephine Callisen, PhD from Harvard University, 1999, 249 pages http://wwwlib.umi.com/dissertations/fullcit/9935746
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Depression and Fatigue in Cancer Patients: Implications for Mental Health Practitioners by Van Duursen, Theresa Renee Tiedemann; PhD from University of Northern Colorado, 2002, 113 pages http://wwwlib.umi.com/dissertations/fullcit/3071871
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Development and Finite Element Implementation of a Damage Model for Fatigue of Fibre-reinforced Polymers by Van Paepegem, Wim; PhD from Rijksuniversiteit Te Gent (belgium), 2002 http://wwwlib.umi.com/dissertations/fullcit/f664849
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Do Illness Perception and Coping Influence Disability in Chronic Fatigue Syndrome? by Cohen, Yoav; PhD from Fairleigh Dickinson University, 2003, 183 pages http://wwwlib.umi.com/dissertations/fullcit/3082846
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Effect of Carbohydrate Supplementation on Metabolism and Performance during Prolonged Exercise (hypoglycemia, Fatigue, Plasma Glucose, Cycling) by Coggan, Andrew Richard, PhD from The University of Texas at Austin, 1986, 99 pages http://wwwlib.umi.com/dissertations/fullcit/8705984
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Effect of Different Levels of Physical Fatigue upon Motor Learning and Subsequent Motor Performance by Stockard, Jerry R., Edd from The Louisiana State University and Agricultural and Mechanical Col., 1972, 88 pages http://wwwlib.umi.com/dissertations/fullcit/7228385
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Effect of Fatigue Loading Spectra on Crack Opening Stress and Crack Shape Development by Khalil Mohamed, Mohamed M.; PhD from University of Waterloo (Canada), 2002, 217 pages http://wwwlib.umi.com/dissertations/fullcit/NQ77238
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Effect of Graded Hyperoxia on Vo2max and Acid Base Balance during Exercise Testing to Volitional Fatigue by Astorino, Todd Anthony; PhD from The University of New Mexico, 2001, 93 pages http://wwwlib.umi.com/dissertations/fullcit/3003403
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Effect of Liquid Absorption on the Fatigue Behavior of Random Fiber Sheet Molding Compounds by Ngô Anh Dung; PhD from Concordia University (Canada), 1989 http://wwwlib.umi.com/dissertations/fullcit/NL51324
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Effect of Nanoparticles on the Fatigue Behavior of a Semicrystalline Polymer by Bellemare, Simon C.; Msca from Ecole Polytechnique, Montreal (Canada), 2002, 230 pages http://wwwlib.umi.com/dissertations/fullcit/MQ75943
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Effect of Shear Load on Fretting Fatigue Behavior of Titanium-aluminum-vanadium by Leiva, Orly; PhD from The University of Dayton, 2003, 147 pages http://wwwlib.umi.com/dissertations/fullcit/3085499
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Effects of Calf Muscle Fatigue on Muscle-joint Complex Stiffness of the Lower Extremity during Functional Activities by Ju, Yan-ying; PhD from University of Pittsburgh, 2002, 119 pages http://wwwlib.umi.com/dissertations/fullcit/3066960
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Effects of Dryland Resistance Interval Training on Aerobic Capacity, Blood Lactate, and Muscle Fatigue in Age-group Swimmers by Castle, John Martin, PhD from Syracuse University, 1993, 159 pages http://wwwlib.umi.com/dissertations/fullcit/9401658
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Effects of Fatigue on Shock Attenuation during Running by Mercer, John Andrew; PhD from University of Oregon, 1999, 147 pages http://wwwlib.umi.com/dissertations/fullcit/9940422
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Effects of Fatigue on the Biomechanical Characteristics of the Diagonal Stride in Cross-country Skiing by Duoos-asche, Bridget Ann, PhD from University of Minnesota, 1983, 80 pages http://wwwlib.umi.com/dissertations/fullcit/8318060
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Effects of Fod on the Fatigue Crack Initiation of Ballistically Impacted Titaniumaluminum(6)-vanadium(4) Simulated Engine Blades by Birkbeck, Janine C.; PhD from The University of Dayton, 2002, 162 pages http://wwwlib.umi.com/dissertations/fullcit/3059492
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Effects of Hutchings' 'Low Fatigue' Algorithm on Children's Addition Scores Compared under Varying Conditions of Token-economy Reinforcement and Problem Difficulty. by Alessi, Galen James, PhD from University of Maryland College Park, 1974, 151 pages http://wwwlib.umi.com/dissertations/fullcit/7429046
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Effects of Prolonged Running on Ground Reaction Force Patterns Wearing Shoes of Different Midsole Durometers (Fatigue) by Stewart, Douglas Jackson, PhD from University of Illinois at Urbana-champaign, 1985, 309 pages http://wwwlib.umi.com/dissertations/fullcit/8600325
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Effects of Various Levels of Fatigue on the Speed and Accuracy of Visual Recognition by Johnson, Robert Lewis, PhD from The Louisiana State University and Agricultural and Mechanical Col., 1979, 80 pages http://wwwlib.umi.com/dissertations/fullcit/8013123
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Effects of Varying Levels of Fatigue on the Rate of Force Development in Females by Ewing, John Leroy, Jr., PhD from University of Minnesota, 1982, 108 pages http://wwwlib.umi.com/dissertations/fullcit/8221267
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Electromyographic Analysis of the Lumbar Erector Spinae Muscles: Influence of Position, a History of Low Back Pain, Gender and Muscle Location on Fatigue and Recovery by Fall, Michael Paul; PhD from The University of Connecticut, 2001, 104 pages http://wwwlib.umi.com/dissertations/fullcit/3030666
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Environmental and Service Exposure Effects on the Fatigue and Fracture Behaviour of Aircraft Gas Turbine Materials by Thamburaj, Rajkumar; PhD from Carleton University (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL29877
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Exercise As an Intervention for Cancer-related Fatigue: the Subject's View by Coon, Sharon K.; PhD from University of Arkansas for Medical Sciences, 2003, 166 pages http://wwwlib.umi.com/dissertations/fullcit/3088595
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Fatigue Analyses to Assess Crack Initiation Life for Notched Coupons and Complex Components by Leis, B. N; PhD from University of Waterloo (Canada), 1979 http://wwwlib.umi.com/dissertations/fullcit/NK42370
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Fatigue and Cracking Behaviour of Partially Prestressed Concrete Members by El Shahawi, Mohsen; PhD from Queen's University at Kingston (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NK65837
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Fatigue and Fracture Behavior of High Strength and High Conductivity Copper Alloys for High Heat Flux Applications by Li, Meimei; PhD from University of Illinois at Urbana-champaign, 2003, 196 pages http://wwwlib.umi.com/dissertations/fullcit/3086117
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Fatigue and Prealbumin Levels during the Weaning Process in Long-term Ventilated Patients by Delmore, Barbara Ann; PhD from New York University, 2003, 183 pages http://wwwlib.umi.com/dissertations/fullcit/3089862
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Fatigue and Recovery during Double Bouts of Rhythmic and Sustained Grip Flexion by Kearney, Jay T., PhD from University of Maryland College Park, 1972, 287 pages http://wwwlib.umi.com/dissertations/fullcit/7317038
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Fatigue and Recovery Patterns of Women Following Intermittent Isometric and Isokinetic Exercise by Manning, James Michael, PhD from University of Maryland College Park, 1981, 189 pages http://wwwlib.umi.com/dissertations/fullcit/8205244
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Fatigue and Rest of the Hamster Diaphragm by Reid, Wendy Darlene; PhD from The University of British Columbia (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL44553
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Fatigue Assessment Methodology for Sandwich Panels by Dai, Jin; PhD from University of California, Los Angeles, 2002, 116 pages http://wwwlib.umi.com/dissertations/fullcit/3078118
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Fatigue Behavior in an Aluminum Casting Alloy (a356.2): Effects of Some Defects, Sdas, Hipping and Strontium Modification by Zhang, Bin; PhD from The University of Arizona, 2002, 295 pages http://wwwlib.umi.com/dissertations/fullcit/3073279
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Fatigue Behaviour of Beams under Inelastic Cyclic and Random Deflection by Ghamian, M. M; PhD from University of Waterloo (Canada), 1975 http://wwwlib.umi.com/dissertations/fullcit/NK23395
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Fatigue Crack Growth in Welded Joints in Seawater by Lambert, Stephan B; PhD from University of Waterloo (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL42987
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Fatigue Crack Propagation at Elevated Temperatures by Jeglic, Franci; PhD from University of Waterloo (Canada), 1972 http://wwwlib.umi.com/dissertations/fullcit/NK10917
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Fatigue Crack Propagation Behavior of Stainless Steel Welds by Kusko, Chad S.; PhD from Lehigh University, 2002, 264 pages http://wwwlib.umi.com/dissertations/fullcit/3048963
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Fatigue Crack Propagation of Single Cracks and Multiple Crack Arrays in High Strength Steel by Shaw, William John Douglas; PhD from The University of Saskatchewan (Canada), 1979 http://wwwlib.umi.com/dissertations/fullcit/NK41292
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Fatigue Deformation of a Superplastic Aluminum-zinc Eutectoid Alloy by Bowden, John W; PhD from University of Toronto (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL46351
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Fatigue in Boric Acid-sulphuric Acid Anodised Aluminium Alloys by Cree, Alistair Murray; PhD from Open University (united Kingdom), 2002 http://wwwlib.umi.com/dissertations/fullcit/f679169
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Fatigue in Diabetes Mellitus: Testing a Middle Range Theory of Well-being Derived from Neuman's Theory of Optimal Client System Stability and the Neuman Systems Model by Casalenuovo, Gregory Allen; PhD from The University of Tennessee, 2002, 117 pages http://wwwlib.umi.com/dissertations/fullcit/3054100
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Fatigue Life Evaluation for a Metal Subjected to a Certain Class of Random Loading Using the Modified Life Law Concept by El Menoufy, M. B; PhD from University of Waterloo (Canada), 1982 http://wwwlib.umi.com/dissertations/fullcit/NK55204
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Fatigue Mechanism Maps by Collins, Anthony Louis William; PhD from University of Waterloo (Canada), 1979 http://wwwlib.umi.com/dissertations/fullcit/NK49751
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Fatigue of Graphite Fibre Composites with Controlled Contraction Matrices by Lam, Patrick Wing-kwong; PhD from University of Toronto (Canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK65131
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Fatigue of Reinforcing Bars by Jhamb, Ishwar C; PhD from University of Alberta (Canada), 1972 http://wwwlib.umi.com/dissertations/fullcit/NK11142
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Fatigue of Silicon Structural Films for Microelectromechanical Applications by Muhlstein, Christopher Lado; PhD from University of California, Berkeley, 2002, 127 pages http://wwwlib.umi.com/dissertations/fullcit/3082338
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Fatigue of Titanium Alloys and Intermetallics by Shen, Weimin; PhD from Princeton University, 2002, 284 pages http://wwwlib.umi.com/dissertations/fullcit/3048748
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Force and Fatigue in an Isometrically Contracted Muscle by Mcglynn, George Henry, Edd from University of California, Berkeley, 1966, 61 pages http://wwwlib.umi.com/dissertations/fullcit/6615311
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Fracture and Fatigue Failure of Spot Welds under General Combined Loading Conditions by Lin, Shih-huang; PhD from University of Michigan, 2003, 197 pages http://wwwlib.umi.com/dissertations/fullcit/3079490
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Fretting Fatigue Damage Accumulation and Crack Nucleation in High-strength Steels by Pape, John Andrew; PhD from Georgia Institute of Technology, 2002, 298 pages http://wwwlib.umi.com/dissertations/fullcit/3046928
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Gender Differences and the Effects of Isometric Fatigue and Relative Isometric Fatigue on the Maximum Speed of Human Forearm Flexion under Resisted and Unresisted Conditions by Garcia, Zulma Christine, PhD from University of Massachusetts, 1983, 356 pages http://wwwlib.umi.com/dissertations/fullcit/8401064
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High Strain Multiaxial Fatigue by Valaire, Bruce Thomas; PhD from Universite De Sherbrooke (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NL20925
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Hydrostatic Stress Effects in Low Cycle Fatigue by Allen, Phillip Andrew; PhD from Tennessee Technological University, 2002, 284 pages http://wwwlib.umi.com/dissertations/fullcit/3080897
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Improved Fatigue Performance of Threaded Drillstring Connections by Cold Rolling by Kristoffersen, Steinar; Dring from Norges Teknisk-naturvitenskapelige Universitet (norway), 2002, 197 pages http://wwwlib.umi.com/dissertations/fullcit/f679121
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Inelastic Deformation and Fatigue Response of Spectrum Loaded Strain Controlled Axial and Flexural Members by Jhansale, H. R; Advdeg from University of Waterloo (Canada), 1971 http://wwwlib.umi.com/dissertations/fullcit/NK08624
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Influence of Martensite Transformation on the Fatigue Crack Propagation in Metastable Austenitic Stainless Steels by Swaminathan, V. P; PhD from University of Waterloo (Canada), 1977 http://wwwlib.umi.com/dissertations/fullcit/NK33509
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Influence of Residual Stress on Fatigue Failure of Welded Joints by Lu, Xiangyang; PhD from North Carolina State University, 2003, 202 pages http://wwwlib.umi.com/dissertations/fullcit/3073330
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Initiation and Coalescence of Fatigue Cracks in Welded Joints in Steel by Otegui, José Luis; PhD from University of Waterloo (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL45369
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Interpretable Classification Model for Automotive Material Fatigue by Lee, Kee Khoon; PhD from University of Southampton (united Kingdom), 2002 http://wwwlib.umi.com/dissertations/fullcit/f460609
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Investigation of Mechanisms Contributing to Fatigue Endurance of 52100 Steel by Rivero-diaz, Iris V.; PhD from The Pennsylvania State University, 2002, 181 pages http://wwwlib.umi.com/dissertations/fullcit/3051735
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Is the Acute Neuromuscular Fatigue Produced during Resistance Training Associated with Chronic Increases in Muscle Strength and Muscle Fiber Area? by Brandenburg, Jason Peter; PhD from University of Victoria (Canada), 2002, 141 pages http://wwwlib.umi.com/dissertations/fullcit/NQ68121
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Isokinetic Fatigue, Electrical Activity and Morphology of the Human Tibialis Anterior Muscle by Anderson, Paul Allen, PhD from University of Maryland College Park, 1985, 111 pages http://wwwlib.umi.com/dissertations/fullcit/8523049
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Isotonic Fatigue and Maximum Speed of Human Forearm Flexion under Resisted and Unresisted Conditions. by Wolcott, Judith Gail, PhD from University of Massachusetts, 1977, 277 pages http://wwwlib.umi.com/dissertations/fullcit/7730585
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Leg Muscular Fatigue Effects: Postural Control by Joyce, Christopher John; PhD from University of Virginia, 2000, 198 pages http://wwwlib.umi.com/dissertations/fullcit/9975522
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Linear Elastic Analysis of Fatigue Cracks in Piping Tees and a General Solution for Irregular Cracks by Oore, Mordecai; PhD from University of Waterloo (Canada), 1979 http://wwwlib.umi.com/dissertations/fullcit/NK42380
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Load Interaction Effects in Fatigue Crack Propagation by Adetifa, Olajire Adigun; PhD from University of Waterloo (Canada), 1975 http://wwwlib.umi.com/dissertations/fullcit/NK27034
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Local Maxima of Stationary Stochastic Processes and Stochastic Modelling of Fatigue by Desmond, Anthony F; PhD from University of Waterloo (Canada), 1983 http://wwwlib.umi.com/dissertations/fullcit/NK61391
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Malnutrition and Fatigue in Coccidioidomycosis: Measurement and Mechanisms by Bowers, Jennifer Muir; PhD from The University of Arizona, 2002, 243 pages http://wwwlib.umi.com/dissertations/fullcit/3061018
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Measurement of Fatigue in Myasthenia Gravis Patients by Kittiwatanapaisan, Waraluk; Dsn from The University of Alabama at Birmingham, 2002, 132 pages http://wwwlib.umi.com/dissertations/fullcit/3066319
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Mode-I Fatigue Fracture of Interface for Fiber-reinforced Polymer Composite Bonded to Wood by Jia, Junhui; PhD from West Virginia University, 2002, 290 pages http://wwwlib.umi.com/dissertations/fullcit/3076372
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Model Analysis of Fatigue Life Estimation of Welded Structures by Wahab, Muhammad A; PhD from University of Alberta (Canada), 1984 http://wwwlib.umi.com/dissertations/fullcit/NK67366
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Modelling and Diagnostics of Beams with Fatigue Cracks by Ibrahim, Ahmed M. K; PhD from University of Waterloo (Canada), 1987 http://wwwlib.umi.com/dissertations/fullcit/NL45383
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Muscular Fatigue and Recovery Patterns of the Forearm Flexors at Various Levels of Muscular Strength by Wolfe, Kurt Francis, PhD from University of Maryland College Park, 1979, 107 pages http://wwwlib.umi.com/dissertations/fullcit/8017197
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Near-threshold Fatigue Behavior of Copper Alloys in Air and Aqueous Environments: a High Cyclic Frequency Study by Ahmed, Tawfik M.; PhD from The University of British Columbia (Canada), 2002, 180 pages http://wwwlib.umi.com/dissertations/fullcit/NQ74985
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Nonlinear Analysis of Muscle Fatigue in Low Back Pain Patients before and after Exercise Therapy by Liu, Yiwei; Ms from Loyola University of Chicago, 2003, 56 pages http://wwwlib.umi.com/dissertations/fullcit/1413570
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Optimization of Rest Breaks; a Productivity Enhancement (industrial, Fatigue, Mental Work) by Boothe, Robert Stephens, Dba from The Florida State University, 1984, 274 pages http://wwwlib.umi.com/dissertations/fullcit/8427290
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Oxygen Consumption and Heart Rate Changes of Two Gymnastic Ring Routines due to Warm-up, Training and Fatigue by Schwarzkopf, Robert James, PhD from University of Minnesota, 1972, 164 pages http://wwwlib.umi.com/dissertations/fullcit/7227806
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Parameter Describing the Effect of Static Mean Stresses in Multiaxial Fatigue and Its Use in Fatigue Life Predictions for Induction-hardened Shafts Cycled in Torsion by Kaufman, Rebecca Peace; PhD from University of Waterloo (Canada), 2002, 197 pages http://wwwlib.umi.com/dissertations/fullcit/NQ77235
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Physiological and Mechanical Alterations due to Fatigue While Running a Fourminute-mile on a Treadmill. by Sparks, Kenneth Earl, PhD from Indiana University, 1975, 145 pages http://wwwlib.umi.com/dissertations/fullcit/7602892
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Prediction of Fatigue Damage Growth in Notched Composite Laminates by Choi, Sung Won; PhD from University of California, Los Angeles, 2002, 93 pages http://wwwlib.umi.com/dissertations/fullcit/3059543
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Prediction of Residual Fatigue Life from Nde of Corroded Components by Shell, Eric Brian; PhD from The University of Dayton, 2002, 143 pages http://wwwlib.umi.com/dissertations/fullcit/3069532
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Prediction of Thermal Distortion and Thermal Fatigue in Shot Sleeves by Shi, Qi; PhD from The Ohio State University, 2002, 169 pages http://wwwlib.umi.com/dissertations/fullcit/3081965
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Probabilistic Life Prediction of Structures under Fatigue and Creep by Mao, Hongyin; PhD from Vanderbilt University, 2002, 157 pages http://wwwlib.umi.com/dissertations/fullcit/3047446
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Progressive Fatigue Effects on Manual Lifting Factors by Banks, Anthony D'wayne; PhD from Louisiana State University and Agricultural & Mechanical College, 2003, 230 pages http://wwwlib.umi.com/dissertations/fullcit/3085661
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Psychological Aspects of Tinnitus the Effects of Attentional Focus, Anxiety and Fatigue by Leader, Leslie G; PhD from The University of British Columbia (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL36676
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Recovery from Local Muscle Fatigue As Related to Age and Sex by Mathews, Alfred Raleigh, Jr, Edd from University of California, Berkeley, 1966, 46 pages http://wwwlib.umi.com/dissertations/fullcit/6608250
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Relationships between Individual Differences in Strength, Fatigue, and Motor Learning by Whitley, Jimmie Donald, Edd from University of California, Berkeley, 1968, 75 pages http://wwwlib.umi.com/dissertations/fullcit/6903548
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Repair of Fatigued Steel Bridge Girders with Carbon Fiber Strips by Nozaka, Katsuyoshi; PhD from University of Minnesota, 2002, 174 pages http://wwwlib.umi.com/dissertations/fullcit/3039647
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Residual Stress Effects on Fatigue Life Via the Stress Intensity Parameter, K by Roberts, Jeffrey Lynn; PhD from The University of Tennessee, 2002, 118 pages http://wwwlib.umi.com/dissertations/fullcit/3086838
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Role of Crack Nucleation Versus Propagation on the Fatigue Behavior of Titaniumvanadium-iron-aluminum Beta Titanium Alloy by Srinivasan, Shankar Pattamadai; PhD from The University of Utah, 2002, 111 pages http://wwwlib.umi.com/dissertations/fullcit/3067629
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Role of Delamination and Interlaminar Fatigue in the Failure of Laminates with Ply Dropoffs by Shim, Dong Jin; PhD from Massachusetts Institute of Technology, 2002 http://wwwlib.umi.com/dissertations/fullcit/f592449
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Simulation and Analysis of Dynamic Loads on Cylindrical Gears and an Improved Method for Fatigue Damage Assessment by Arumugam, Selva Kumar; PhD from Concordia University (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL30694
Dissertations 171
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Sleep Quality, Daytime Functioning and Psychological Adjustment in Chronic Fatigue Syndrome: a Comparative Analysis by Fossey, Myrtis-eirene; Ma from Concordia University (Canada), 2002, 137 pages http://wwwlib.umi.com/dissertations/fullcit/MQ72858
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Some Effects of Seating Arrangement and Task Duration on Fatigue, Attention, Participation, and Preference of Individuals Engaged in Small-group Media Tasks. by Fulrath, Douglas Kent, Edd from Boston University School of Education, 1976, 194 pages http://wwwlib.umi.com/dissertations/fullcit/7704066
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Some Factors Affecting Fatigue Crack Propagation by Fakinlede, Omotayo Abayomi; PhD from University of Alberta (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NL22921
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Static and Fatigue Behaviors of Rc Beams Strengthened with Carbon-fiber Sheets Bonded by Organic and Inorganic Matrices by Deng, Yong; PhD from The University of Alabama in Huntsville, 2002, 198 pages http://wwwlib.umi.com/dissertations/fullcit/3062599
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Static and Fatigue Design of High Pressure Vessels with Blind-ends and Cross-bores by Chaaban, Ahmad; PhD from University of Waterloo (Canada), 1985 http://wwwlib.umi.com/dissertations/fullcit/NL20645
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Stigma and Legitimation in Chronic Fatigue Syndrome: the Role of Social Location by Beaulieu, Marcia Cecille; PhD from Mcgill University (Canada), 1997, 358 pages http://wwwlib.umi.com/dissertations/fullcit/NQ44359
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Stochastic Fatigue Crack Growth an Experimental Study by Mbanugo, Chinwendu C. Ike; PhD from Mcgill University (Canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK50507
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Stochastic Fatigue Crack Initiation and Propagation in Polycrystalline Solids by Ghonem, H; , PhD from Mcgill University (Canada), 1978 http://wwwlib.umi.com/dissertations/fullcit/NK38235
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The Determinants of Fatigue in Working Women by Weyman, W. Jean Martin, PhD from Boston College, 1996, 81 pages http://wwwlib.umi.com/dissertations/fullcit/9706667
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The Effect of a Small and Moderate Dose of Alcohol on Fatigue Parameters of the Forearm Flexor Muscles by Williams, Melvin Hugh, PhD from University of Maryland College Park, 1968, 133 pages http://wwwlib.umi.com/dissertations/fullcit/6907643
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The Effect of Edge Treatment on Fatigue Strength of 2024-t3 Luminum Alloy by Nawwar, A. M; PhD from The University of Manitoba (Canada), 1976 http://wwwlib.umi.com/dissertations/fullcit/NK30057
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The Effect of Fatigue and Environment on the Adhesion and Delamination of Thin Polymer Films by Snodgrass, Jeffrey Matthew; PhD from Stanford University, 2002, 141 pages http://wwwlib.umi.com/dissertations/fullcit/3038154
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The Effect of Fatigue on Motor Learning by Benson, David William, PhD from University of Southern California, 1966, 179 pages http://wwwlib.umi.com/dissertations/fullcit/6607065
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The Effect of Image/Surround Brightness Contrast Ratios on Student Preference, Attention, Visual Comfort, and Visual Fatigue. by Desrosiers, Elaine Virginia, Edd from Boston University School of Education, 1976, 210 pages http://wwwlib.umi.com/dissertations/fullcit/7613553
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The Effect of Local Fatigue on Motor Performance and the Implications for Physical Education Instruction by Al-sarhid, Ahmad Abdulrahman, Edd from University of Florida, 1985, 107 pages http://wwwlib.umi.com/dissertations/fullcit/8615433
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The Effect of Mean Stress and Overstrains on the Fatigue Behaviour of Structural Steels by Watson, Peter; Advdeg from University of Waterloo (Canada), 1971 http://wwwlib.umi.com/dissertations/fullcit/NK07789
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The Effect of Physical Fatigue on Two Motor Learning Tasks by Phillips, William Harper, Jr., Edd from University of California, Berkeley, 1962, 45 pages http://wwwlib.umi.com/dissertations/fullcit/6413128
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The Effect of Tempering, Grain Size and Second Phase on Low Cycle Fatigue of Polycrystal Aluminum-4.5wt. Percent Copper Alloy by Mohamed, Aezeden Omar; Msc from The University of Manitoba (Canada), 2002, 99 pages http://wwwlib.umi.com/dissertations/fullcit/MQ76817
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The Effect of Training on Diaphragmatic Endurance and Fatigue in Quadriplegia by Gross, Ditza; PhD from Mcgill University (Canada), 1978 http://wwwlib.umi.com/dissertations/fullcit/NK43063
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The Effect of Water Immersion at Varying Temperatures upon Muscular Fatigue and Recovery of the Forearm Flexor Muscles by Bundschuh, Ernest Louis, PhD from University of Maryland College Park, 1969, 159 pages http://wwwlib.umi.com/dissertations/fullcit/7013709
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The Effects of Cycling-induced Fatigue upon Running Kinetics and Kinematics during Triathlons by Gullett, Steven Lee, PhD from The University of Toledo, 1987, 218 pages http://wwwlib.umi.com/dissertations/fullcit/8722193
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The Effects of Fretting on Fatigue Characteristics of a Mechanically Fastened Aircraft Joint by Shah, Akbar Hussain; PhD from The University of Utah, 2002, 131 pages http://wwwlib.umi.com/dissertations/fullcit/3058256
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The Effects of Loading Condition and Microstructure on Fatigue Behavior by Yu, Maotao; PhD from University of Waterloo (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL32930
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The Effects of Measurement Mode, Joint Angle, Load, and Fatigue on Joint Position Sense and Sensation of Muscle Force in the Knee (muscle Force Perception) by Camper, Stephen Blane, PhD from Temple University, 1992, 157 pages http://wwwlib.umi.com/dissertations/fullcit/9218056
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The Effects of Practice on the Reading Rate, Accuracy, Duration, and Visual Fatigue of Students with Low Vision When Accessing Standard-size Print with Optical Devices by Smith, Janice Kay, PhD from The University of Arizona, 1999, 203 pages http://wwwlib.umi.com/dissertations/fullcit/9927449
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The Effects of Readers' Fatigue on the Grading of Essays. by Steller, Nancy Ann Dodrill, PhD from University of Georgia, 1978, 112 pages http://wwwlib.umi.com/dissertations/fullcit/7822356
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The Effects of Rhythmical Exercise on Isometric Fatigue of the Non-involved Muscles by Seaward, Brian Francis Luke, PhD from University of Maryland College Park, 1987, 117 pages http://wwwlib.umi.com/dissertations/fullcit/8725567
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The Effects of Three Selected Fatigue Treatments on Visual Acuity and the Peripheral Field. by Mintz, Dwain P., Edd from Utah State University, 1974, 99 pages http://wwwlib.umi.com/dissertations/fullcit/7514459
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The Effects of Total and Partial Replacement of Depleted Body Fluids, Electrolytes, and Carbohydrates upon Fatigue and Muscular Strength during Strenuous Activity in a Hot, Humid Environment. by Harrington, Earnest Lawrence, Sr., Edd from The University of Southern Mississippi, 1974, 102 pages http://wwwlib.umi.com/dissertations/fullcit/7425503
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The Fatigue Crack Propagation Behavior of a Polycrystalline Nickel-base Superalloy in the Near Threshold Region by Padula, Santo A., Ii; PhD from Michigan Technological University, 2002, 202 pages http://wwwlib.umi.com/dissertations/fullcit/3045955
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The Impact of Fatigue on Communication: a Study of the Dual-career Lifestyle by Litterst, Judith Kay, PhD from University of Minnesota, 1983, 264 pages http://wwwlib.umi.com/dissertations/fullcit/8318094
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The Influence of Physical Fatigue on Massed Vs Distributed Motor Learning by Caplan, Calvin Stephen, Edd from University of California, Berkeley, 1969, 55 pages http://wwwlib.umi.com/dissertations/fullcit/7012986
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The Influence of Roughness on Gear Surface Fatigue by Krantz, Timothy Lewis; PhD from Case Western Reserve University, 2002, 288 pages http://wwwlib.umi.com/dissertations/fullcit/3066036
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The Low-cycle Fatigue Behavior of an Alpha-two + Beta Titanium Aluminide Alloy by Stevens, Katherine Anne; PhD from The Ohio State University, 2002, 374 pages http://wwwlib.umi.com/dissertations/fullcit/3059332
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The Moderation of Comprehension in Reading by Three Perception Formats and Three Fatigue Levels. by Rancourt, Karen Logozzo, PhD from University of Maryland College Park, 1973, 240 pages http://wwwlib.umi.com/dissertations/fullcit/7416573
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The Prediction of Maximum Speed of Human Movement by Two Selected Muscular Coordination Mechanisms and by Maximum Static Strength and the Effects of Practice and Fatigue upon Maximum Speed of Human Movement Mechanisms. by Lagasse, Pierre Philippe, PhD from University of Massachusetts, 1975, 174 pages http://wwwlib.umi.com/dissertations/fullcit/7527592
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The Relation between Burnout and Compassion Fatigue in Fire Fighter-paramedics by Bissett, Jennifer L.; PhD from University of Houston, 2002, 93 pages http://wwwlib.umi.com/dissertations/fullcit/3056463
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The Relationship between Coping Focus and Psychological Well-being in Women with Chronic Fatigue Syndrome by Schmall, Susan, PhD from California Institute of Integral Studies, 1991, 127 pages http://wwwlib.umi.com/dissertations/fullcit/9224783
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The Relationship between Dehydration, Electrolyte Imbalance, Environmental Heat, and Local Fatigue with Exercise-associated Muscle Cramps by Jung, Alan Peter; PhD from The University of Alabama, 2003, 63 pages http://wwwlib.umi.com/dissertations/fullcit/3092360
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The Relationship between Integrated Emg Fatigue Curve and Resting, Exercise and Post-exercise Blood Flow in the Human Forearm by Jessup, George Terrill, PhD from University of Southern California, 1972, 131 pages http://wwwlib.umi.com/dissertations/fullcit/7211933
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The Relationship of Selected Serum Non-protein Nitrogen Parameters and the Onset of Physiological Fatigue in Man. by Bjurstrom, Larry Alan, PhD from Kent State University, 1973, 142 pages http://wwwlib.umi.com/dissertations/fullcit/7407300
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The Relationships between Fatigue, Depression, and Sleep Disturbance after Myocardial Infarction by El-mokadem, Naglaa Mohamed; PhD from Case Western Reserve University (health Sciences), 2003, 137 pages http://wwwlib.umi.com/dissertations/fullcit/3088689
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The Respiratory Muscles : Ventilation Distribution and Fatigue by Roussos, C. S; PhD from Mcgill University (Canada), 1978 http://wwwlib.umi.com/dissertations/fullcit/NK39786
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The Response of Chimneys to Wind-induced Loads and the Evaluation of the Resulting Fatigue Damage by Daly, Albert F; PhD from The University of Western Ontario (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL33008
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The Role of Elevated Levels of Inorganic Phosphate and Hydrogen Ions in Muscular Fatigue: a Re-examination Near Physiological Temperatures by Debold, Edward Patrick; PhD from Marquette University, 2002, 152 pages http://wwwlib.umi.com/dissertations/fullcit/3076304
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The Role of Severe Life Stress, Social Support, and Attachment in the Onset of Chronic Fatigue Syndrome by Mayer, Melissa Isabella; Edd from University of Toronto (Canada), 1998, 111 pages http://wwwlib.umi.com/dissertations/fullcit/NQ41591
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Treatment of Chronic Fatigue Syndrome: a Cognitive-behavioral Approach to Enhance Personal Mastery by Strang, Jennifer Mary; PhD from Arizona State University, 2002, 92 pages http://wwwlib.umi.com/dissertations/fullcit/3054667
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Understanding Fatigue: an Exploratory Study of the Role of Psychosocial Variables by Arpin-cribbie, Chantal Annette; Ma from The University of Manitoba (Canada), 2002, 101 pages http://wwwlib.umi.com/dissertations/fullcit/MQ76887
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Use of the Gear Mesh Vibration Instantaneous Phase Observable for Prognosis of Tooth Bending Fatigue Failure by Van Dyke, Michael B.; PhD from The Pennsylvania State University, 2002, 134 pages http://wwwlib.umi.com/dissertations/fullcit/3065009
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Using Surface Electromyography to Study Cervical Extensor Muscle Activity: an Investigation of Methodological Considerations and the Effects of Age on Fatigue Development and Recovery by Joines, Sharon Melissa Bennett; PhD from North Carolina State University, 2002, 237 pages http://wwwlib.umi.com/dissertations/fullcit/3076416
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Vocal Fatigue in Choral Singing: Causes and Suggestions for Prevention Voiced by Prominent Choral Directors by Cook-koenig, Carol Ann, PhD from The Florida State University, 1995, 425 pages http://wwwlib.umi.com/dissertations/fullcit/9526487
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. CLINICAL TRIALS AND FATIGUE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning fatigue.
Recent Trials on Fatigue The following is a list of recent trials dedicated to fatigue.8 Further information on a trial is available at the Web site indicated. •
Developmental Study on Fatigue in Cancer Condition(s): Neoplasms Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: L-carnitine is a supplement (type of vitamin) that has been suggested to be decreased in patients with cancer. We will identify patients that have terminal cancer and fatigue. The purpose of this study is to determine if L-carnitine replacement improves fatigue in cancer patients with L-carnitine deficiency. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034450
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Epoetin Alfa in Treating Fatigue in Patients With Advanced Solid Tumors Who Are Not Receiving Chemotherapy Condition(s): unspecified adult solid tumor, protocol specific; Fatigue Study Status: This study is currently recruiting patients. Sponsor(s): M.D. Anderson Cancer Center; National Cancer Institute (NCI)
8
These are listed at www.ClinicalTrials.gov.
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Purpose - Excerpt: RATIONALE: Epoetin alfa may help improve energy levels and quality of life in patients who have advanced solid tumors. PURPOSE: Randomized clinical trial to study the effectiveness of epoetin alfa in treating fatigue in patients who are not receiving chemotherapy for advanced solid tumors. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00052221 •
Genetics of Fibromyalgia Condition(s): Fibromyalgia; Irritable Bowel Syndrome; Chronic Fatigue Syndrome; Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Purpose - Excerpt: The Fibromyalgia Family Study identifies and collects blood samples from families with two or more members affected with Fibromyalgia Syndrome (FMS). The primary goal of the study is to identify genes that predispose people to FMS and/or symptoms related to FMS; identifying these genes may lead to a better understanding of the disease and more effective treatments. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00071162
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Lethargic Depression Study Condition(s): Major Depressive Disorder Study Status: This study is currently recruiting patients. Sponsor(s): (Sponsor Name Pending) Purpose - Excerpt: Major Depressive Disorder (MDD) study in patients with decreased energy, pleasure and interests Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00064467
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Massage Therapy for Cancer-Related Fatigue Condition(s): Breast Neoplasms; Ovarian Neoplasms; Prostatic Neoplasms; Colorectal Neoplasms Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The purpose of this study is to develop methods for studying the effect of bodywork therapy on symptoms of fatigue in patients undergoing cancer chemotherapy.
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Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00039793 •
Methylphenidate to Improve Quality of Life in Patients Undergoing Radiation Therapy for Brain Tumors Condition(s): adult brain tumor; brain metastases; cognitive and functional effects; Depression; Fatigue; Quality of Life Study Status: This study is currently recruiting patients. Sponsor(s): Comprehensive Cancer Center of Wake Forest University; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Methylphenidate may decrease side effects of radiation therapy. It is not yet known if methylphenidate is effective in improving quality of life in patients with primary or metastatic brain tumors. PURPOSE: Randomized phase III trial to determine the effectiveness of methylphenidate in improving quality of life in patients who have brain tumors and are undergoing radiation therapy. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00031798
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Modafinil in Treating Fatigue and Behavioral Change in Patients With Primary Brain Cancer Condition(s): adult brain tumor; Fatigue; cognitive/functional effects Study Status: This study is currently recruiting patients. Sponsor(s): Jonsson Comprehensive Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Modafinil may be effective in relieving fatigue and improving behavioral changes such as memory loss in patients who have undergone treatment for primary brain cancer. The effectiveness of modafinil in relieving fatigue and improving behavioral change is not yet known. PURPOSE: Randomized clinical trial to determine the effectiveness of modafinil in treating fatigue and behavioral changes in patients who have undergone treatment for primary brain cancer. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00052286
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Modafinil in Treating Fatigue in Patients Receiving Chemotherapy for Cancer Condition(s): Fatigue; unspecified adult solid tumor, protocol specific Study Status: This study is currently recruiting patients. Sponsor(s): University of Rochester; National Cancer Institute (NCI)
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Purpose - Excerpt: RATIONALE: Modafinil may be effective in relieving fatigue in patients with cancer who are undergoing chemotherapy. The effectiveness of modafinil in relieving chemotherapy-related fatigue is not yet known. PURPOSE: Randomized phase III trial to determine the effectiveness of modafinil in treating fatigue in patients who are receiving chemotherapy for cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00042848 •
Modafinil to Treat Fatigue in Post-Polio Syndrome Condition(s): Postpoliomyelitis Syndrome Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Neurological Disorders and Stroke (NINDS) Purpose - Excerpt: This study, conducted at the Walter Reed Army Medical Center, the National Rehabilitation Hospital, and the National Institutes of Health, will examine whether the drug Modafinil can decrease fatigue in patients with post-polio syndrome. Many people who have had polio develop weakness and severe fatigue several years after their recovery from the acute disease. Modafinil is approved by the Food and Drug Administration to improve wakefulness in patients with narcolepsy (disease in which patients have excessive daytime sleepiness) and has been used to treat patients with fatigue related to other medical conditions, such as multiple sclerosis. This study will compare the effects of two doses of Modafinil and of a placebo (a pill with no active ingredient) on fatigue in patients with post-polio syndrome. Patients who develop fatigue, weakness, muscle pain or atrophy, and functional loss at least 15 years after recovering from polio and whose symptoms cannot be attributed to another cause may be eligible for this study. Candidates will be screened with a medical history, physical and neurological examinations, fatigue rating scales, electrocardiogram, blood and urine tests, drowsiness and depression evaluations, and an electroymogram (EMG) to diagnose nerve or muscle problems. For the EMG, electrodes (small metal discs) are taped to the skin and a needle is inserted into a muscle to record the electrical activity. Candidates will also undergo a sleep study to exclude abnormal sleep patterns as the cause of the fatigue. For this study, patients stay overnight at the NIH hospital. Electrodes are placed on the throat, on a finger, and on the chest (for an electrocardiogram), and a respiratory belt is placed around the chest-abdomen area. During sleep (from 10:30 p.m. to 6 a.m.), brain waves, eye and leg movements, muscle tone, respiration, and heart rate are recorded. Beginning at 8 a.m. the following morning, the patient takes 20-minute naps to measure the level of daytime sleepiness, using a recording technique similar to that of the all-night study. When five naps are completed, the sleep study ends. Candidates may also undergo a lumbar puncture (spinal tap) to check for certain chemicals in the spinal fluid that might be related to fatigue and to look for possible causes of post-polio syndrome. This procedure is optional. For the lumbar puncture, a local anesthetic is given and a needle is inserted in the space between the bones in the lower back where the cerebrospinal fluid circulates below the spinal cord. A small amount of fluid is collected through the needle. Patients enrolled in the study will complete a sleep diary during the entire study period. They will be randomly assigned to one of two treatment groups-Modafinil or placebo-for 6 weeks, followed by a 2-week washout period with no medication, and then a crossover
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phase, in which patients who took Modafinil for the first 6 weeks now take placebo, and those who took placebo now take Modafinil. At the first study visit, patients will be given a supply of study medication and have blood drawn. They will take one pill twice a day during both study phases. In both study phases, evaluations will be done 3 and 6 weeks after starting the medication. The evaluations include filling out the same forms completed at the screening visit, a review of drug side effects, and a review of medical problems since the last study visit. At the 6-week visit, blood is also drawn. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00067496 •
Standard Follow-up Compared With Extended Follow-up in Treating Patients Who Have Undergone Stem Cell Transplantation for Cancer Condition(s): Cancer; Depression; Fatigue; menopausal symptoms; psychosocial effects and treatment; transitional care planning Study Status: This study is currently recruiting patients. Sponsor(s): Fred Hutchinson Cancer Research Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Telephone counseling by trained counselors may enhance the well-being and quality of life of patients who have undergone stem cell transplantation for cancer. PURPOSE: Randomized clinical trial to compare the effectiveness of standard follow-up care with extended follow-up care in treating patients who have undergone stem cell transplantation for cancer. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00049465
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Darbepoetin Alfa Compared With Epoetin alfa in Treating Anemia in Patients Receiving Chemotherapy for Cancer Condition(s): Fatigue; Anemia; unspecified adult solid tumor, protocol specific Study Status: This study is no longer recruiting patients. Sponsor(s): Jonsson Comprehensive Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Darbepoetin alfa and epoetin alfa may stimulate red blood cell production to treat patients who have anemia and are receiving chemotherapy. It is not yet known whether darbepoetin alfa is more effective than epoetin alfa in treating anemia. PURPOSE: Randomized phase III trial to compare the effectiveness of darbepoetin alfa with that of epoetin alfa in treating anemia in patients who are receiving chemotherapy for cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00046982
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D-MPH in the treatment of fatigue and neurobehavioral function related to chemotherapy in adult cancer patients Condition(s): Fatigue; Neoplasms Study Status: This study is no longer recruiting patients. Sponsor(s): Celgene Corporation Purpose - Excerpt: To evaluate the efficacy of dexmethylphenidate (d-MPH) in the treatment of chemotherapy-related fatigue in adult cancer subjects. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00047476
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Methylphenidate in Treating Patients With Melanoma Condition(s): unspecified adult solid tumor, protocol specific; Fatigue; Quality of Life Study Status: This study is no longer recruiting patients. Sponsor(s): National Cancer Institute (NCI); Eastern Cooperative Oncology Group Purpose - Excerpt: RATIONALE: Methylphenidate may relieve some of the side effects of chemotherapy in patients with melanoma. It is not known whether receiving methylphenidate is more effective than receiving no further therapy in treating patients with melanoma. PURPOSE: Randomized phase III trial to determine if methylphenidate is more effective than no further therapy for the relief of fatigue and drowsiness in treating patients with melanoma who have received high-dose interferon alfa for 8-24 weeks. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00003266
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Study of Health Promotion in Patients With Early-Stage Breast or Prostate Cancer Condition(s): stage I breast cancer; stage II breast cancer; stage I prostate cancer; stage II prostate cancer; Fatigue; Nutrition; psychosocial effects/treatment; Quality of Life; Depression Study Status: This study is no longer recruiting patients. Sponsor(s): Duke Comprehensive Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Telephone counseling by a nutritionist and a personal trainer may improve physical function and quality of life in patients who have earlystage breast cancer or prostate cancer. PURPOSE: Randomized clinical trial to compare the effectiveness of a home-based, diet and exercise-based counseling program with that of a standard home-based counseling program in promoting health in patients who have early-stage breast cancer or prostate cancer. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00037024
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Combination Chemotherapy Plus Fluoxetine in Treating Patients With Advanced or Recurrent Non-Small Cell Lung Cancer Condition(s): Anxiety Disorder; Depression; Fatigue; Non-small cell lung cancer Study Status: This study is suspended. Sponsor(s): Cancer and Leukemia Group B; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one chemotherapy drug may kill more cancer cells. An antidepressant such as fluoxetine may improve the quality of life in patients undergoing chemotherapy. PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy plus fluoxetine in treating patients who have advanced or recurrent non-small cell lung cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00005850
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Compare the Medical Conditions of Gulf War Veterans to Non-Deployed Veterans Condition(s): Chronic Fatigue Syndrome; Fibromyalgia; Post-Traumatic Stress Disorder; neurologic abnormalities; general health status Study Status: This study is completed. Sponsor(s): Department of Veterans Affairs; Department of Veterans Affairs Cooperative Studies Program Purpose - Excerpt: Primary Hypothesis: Gulf War veterans will have an equal prevalence or mean level of the following medical and psychological conditions frequently reported in the literature compared to a control group of nondeployed veterans: (1) chronic fatigue syndrome, (2) fibromyalgia, (3) post-traumatic stress disorder, (4) neurologic abnormalities, including peripheral neuropathy and cognitive dysfunction, and (5) general health status. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00032461
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Dexmethylphenidate in Treating Patients With Fatigue and Behavior Change After Chemotherapy Condition(s): Fatigue; cognitive/functional effects; unspecified adult solid tumor, protocol specific Study Status: This study is completed. Sponsor(s): Jonsson Comprehensive Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Dexmethylphenidate may be effective in relieving fatigue and improving neurobehavioral changes such as loss of concentration and memory in patients with cancer who have received chemotherapy. PURPOSE: Randomized phase II trial to study the effectiveness of dexmethylphenidate in treating patients who have fatigue and neurobehavioral changes after undergoing chemotherapy.
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Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00052533 •
Docetaxel With or Without Infliximab in Treating Weight Loss, Loss of Appetite, and Fatigue in Patients with Advanced Non-Small Cell Lung Cancer Condition(s): Anorexia; Cachexia; Fatigue; Non-small cell lung cancer; Quality of Life Study Status: This study is suspended. Sponsor(s): North Central Cancer Treatment Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Infliximab may improve cancer-related weight loss, lack of appetite, and fatigue. It is not yet known whether docetaxel is more effective with or without infliximab in preventing weight loss and fatigue in patients with advanced cancer. PURPOSE: Randomized phase III trial to determine the effectiveness of docetaxel with or without infliximab in preventing weight loss, loss of appetite, and fatigue in patients who have advanced non-small cell lung cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00040885
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Epoetin alfa With or Without Dexamethasone in Treating Fatigue and Anemia in Patients With Hormone-Refractory Prostate Cancer Condition(s): recurrent prostate cancer; Anemia; Fatigue Study Status: This study is not yet open for patient recruitment. Sponsor(s): Eastern Cooperative Oncology Group; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Epoetin alfa may stimulate red blood cell production and may help improve cancer-related anemia and fatigue. Steroid therapy with dexamethasone may increase the effectiveness of epoetin alfa. It is not yet known if epoetin alfa is more effective with or without dexamethasone in treating anemia-related fatigue in patients with prostate cancer. PURPOSE: Randomized phase III trial to compare the effectiveness of epoetin alfa with or without dexamethasone in treating anemia-related fatigue in patients who have prostate cancer that is refractory to treatment with hormone therapy. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00060398
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Glucocorticoid Effects on Cellular Cytokine Release Condition(s): Depressive Disorder; Fatigue Syndrome, Chronic; Fibromyalgia; Healthy; Inflammation
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Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: A variety of hormones and immune system processes are responsible for how the body responds to illness. This study concentrates on how the hormone cortisol effects the release of immune system factors called cytokines. Cortisol is a hormone produced in the adrenal glands as a response to stimulation from the pituitary gland. Abnormal levels of cortisol have been seen in several diseases such as depression and multiple sclerosis. Cytokines are factors produced by certain white blood cells. They act by changing the cells that produce them (autocrine effect), altering other cells close to them (paracrine), and effecting cells throughout the body (endocrine effect). Cytokines are important in controlling inflammation processes. In this study researchers would like to determine if changes in levels of hormones in the blood are associated with changes in cytokine levels. In addition, researchers would like to learn more about how cytokines respond to hormones in certain diseases. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001415 •
Study of the Hypothalmic-Pituitary-Adrenal (HPA) Axis and its Role in Major Depression Condition(s): Fatigue Syndrome, Chronic; Healthy; Mood Disorders Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: Major depression represents a major public health problem worldwide and in the U.S. Fifteen percent of the U.S. population has depression at some point in life (40 million individuals). The condition is more common in women, occurring at a female to male ratio of 5:2. Presently, 6-8% of all outpatients in primary care meet the diagnostic criteria for major depression. Fifteen percent of untreated patients with depression will commit suicide. Most of the people committing suicide are depressed. Researchers believe that by the year 2020 suicide will be the 10th most common cause of death in the U.S. In addition to mortality due to suicide, depression is also associated with other severe health conditions. Areas of the brain (hippocampus) begin to deteriorate, heart disease, and decreased bone mineral density (osteoporosis) are all associated with major depression. Researchers have believed for years that hormones controlled by the hypothalmus, pituitary gland, and adrenal gland (Commonly referred to as the HPA axis or system) are in some way associated with psychiatric illnesses like depression. According to previous studies, researchers have theorized that increased activity of the HPA axis is associated with depressed patients with typical melancholic features. Melancholia refers to the feelings of anhedonia (absence of pleasure from activites that would normally be thought of as pleasurable), insomnia (inability to sleep), guilt, and psychomotor changes. On the other hand a decrease in activity of the HPA axis may be associated with the atypical features of depression. This study has already developed and refined studies that have improved the understanding of the HPA axis in healthy humans and depressed patients. Researchers have already identified and plan to continue identifying distinct subtypes of depressive disorders based on the activity of the HPA axis. Study Type: Observational Contact(s): see Web site below
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Web Site: http://clinicaltrials.gov/ct/show/NCT00001479
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “fatigue” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
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CHAPTER 6. PATENTS ON FATIGUE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “fatigue” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on fatigue, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Fatigue By performing a patent search focusing on fatigue, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We
9Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on fatigue: •
Composition for the prevention of muscle fatique and skeletal muscle adaptation of strenuous exercise Inventor(s): Cavazza; Claudio (Rome, IT) Assignee(s): Sigma-Tau HealthScience S.p.A. (Pomezia, IT) Patent Number: 6,602,512 Date filed: January 3, 2002 Abstract: A composition is disclosed suitable for the prevention and/or treatment of muscular energetic deficiencies and states of asthenia for enhancing sport performances and for the treatment of states of heart fatigue, that may take the form of a dietary supplement, dietetic support or of an actual medicine, which comprises as characterizing active ingredients a combination of L-carnitine and/or at least one alkanoyl L-carnitine and creatinol-phosphate. Excerpt(s): The present invention relates to a composition for the prevention and treatment of muscular energetic deficiencies, states of asthenia and muscle fatigue, states of heart fatigue and post-infarct conditions and for enhancing sporting performances. Accordingly, the composition may take the form and exert the action of a dietary supplement or of an actual medicine, depending upon the support or preventive action, or the strictly therapeutic action, which the composition is intended to exert in relation to the particular individuals it is to be used in. (b) creatinol-phosphate or a pharmacologically acceptable salt thereof. Web site: http://www.delphion.com/details?pn=US06602512__
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Cushioned rubber floor article for use in hair styling salons and other service environments Inventor(s): Burke, III; William O. (LaGrange, GA), Streeton; Amy B. (LaGrange, GA) Assignee(s): Milliken & Company (Spartanburg, SC) Patent Number: 6,599,615 Date filed: November 15, 2001 Abstract: The present invention is a floor mat made from a rubber composite, the composite having a foam rubber core positioned between dense rubber layers. Protrusions or cleats, which are produced during the vulcanization process, extend outwardly from the lower surface of the mat. The present mat offers mat users desirable anti-fatigue characteristics that are achieved by (a) a combination of dense rubber and foam rubber layers and (b) the spaced positioning of a plurality of cleats over one surface of the mat. Such a mat is anticipated to be useful in service environments, such as hair styling salons, retail outlets, or restaurant kitchens, for example. Excerpt(s): Generally, the present disclosure relates to a rubber floor mat. Specifically, the present disclosure relates to a rubber floor mat that provides a high level of comfort to the users thereof, even during extended periods of standing. Moreover, the surfaces of the mat exhibit resistance to chemicals, stains, and scuffing. Additionally, these mats have little tendency to absorb water during use. Such mats are suitable for use in a
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variety of applications where the mats' anti-fatigue and other physical properties are desirable. The present mat is particularly well suited for use by hair stylists, beauticians, and barbers, although use by other service professionals will be described herein. For some time now, employers have struggled with how to better protect employees from the rigors of standing in a relatively stationary position for long periods. People who stand for long periods may develop Cumulative Standing Trauma (CST) because of excessive stress on the back, legs, and other various muscles. CST can lead to varicose veins and to arch and heel pain from flattened feet. Such problems can result in increased absenteeism and health care costs for the employer and lower job satisfaction for the employee. Seeking to minimize the fatigue and discomfort felt by workers standing on concrete or other hard flooring surfaces, employers have used a variety of mats and other flooring articles in an attempt to cushion the work surface where employees stand. To this end, several types of mats or flooring articles have been used to combat CST and to cushion the work surfaces of stationary employees. These range from traditional carpeting to mats made from vinyl, rubber, or tufted substrates. When considering service industries, such as hair salons, restaurants, and retail outlets, for example, the problems associated with the previous alternatives become clear. Web site: http://www.delphion.com/details?pn=US06599615__ •
Ergonomic hand scraper Inventor(s): Panfili; Fran.cedilla.ois (Berthierville, CA), Panfili; Jean-Pierre (Berthierville, CA) Assignee(s): Ltee; A. Richard (Berthierville, CA) Patent Number: 6,629,331 Date filed: January 23, 2001 Abstract: A hand scraper having a blade with a cutting edge that is attached to a handle having a rear end, a central portion and a front end with a bottom portion shaped and sized to receive and act as a support for the blade. The handle is upwardly curved over all its length in order to give room to a user's fingers below its central portion when this central portion is gripped by the fingers and the blade and the bottom portion of the rear end of the handle are in contact with a surface, and simultaneously to allow maximum transfer of pressure exerted by the user in the central section of the handle towards the blade at the front end thereof. Advantageously also, the central portion of the handle is covered at least in part with a layer of rubber material in order to maximize grip and reduce hand fatigue in use. Excerpt(s): The present invention relates to a hand scraper. More specifically, it relates to a hand scraper having an ergonomic design that gives it more powerful scraping effect in addition of making it more comfortable and safer in use. There are numerous hand scrapers presently available on the market, which basically comprise a blade extending transversely at one end of a supporting handle. Such scrapers are commonly used to remove paint or other materials from a surface. Web site: http://www.delphion.com/details?pn=US06629331__
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Ergonomic seating unit Inventor(s): Guery-Strahm; Ruth (Leeacherstrasse 33, Ebmatingen, CH CH-8123) Assignee(s): Guery-Strahm; Ruth (Ebmatingen, CH) Patent Number: 6,616,238 Date filed: January 30, 2002 Abstract: An ergonomic seating unit is disclosed for promoting active and dynamic sitting and eliminating fatigue resulting from extended sitting. The seating unit comprises a substantially egg-shaped, or ball-shaped, fluid filled, deformable balloon forming a flexible, mobile seat which conforms to the shape of a user when sat upon, and a main frame for loosely containing the flexible balloon being freely removable from the main frame when the seating unit is unoccupied and being movably wedged in place by the main frame when the seat is occupied. Excerpt(s): The present invention generally relates to an ergonomically designed seating unit which naturally exercises the body by providing active sitting and, more particularly, to such an ergonomically designed seating unit which employs a fluidfilled, substantially egg-shaped, or ball-shaped seat, which promotes continuous movement of the spine, hips and upper body. Increasingly, scholars, students and workers are required to spend prolonged periods seated at a learning place, or a workstation. As a result, the potential for back, shoulder and neck problems has considerably increased. This is particularly true when seated in a conventional chair having a rigid seat which, with prolonged use, restricts blood circulation to the legs and does not allow for constant small movements of the spine, hips and arms. These small movements, herein referred to as "active sitting" or "dynamic sitting", are especially beneficial in reducing or preventing pains in the upper body. Children, while in growth, are especially endangered in this respect, and if not properly seated, can catch permanent damage to their body. To them the principle of "active sitting" applies therefore especially. Web site: http://www.delphion.com/details?pn=US06616238__
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Extrafine copper alloy wire, ultrafine copper alloy wire, and process for producing the same Inventor(s): Aoyama; Seigi (Ibaraki, JP), Goto; Shigetoshi (Ibaraki, JP), Ichikawa; Takaaki (Ibaraki, JP), Komuro; Hiroshi (Ibaraki, JP), Matsui; Hakaru (Ibaraki, JP), Okada; Ryohei (Ibaraki, JP), Seya; Osamu (Ibaraki, JP), Tamura; Koichi (Ibaraki, JP) Assignee(s): Hitachi Cable Ltd. (Tokyo, JP) Patent Number: 6,627,009 Date filed: November 17, 2000 Abstract: In an extrafine or ultrafine copper alloy wire having an outer diameter of not more than 0.1 mm, the copper alloy wire is formed of a heat treated copper alloy comprising 0.05 to 0.9% by weight in total of at least one metallic element selected from the group consisting of tin, indium, silver, antimony, magnesium, aluminum, and boron and not more than 50 ppm of oxygen with the balance consisting of copper. By virtue of this constitution, the extrafine or ultrafine copper alloy wire has a combination of excellent bending fatigue lifetime based on high tensile strength and excellent torsional strength based on high elongation or a combination of excellent tensile strength,
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electrical conductivity, and drawability and good elongation. The invention has been described in detail with particular reference to preferred embodiments, but it will be understood that variations and modifications can be effected within the scope of the invention as set forth in the appended claims. Excerpt(s): The invention relates to an extrafine copper alloy wire, an ultrafine copper alloy wire, and a process for producing the same, and more particularly to an extrafine copper alloy wire, with an outer diameter of 0.02 to 0.1 mm, possessing excellent bending fatigue lifetime and torsional strength and an ultrafine copper alloy wire, with a wire diameter of not more than 0.08 mm, possessing excellent tensile strength, electrical conductivity, and drawability and good elongation, and a process for producing the same. A reduction in size of electronic equipment, IC testers, medical ultrasound system and the like has led to an ever-increasing demand for a reduction in diameter of electric wires for use in these types of equipment. In general, conductor wires for electric wires used in this field are classified into three groups, that is, products having an outer diameter of more than 0.1 mm, products having an outer diameter of 0.02 to 0.1 mm, and products having an outer diameter of less than 0.02 mm. For conductor wires having an outer diameter exceeding 0.1 mm, importance is attached to torsional properties and elongation from the viewpoint of preventing loosening of wires, for example, during twisting work or working of terminals. In general, for this application, annealed tough pitch copper (TPC), which is advantageous from the viewpoints of low price and good electrical conductivity, has been used. Web site: http://www.delphion.com/details?pn=US06627009__ •
Facial fatigue reducing pillow construction Inventor(s): Garza; Jesse (8523 Jamestown Dr., Austin, TX 78758) Assignee(s): none reported Patent Number: 6,622,325 Date filed: March 1, 2002 Abstract: A facial fatigue reducing pillow construction (10) for eliminating the application of compressive forces against the side of a user's face including the eye socket and cheek bone areas while the user's head rests on the pillow construction (10) which includes a pillow member (20) having an upper portion (22) provided with a pair of facial relief units 12 12' and a head relief unit (13) aligned along the longitudinal axis of the pillow member (20) wherein the facial relief units (12 12') create voids in the upper portion (22) of the pillow member (20) adjacent a person's eye sockets and cheek bones and the head relief unit (13) is dimensioned to receive and support the side of a user's head. Excerpt(s): Not applicable. Web site: http://www.delphion.com/details?pn=US06622325__
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Fretting fixture for high-cycle fatigue test machines Inventor(s): Campbell; John B. (San Antonio, TX), Davidson; David L. (San Antonio, TX), Owen; Thomas E. (Helotes, TX) Assignee(s): Southwest Research Institute (San Antonio, TX) Patent Number: 6,601,456 Date filed: June 6, 2001 Abstract: A fretting fixture accessory for a_test machine (10) that induces high-cycle fatigue (at kilohertz vibration rates) in a specimen of a material under test. The fretting fixture (20) is clamped to the test specimen (21), for the purpose of testing for fretting damage. The fixture (20) is designed to provide both the normal and shearing forces that result in fretting damage. Excerpt(s): The present invention relates generally to equipment for testing physical characteristics of materials, and more specifically, to a fretting fixture for a test machine that subjects a sample of material to high-cycle stress. One type of stress-related fatigue damage that may occur in materials is "fretting". It occurs on a load-bearing contact surface between two pieces of mating material. Conventional fatigue testing has been empirically based without providing quantitative experimental information on the forces that result in fretting. U.S. Pat. No. 6,023,980, to Thomas E. Owen, et al., entitled "High-Cycle Fatigue Test Machine", describes a test machine that may be used to statically and dynamically load a test specimen in a manner that introduces controlled cyclic fatigue forces at high vibrational rates. A conventional use of this test machine is with a single specimen piece inserted between two actuators of the test machine, but this method of testing, by itself and without the supplemental fretting fixture invention described herein, does not introduce fretting forces in the specimen. However, by changing the method of excitation of this test machine, the static and dynamic forces applied to the specimen are modified and, additionally, the test specimen is made to undergo oscillatory translational motions along its length axis. As a result of these modified forces and translational motions and with the fretting fixture described herein attached to the specimen, the combined arrangement is capable of introducing fretting forces and fretting fatigue in the specimen. Web site: http://www.delphion.com/details?pn=US06601456__
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Gaming machine Inventor(s): Okada; Kazuo (Tokyo, JP) Assignee(s): Aruze Corporation (Tokyo, JP) Patent Number: 6,620,044 Date filed: January 29, 1999 Abstract: A gaming machine is provided with a variable display for displaying principal graphical information corresponding to at least one of a plurality of principal graphical elements, each principal graphical element having a predetermined significance in a principal game of the gaming machine. A secondary display displays secondary graphical information and is provided with a display portion positioned below the display portion of the variable display. A controller produces first control signals that control the variable display to display the principal graphical information as a sequential principal progression of the principal graphical elements, and second control
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signals that control the secondary display to display the secondary graphical information. The secondary graphical information has a predetermined relationship to the sequential progression of the principal graphical elements. During the period of variation of the symbols in the variable display, a separate indication that is correlated to the control of the variation action of the variable display is performed by the secondary display. As a result, player monotony while waiting for the result of the game is greatly reduced. The display portion of the secondary display is provided below the display portion of the variable display. Therefore, a player can watch the separate indication of the secondary display and the indication of the variable display substantially simultaneously over an extended period of time without fatigue. Excerpt(s): This invention relates generally to gaming machines, and more particularly to gaming machines such as slot machines or the like that have a variable display for displaying image information representative of a plurality of symbols necessary for a game and a controller such as a microcomputer for controlling the variation action of the variable display. A gaming machine such as a slot machine usually has a mechanical variable display formed of rotatable display elements that are provided with a plurality of symbols disposed on peripheral surfaces thereof. The symbols are visible through a display window at the front of the slot machine. Alternatively, an electrical variable display is formed of indicating elements with symbols on a display screen. In response to a "start" operation by a player, a controller drives the variable display to start the rotation of each rotatable display element and to stop the rotation of each rotatable display element in a determined sequence automatically after a predetermined period of time has elapsed, or in response to initiation of a "stop" operation by the player. When the rotation of all of the rotatable display elements has ceased, there is shown a specific combination of symbols (winning pattern) in the display window. The player is then given an award by paying out gaming medium such as coins. In a recent popular model of a gaming machine, a "win" corresponding to a predetermined plurality of winning symbols being completely positioned on the effective line of the display when rotation of the rotatable display elements ceases occurs only when a win has been established by a system internal to the gaming machine. In a practical machine, this happens when a sampling operation of a random number issued by a microcomputer has been determined to constitute a win. The reason why such gaming machines have become popular is that if the particular symbols that appear on the display when the rotatable display elements are stopped were to depend completely on the stop operation, or timing, of the player, the end result (i.e., win or loss) of the game would be responsive to the skill of the player. Consequently, only the relative abilities of the players would be emphasized, and the wholesomeness of the game would be compromised. A further reason for the popularity of such machines is that their designers have solved a number of problems related to management of the pay out rate of the coins for amusement shops. Web site: http://www.delphion.com/details?pn=US06620044__ •
Ion processed stylish ornament Inventor(s): Kaizuka; Kazutoshi (Fukuoka, JP) Assignee(s): Create Co., LTD (Fukuoa, JP) Patent Number: 6,615,491 Date filed: October 9, 2000
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Abstract: An ornament is provided that is useful in causing negative ions to be generated from the surface, thereby improving the immunity strength, improving psychological stability and bodily functions, improving the discharge of egesta and the function of the respiratory organs, and reducing fatigue of the person wearing the ornament. The ornament includes a plating layer which is formed by mixing a pulverized multiple element mineral powder and a pulverized sandstone powder. The negative ions are always generated, which act on the blood of a human body and put the human body in a state that is slightly inclined towards negative ions, thereby causing the body to be balanced, the metabolism to become activated, and the body to become healthy and resistant to aging. Excerpt(s): The present invention relates to personal ornaments having their surfaces plated with a mixture of a multielement mineral power and a sandstone powder. The plated ornaments such as a brooch, a necklace, a pin, a bracelet, an earring, a corsage, a ring, a hair ornament, a wristwatch, a wristwatch band, etc., generate negative ions from their plated surfaces. The negative ions generated, in turn, will have particular utility in bringing out positive health benefits such as improving immunity strength and other bodily functions. There exist a wide variety of metal and plastic ornaments, some of which have their surfaces plated. The plating performed on existing ornaments, however, has a limited purpose of beautifying the surface or preventing rust. The existing technology for plating ornaments does not cause negative ions to be generated from their surfaces, and has no utility in improving health of the persons wearing the ornaments. Web site: http://www.delphion.com/details?pn=US06615491__ •
Mentation test method and mentation test apparatus Inventor(s): Kajimoto; Osami (Noba Kaneichi Tsukuno-Dai 5002, 185-12 Hiraoka-Cho, Sakai, Osaka, JP), Takahashi; Takeo (A-2-107, 8-1 Aomadani Higashi, Minoo, Osaka, JP) Assignee(s): none reported Patent Number: 6,648,834 Date filed: March 21, 2001 Abstract: A mentation test method that can test mentation of a human such as conjecture of brain's mentation age, discrimination of early stage of dementia and prediction of onset of dementia in addition to diagnosis of prediction probability of onset of dementia and screening of mental functions of senile dementia patients, decision of the effect of rehabilitation of the aftereffects of cerebrovascular disfunction, investigation of the therapeutic effects of medicines and side effects such as sleepiness, testing of degree of intoxication, testing of peripheral attention visual field, testing of cerebral dominant hemisphere, testing of various psychoneurosis such as schizophrenia and cerebrovascular disorder (syndrome and diagnosis, and decision of the effects of rehabilitation and treatment), and check of the degree of fatigue. Excerpt(s): The present invention relates to a method for testing mentation of humans, and a mentation test apparatus. More specifically, the present invention relates to a highly reproducible and reliable mentation test method that is able to sensitively test human mentation without being affected by intelligence, educational carrier and the effects of repeated learning, and a mentation test apparatus. However, many other functions such as flexibility of mentation, attention span (fatigue), visual search ability and motor ability are required besides the working memory for achieving the task of the
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TMT method. Accordingly, lower performance of the aged person is conjectured as a result of age-related changes of these factors above. However, it is impossible in the currently available TMT method to analyze what factors have affected to what extent on the decrease of the score, thereby making it impossible to assess the working memory ability of aged persons and dementia patients. Web site: http://www.delphion.com/details?pn=US06648834__ •
Methods of treating fibromyalgia Inventor(s): Kranzler; Jay D. (La Jolla, CA), Rao; Srinivas G. (San Diego, CA) Assignee(s): Cypress Bioscience, Inc. (San Diego, CA) Patent Number: 6,602,911 Date filed: December 19, 2001 Abstract: The present invention provides a method of treating fibromyalgia syndrome (FMS), chronic fatigue syndrome (CFS), and pain in an animal subject. The method generally involves administering a therapeutically effective amount of a dual serotonin norepinephrine reuptake inhibitor compound or a pharmaceutically acceptable salt thereof, wherein said dual serotonin norepinephrine reuptake inhibitor compound is characterized by a non-tricyclic structure and an equal or greater inhibition of norepinephrine reuptake than serotonin reuptake. In particular, the use of milnacipran to treat FMS, CFS, and pain is disclosed. Excerpt(s): The present invention relates to methods for the treatment of fibromyalgia syndrome, chronic fatigue syndrome, and pain. In particular, the present invention relates to methods of treating fibromyalgia syndrome, chronic fatigue syndrome, and pain with a sub-class of dual serotonin norepinephrine reuptake inhibitors characterized by a non-tricyclic structure and inhibit the reuptake of norepinephrine to an equal or greater extent than they inhibit the reuptake of serotonin. Fibromyalgia syndrome (FMS) is the most frequent cause of chronic, widespread pain, estimated to affect 2-4% of the population. FMS is characterized by a generalized heightened perception of sensory stimuli. Patients with FMS display abnormalities in pain perception in the form of both allodynia (pain with innocuous stimulation) and hyperalgesia (increased sensitivity to painful stimuli). The syndrome, as defined by the American College of Rheumatology's criteria, involves the presence of pain for over 3 months duration in all four quadrants of the body, as well as along the spine. In addition, pain is elicited at 11 out of 18 "tender points" upon palpation. Other associated symptoms include fatigue, nonrestorative sleep, and memory difficulties. Chronic fatigue syndrome (CFS) is a debilitating disorder characterized by profound tiredness or fatigue. Patients with CFS may become exhausted with only light physical exertion, and must often function at a level of activity substantially lower than their capacity before the onset of illness. In addition to the key defining characteristic of fatigue, CFS patients generally report various nonspecific symptoms, including weakness, muscle aches and pains, excessive sleep, malaise, fever, sore throat, tender lymph nodes, impaired memory and/or mental concentration, insomnia, and depression. Like patients with FMS, patients with CFS suffer from disordered sleep, localized tenderness, and complaints of diffuse pain and fatigue. Web site: http://www.delphion.com/details?pn=US06602911__
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Nursing pillow for anatomically correct positioning of baby and mother Inventor(s): Igoe; Kenneth Edward (35 Lawson Farm Rd., Londonderry, NH 03053), Skattum; Gurli (Hunshovde 8, Giovik, NO 2800), Skoug; Stein Erik (28 Charron Ave., Ste 3, Nashua, NH 03063) Assignee(s): none reported Patent Number: 6,651,282 Date filed: January 19, 2000 Abstract: A flexible, crescent shaped pillow to assist mothers to maintain an anatomically correct alignment between mouth and nipple while breast feeding. This alignment is a key factor in ensuring optimum flow of milk. The pillow is both highly flexible and supportive. These are the key features that make it an effective aide to breast feeding mothers. These properties are achieved through the use of a low density bead filling which can shift and flow within the casing, thus providing the correct support where it is needed. The pillow is designed to be used while feeding in a variety of positions and from either breast. Use of the pillow also reduces fatigue and stress for both baby and mother while nursing. The bead filling allows for the passage of air and liquids through the pillow. This contributes to increased safety in terms of reduced risk of suffocation. and less opportunity for the growth of mold and bacteria. Excerpt(s): This invention is a pillow specifically designed to permit the easy adjustment of its filling to support the baby in a variety of nursing positions in anatomically correct mouth-nipple alignment for feeding at either breast through the entire nursing session. With the baby thus positioned and supported, the mother can also maintain an ergonomically correct position for herself. Nursing becomes a relaxed healthy experience for both baby and mother. The invention addresses two key factors that contribute to breast feeding problems. 1. Alignment. Alignment of the baby's mouth and mother's nipple is key to ensure proper breast feeding. If the alignment is incorrect, the baby may receive an inadequate supply of milk, or in the worst case, actually expend more calories in getting the milk than are contained in the milk received. This condition, know as "Insufficient Milk Syndrome", may jeopardize the health and development of the baby. Web site: http://www.delphion.com/details?pn=US06651282__
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Treatment of premenstrual syndrome and menopause Inventor(s): Andrus; G. Merrill (Orem, UT), Ellenberger; Suzanne R. (Woodward, OK), Ellenberger; William P. (Woodward, OK) Assignee(s): Designed Nutritional Products, Inc. (Vineyard, UT) Patent Number: 6,613,792 Date filed: August 2, 1999 Abstract: A method of treating premenstrual syndrome and menopausal symptoms in a patient, the method comprising: administering to the patient an 1H-indole-3-methanol compound (e.g., 1H-indole-3-methanol; ascorbigen) in a medically acceptable manner in a pharmaceutically effective amount. It has been found that the administration of such indoles, particularly, 1H-indole-3-methanol, greatly relieves the symptoms of PMS. Patients with PMS have reported decreased menstrual cramping, decreased menstrual flow, shorter duration of menses, decreased fatigue, less frequent headaches, improved
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mood, and decreased bloating resulting from the oral administration each day or during specific portions of the menstrual cycle of pharmaceutically effective amounts of dietary indoles derived from 1H-indole-3-methanol. It has also been found that the administration of such indoles, particularly, 1H-indole-3-methanol, greatly relieves the symptoms of menopause. Excerpt(s): This invention relates to the use of various naturally occurring compounds to treat the symptoms of diseases, and, more particularly, to the use of the natural product indole-3-methanol and related compounds to alleviate the symptoms associated with premenstrual syndrome and menopause. Premenstrual syndrome ("PMS"), a chronic complaint of a substantial percentage of women between the ages of 12 and 50, manifests in symptoms before and during menses. The symptoms include pain, marked general tension, marked irritability, anxiety, depression, abdominal bloating, swelling of subcutaneous tissues, nausea, fatigue, painful swelling of the breasts, headaches, dizziness, and palpitations. J. T. E. Richardson, "The Menstrual Cycle, Cognition, and Paramenstrual Symptomatology", Cognition and the Menstrual Cycle(Springer-Verlag 1992). While virtually all women experience pain at the onset of menstruation, many women also experience some of the listed symptoms several days before the onset of menses. The symptoms vary from one menstrual cycle to another, and vary considerably among individual women. These symptoms are generally conceded to be related to the release of various hormones, including estrogens. For women who experience severe PMS, there is considerable desire for their pain and suffering to be relieved. Some women find that their cognitive abilities are impaired and hope for ways to improve their cognitive performance during the days when affected by PMS. Id. Web site: http://www.delphion.com/details?pn=US06613792__ •
Use of tropical root crops in effective intervention strategies for treating difficult and complex cases and chronic diseases Inventor(s): Slimak; Karen M. (P.O. Box 2444, Springfield, VA 22152) Assignee(s): none reported Patent Number: 6,632,461 Date filed: July 12, 2001 Abstract: This invention relates to an effective intervention plan. In one aspect, the invention relates to the treatment of various symptoms, conditions or diseases, such as diarrhea, constipation, congestion, eczema, asthma, fatigue, muscle weakness, tension and spasms, irritable bowel syndrome, swelling, anxiety, multiple chemical sensitivities, moderate to excessive and moderate to severe symptoms due to food allergies, sensitivities and intolerances, bloating, pain, headaches, leaky gut, hypersensitivity, sleep difficulties, severe under weight, eating disorders, obsessive, compulsive disorders, panic attacks, sensory sensitivities, Alzheimer's disease, acid refulx, irritability, delayed motor skills, delayed social skills, autism, PDD, infantile spasms and seizures by withholding for a period of at least 5 days all foods except for root crops. Excerpt(s): This invention relates to an effective dietary intervention plan. In one aspect all food is withheld for a period of at least 5 days, except for tropical root crops. In another aspect the invention relates to the treatment of various symptoms, conditions or diseases such as diarrhea, constipation, congestion, eczema, asthma, fatigue, muscle weakness, tension, and spasms, irritable bowel syndrome, swelling, anxiety, multiple chemical sensitivities, moderate to extensive and moderate to severe symptoms due to
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food allergies, sensitivities, and intolerances, bloating, pain, headaches, leaky gut, hyperactivity, sleeping difficulties, severe underweight, eating disorders, obsessive, compulsive disorders, panic attacks, sensory sensitivities, Alzheimer's disease, acid reflux, irritability, delayed motor skills, delayed social skills, autism, PDD, infantile spasms, seizures by withholding from the patient for a period of at least 5 days all food except for concentrated forms of concentrated tropical root crops. Preferably the patient is also removed from external environmental sources of allergens. After the initial withholding period new foods may be introduced according to a particular selection and schedule. In another aspect of the invention the subject undergoes an effective dietary intervention plan in which at least five (5) tropical root crops are selected, each eaten on a successive day, along with selected other meat, vegetables, and oils that the subject has never eaten before, eating a different selection of meat, vegetables, and oils each from different food families each day, with no food or food family being repeated for at least 5 days. In another aspect the invention relates to the treatment of various symptoms, conditions or diseases such as Diarrhea, constipation, congestion, eczema, asthma, fatigue, muscle weakness, tension, and spasms, irritable bowel syndrome, swelling, anxiety, multiple chemical sensitivities, moderate to extensive and moderate to severe symptoms due to food allergies, sensitivities, and intolerances, bloating, pain, headaches, leaky gut, hyperactivity, sleeping difficulties, severe underweight, eating disorders, obsessive, compulsive disorders, panic attacks, sensory sensitivities, Alzheimer's disease, acid reflux, irritability, delayed motor skills, delayed social skills, autism, PDD, infantile spasms, seizures by withholding from the patient for a period of at least 5 days all food except for concentrated forms of concentrated tropical root crops. Preferably the patient is also removed from external environmental sources of allergens. After the initial withholding period new foods may be introduced according to a particular selection and schedule. In another aspect of the invention the subject undergoes an effective dietary intervention plan in which at least seven (7) tropical root crops are selected, each eaten on a successive day, along with selected other meat, vegetables, and oils that the subject has never eaten before, eating a different selection of meat, vegetables, and oils each from different food families each day, with no food or food family being repeated for at least 7 days. In another aspect the invention relates to the treatment of various symptoms, conditions or diseases such as Diarrhea, constipation, congestion, eczema, asthma, fatigue, muscle weakness, tension, and spasms, irritable bowel syndrome, swelling, anxiety, multiple chemical sensitivities, moderate to extensive and moderate to severe symptoms due to food allergies, sensitivities, and intolerances, bloating, pain, headaches, leaky gut, hyperactivity, sleeping difficulties, severe underweight, eating disorders, obsessive, compulsive disorders, panic attacks, sensory sensitivities, Alzheimer's disease, acid reflux, irritability, delayed motor skills, delayed social skills, autism, PDD, infantile spasms, seizures by withholding from the patient for a period of at least 5 days all food except for concentrated forms of concentrated tropical root crops. Preferably the patient is also removed from external environmental sources of allergens. After the initial withholding period new foods may be introduced according to a particular selection and schedule. Web site: http://www.delphion.com/details?pn=US06632461__
Patents 201
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Visual image system Inventor(s): Tabata; Seiichiro (Hino, JP) Assignee(s): Olympus Optical Co., Ltd. (Tokyo, JP) Patent Number: 6,614,927 Date filed: June 2, 1999 Abstract: A visual image system is constructed as including: a three-dimensional visual image reproducer for transmitting a three-dimensional video signal; a parallax quantity detecting section for detecting a parallax quantity in the three-dimensional video signal from the three-dimensional visual image reproducer; a fatigue measure estimating section for estimating the degree of fatigue based on the detected parallax quantity and outputting an image switching signal correspondingly to a fatigue measure estimating quantity; a 3D/2D image switching section for providing an output by switching between three-dimensional and two-dimensional images based on the image switching signal; and an image display section for displaying a three-dimensional image or a twodimensional image. The visual image system thereby fulfills the capability of suitably controlling the degree of three-dimensionality of stereoscopic images by inferring from the inputted video signal the degree of effects likely to be produced on the observer. Excerpt(s): The present invention relates to visual image systems and, more particularly, relates to a visual image system in which the degree of three-dimensionality is controlled by estimating effects produced on the observer based on video signals. Various proposals have been made with respect to visual image systems. For example, the following technique is disclosed in Japanese Patent Publication No.2594235 as that for converting two-dimensional visual image into three-dimensional visual image. In particular, a disclosure has been made with respect to a method for converting a twodimensional visual image into a three-dimensional visual image in which the extent and direction of a horizontal motion in image is detected using a two-dimensional video signal by generating from the two-dimensional video signal a main video signal serving as a reference and a subordinate video signal delayed from the main video signal. The delay amount for generating subordinate video signal is then determined on the basis of an extent of motion and an image switching means for inputting the main or subordinate video signal is regulated depending on the direction of the motion, thereby providing an output with determining which one of the main or subordinate video signal is outputted as a left-eye video signal or a right-eye video signal. Further, the following technique is disclosed in Japanese patent application laid open No.9-116928. In particular, a disclosure has been made with respect to technique for converting a twodimensional visual image into a three-dimensional visual image in which a first phaseshifted visual image of which horizontal phase is gradually delayed by each one field along a vertical direction is produced based on a two-dimensional input image and a second phase-shifted visual image of which horizontal phase is gradually advanced by each one field along the vertical direction is produced based on the input image. One of the first phase-shifted and second phase-shifted images is used as a visual image for the left eye and the other is used for a visual image for the right eye. Web site: http://www.delphion.com/details?pn=US06614927__
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Patent Applications on Fatigue As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to fatigue: •
Activated charcoal based composition and method for reducing hangover symptoms associated with the consumption of alcohol containing beverages Inventor(s): Bhargava, Manoj; (West Bloomfield, MI), Crippen, Raymond C.; (Baltimore, MD), Morse, Thomas F.; (Walled Lake, MI) Correspondence: Pillsbury Winthrop, Llp; P.O. Box 10500; Mclean; VA; 22102; US Patent Application Number: 20030219432 Date filed: March 13, 2003 Abstract: The invention provides a composition which is effective in the prevention or delay of the onset of side effects associated with alcohol consumption or the reduction or alleviation of those effects. The composition of the invention includes activated charcoal and limestone, optionally activated limestone. Optionally, the composition of the invention also includes vitamin B1 and/or other agents such as fatigue relieving agents. Preferably, the composition of the invention is provided in the form of tablets or powder encapsulated in a gelatin capsule. The composition of the invention is provided in pre-dosed quantities varying from between about 100 and 500 milligrams per dose. The invention also provides a method of reducing or alleviating the deleterious effects associated with alcohol consumption. The method includes administration, preferably multiple administration at regularly spaced intervals before, during, and after alcohol consumption of a composition containing activated charcoal and activated limestone. Excerpt(s): This application claims the benefit of U.S. provisional application No. 60/260,916, filed on Jan. 12, 2001, which is hereby incorporated in its entirety by reference. This application is a continuation-in-part of application Ser. No. 10/042,283 filed Jan. 11, 2002. The present invention relates to a composition which is effective in reducing the effects associated with alcohol consumption and to a method based on administering the composition to a subject in need thereof. As long as history has been recorded, every society has used substances that alter mood, thought and feeling. Alcohol based beverages have played a central role throughout modern history as a prominent ingredient in social and cultural gatherings. The association of alcohol based beverages with culinary enjoyment and other human celebrations have been central to the development of western culture. The role of alcohol based beverages in social human activities is increasingly spreading throughout the globe due to the adoption by populations around the world of the western lifestyle and cultural standards. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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This has been a common practice outside the United States prior to December 2000.
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Anti-fatigue mat Inventor(s): Evans, R. Douglas JR.; (Everett, PA), Fedeli, Raymond L.; (Altoona, PA), Healy, Patrick E.; (Gallitzin, PA), Shetler, Heidi G.; (Altoona, PA) Correspondence: Bryan H. Opalko, Esquire; Buchanan Ingersoll, P.C.; One Oxford Centre, 20th Floor; 301 Grant Street; Pittsburgh; PA; 15219; US Patent Application Number: 20030203164 Date filed: May 28, 2003 Abstract: An anti-fatigue mat is provided having a layer of absorbent material attached face-to-face to a layer of cushioning material. The layer of absorbent material has liquid absorbent properties, while the layer of cushioning material has shock absorption properties and is preferably liquid impermeable. While the layer of cushioning material may inherently have some liquid absorbent properties, its primary function is for shock absorption. The layer of absorbent material includes top and bottom surfaces, with the layer of cushioning material attached to the bottom surface of the layer of absorbent material. In one form, since the inventive mat may incur moderate to high foot traffic, a layer of wear-resistant material is attached to the top surface of the layer of absorbent material to increase the useful life of the inventive mat. Alternately, the top surface of the layer of absorbent material may have wear-resistant properties, or the layer of absorbent material may be manufactured to have higher wear characteristics, to increase the useful life of the mat. Excerpt(s): The present application is a continuation-in-part of application Ser. No. 10/116,283 entitled "Absorbent/Cushion Sheet Product", filed on Apr. 4, 2002, the entire disclosure of which is incorporated by reference herein. The present invention is directed toward mats in general and, more particularly, toward an anti-fatigue mat having both absorbent and cushioning properties. It is essential that managers and workers in settings where there exists a potential for leaks or spills of toxic and/or nontoxic liquids be prepared to contain the leaks or cleanup the spills. A number of products have been developed for absorbing liquids from leaks and spills. Typically, each product is directed to a specific type of problem. For example, leaks, splashes and drips of a slippery liquid over a walkway may be addressed by a walk-on mat that absorbs the liquid and has an upper surface that is resistant to the wear of foot traffic. These walk-on mat products may also be used in non-traffic areas as absorbent pads. Puddles of liquid are often cleaned up by throwing absorbent response pads or pillows on the puddle. The outward flow of a leak or spill is often contained by placing an absorbent sock around the outer edges of the liquid to soak up the liquid as it reaches the sock. Drips and sprays are typically absorbed from surfaces with absorbent wipes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Anti-reflective glass surface with improved cleanability Inventor(s): Lin, Juei-Hua; (US) Correspondence: Darby & Darby P.C.; 805 Third Avenue; New York; NY; 10022; US Patent Application Number: 20030170459 Date filed: March 5, 2002 Abstract: A low reflectance glass surface with improved cleanability is disclosed which includes a particular combination of surface structures which produce a low reflectance
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yet high clarity glass. The surface structure includes a plurality of islands distributed at a density of about 60 to about 10,000 islands per square millimeter. The glass surface also includes a skeletalized silica structure of about 100 to about 400 angstroms in diameter uniformly distributed over the surface. By combining the various surface structures on one piece of glass, unique properties of low reflectance yet high clarity are provided, which is particularly suitable for use in picture frames where any distortion would distract from viewing a picture contained therein and also in computer or t.v. screens where distortion or glare could produce operator fatigue or stress. The glass structure is achieved by a process which is readily adaptable to existing production lines without requiring major modifications. Consequently, the low glare high clarity glass can be produced economically, allowing use in applications not previously adaptable to the highly expensive anti-reflection glass previously available. Excerpt(s): This invention relates to the surface structure of anti-reflective glass and more particularly to a surface structure of glass which has a low reflectance while attaining high clarity and is easy to clean. This invention also relates to methods of producing such surface structures of glass. It is known that glass can be treated to reduce glare (reflection) by making use of two different physical phenomena, diffusion and anti-reflection. Diffusion refers to the phenomenon by which reflections of light are scattered in various directions, so that the intensity of the reflections in the direction of a viewer is reduced, but the total hemispherical reflection remains the same. "Diffusion etching" treats a glass surface to increase the diffusion effect. Reducing glare by diffusion may be achieved by roughening the glass surface using physical or chemical means, e.g., by grinding, sand blasting, or acid etching. Frosted glass is a typical light diffusion material which is usually made by acid etching of the glass surface. However, frosted glass cannot be used in applications where high clarity is required along with low glare. Examples of such applications are in picture frames; a protective surface for a cathode ray (picture) tube in television receivers; or as a screen for computer monitors. The above applications require a high level of clarity to prevent distortion of the images and colors displayed by a picture, such as a photograph, or to prevent detracting from the visual appreciation of the image. It is also desirable and important to reduce glare to prevent reflected light from interfering with observation of the picture or photograph contained therein. The reduction of glare is of particular importance in computer monitors where fatigue or stress may be induced by unwanted reflections. At the same time, image clarity must be maintained to minimize distortion. Distortion can cause eye strain if the image is viewed for long periods for time. Various attempts have been made to improve the light transmission qualities of frosted glass. However, the degree of clarity that has been achieved in such products has not been sufficient to enable them to be used in picture frames or in monitor screens. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Apparatus and method to substantially minimize low-cycle fatigue of electrical connections Inventor(s): McKeown, Stephen A.; (Endicott, NY) Correspondence: Geoffrey H. Krauss; Bae Systems Controls Inc; Legal Department; 600 Main Street, RM. O8; Johnson City; NY; 13790; US Patent Application Number: 20030182959 Date filed: March 26, 2002
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Abstract: An apparatus to substantially minimize low-cycle fatigue of at least one electrical connection between a first component and a second component includes at least one thermoelectric device to thermally contact at least the first component and includes at least one sensor that is coupled to at least one of the first component or the second component. A controller is provided and coupled to the at least one thermoelectric device and to the at least one sensor. The controller controls operation of the thermoelectric device to substantially minimize low-cycle fatigue by transferring heat from at least the first component in response to signals from the at least one sensor. Excerpt(s): The present invention relates generally to electronic devices, and more particularly to an apparatus and method to substantially minimize breakage or lowcycle fatigue of electrical connections between components. Electronic devices and integrated circuits are being required to perform more functions at ever increasing speeds. Component densities are also increasing while packaging size requirements are decreasing. The higher component densities, higher operating frequencies and tighter packaging requirements are resulting in the generation of more heat that must be managed for proper operation and longevity of current and future high performance electronic devices and circuits. Components in an electronic device can be electrically connected to one another by solder connections. For example, a microelectronic die, chip or other component may be electrically connected to a printed wiring board (PWB) or the like by a plurality of solder ball connections or a ball-grid array (BGA). Because of possible size variations and differences in composition between the electrically connected components, they can expand and contract at different rates of thermal expansion during thermal cycling as the components build up heat under operating conditions and cool down during low duty cycles or non-operating conditions. Additionally, variations in ambient temperature under both operating and nonoperating conditions can also cause the components to expand and contract at different rates. The repeated thermal expansion and contraction of the components can result in low-cycle fatigue and breakage of the solder connections or BGA connecting the components. Low-cycle fatigue can be an especially significant problem with ceramic components that have low expansion relative to typical PWB materials. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Aqueous metal bicarbonate solution and method of use Inventor(s): Beckett, Russell John; (Red Hill, AU) Correspondence: Jones, Tullar & Cooper, P.C.; P.O. Box 2266 Eads Station; Arlington; VA; 22202 Patent Application Number: 20030180386 Date filed: January 21, 2003 Abstract: An aqueous neutral to mildly alkaline metal bicarbonate solution is disclosed. The solution comprises metal bicarbonate dissolved in the solution, the metal bicarbonate comprising bicarbonate anions and metal cations. In addition there is a pH adjusting agent in the solution in an amount whereby the solution is at a neutral to mildly alkaline pH. Also disclosed is a process of preparing an aqueous neutral to mildly alkaline metal bicarbonate solution comprising bicarbonate anions and metal cations. The process comprises reacting a compound selected from the group consisting of metal carbonate, metal carbonate hydroxide, metal oxide, metal hydroxide and any mixture thereof with an effective concentration of a pH adjusting agent to produce the aqueous neutral to mildly alkaline metal bicarbonate solution, wherein the pH adjusting
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agent is present in an amount whereby the solution is at a neutral to mildly alkaline pH. Further disclosed are a method of preventing and/or treating certain inflammatory diseases and/or degenerative diseases in a mammal, a method of preventing and/or treating certain viral diseases in a mammal, a method of decreasing and/or treating senescence and/or of increasing longevity in a mammal, a method of scavenging protons in a mammal, a method of decreasing proton concentrations in a mammal by altering carbonic anhydrase enzyme reactions in said mammal, a method of decreasing inflammation and/or inflammatory conditions in a mammal and a method of increasing motor activity and/or decreasing fatigue in a mammal. Excerpt(s): This invention relates to an aqueous metal bicarbonate solution, a process of preparing the aqueous metal bicarbonate solution and a method of preventing and treating certain inflammatory diseases, degenerative diseases and viral diseases in mammals. Generally the certain inflammatory diseases, degenerative diseases and viral diseases in mammals are those that require extracellular or intracellular acidic conditions or extracellular or intracellular proton concentrations at some point in disease process or disease pathogenesis. Typically the certain inflammatory diseases, degenerative diseases and viral diseases in mammals are those that require the activities of carbonic anhydrase enzymes and/or the activities of acid (aspartic) protease enzymes and/or the activities of endosomal or lysosomal acid-requiring-enzymes and/or the activities of V-type ATPase proton pumps at some point in disease process or disease pathogenesis. Typically the certain inflammatory diseases, degenerative diseases and viral diseases in mammals are represented by the diseases of arthritis and influenza. This invention relates to a method of using an aqueous metal bicarbonate solution to decrease senescence and to increase longevity in mammals. Generally senescence is decreased and longevity is increased in mammals by improving the buffering capacity of the extracellular and intracellular fluids of the body. Generally senescence is decreased and longevity is increased in mammals by the improved buffering capacity causing a decrease in proton concentrations in the extracellular and intracellular fluids of the body. Typically senescence is decreased and longevity is increased in mammals by improving the buffering capacity of the extracellular and intracellular bicarbonate buffers. Typically senescence is decreased and longevity is increased in mammals by the improved extracellular and intracellular bicarbonate buffers causing a decrease in proton concentrations. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Austenitic stainless steel excellent in high temperature strength and corrosion resistance, heat resistant pressurized parts, and the manufacturing method thereof Inventor(s): Iseda, Atsuro; (Kobe-shi, JP), Semba, Hiroyuki; (Sanda-shi, JP) Correspondence: Clark & Brody; Suite 600; 1750 K Street, N.W.; Washington; DC; 20006; US Patent Application Number: 20030198567 Date filed: April 16, 2003 Abstract: An austenitic stainless steel suited for ultra supercritical boilers, which consists of C: 0.03-0.12%, Si: 0.1-1%, Mn: 0.1-2%, Cr: not less than 20% but less than 28%, Ni: more than 35% but not more than 50%, W: 4-10%, Ti: 0.01-0.3%, Nb: 0.01-1%, sol. Al: 0.0005-0.04%, B: 0.0005-0.01%, and the balance Fe and impurities; and also characterized by the impurities whose contents are restricted to P: not more than 0.04%, S: not more than 0.010%, Mo: less than 0.5%, N: less than 0.02%, and O (oxygen): not more than
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0.005%.Heat resistant pressurized parts excellent in thermal fatigue properties and structural stability at high temperatures, which have a coarse grain whose grain size number is 6 or less, and whose mixed grain ratio is 10% or less. Excerpt(s): The present invention relates to an austenitic stainless steel suited for such use as pipes or tubes, steel plates or sheets, steel bars and forgings (hereinafter collectively referred to as "heat resistant pressurized parts"), which constitute power generation boilers or heating furnaces for the chemical industry. The present invention also relates to heat resistant pressurized parts made of the above steel, excellent in high temperature strength and corrosion resistance, and to the manufacturing method of these parts. These parts are excellent in high temperature strength and corrosion resistance as well as in thermal fatigue properties and microstructural stability (hereinafter referred to as "structural stability" for short). Ultra supercritical boilers that are very effective because of using a high temperature and pressurized steam have recently been built or are under construction all over the world. The planned steam temperature will elevate from about 600.degree. C. to 650.degree. C., or to about 700.degree. C. in future. Ultra supercritical boilers are very advantageous for saving energy, an efficient use of resources, and environment preservation because fossil fuels are burnt with high efficiency. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Deposit metal welding method Inventor(s): Wada, Kazumi; (Kanagawa, JP) Correspondence: Harrington & Smith, Llp; 4 Research Drive; Shelton; CT; 06484-6212; US Patent Application Number: 20030209591 Date filed: May 10, 2002 Abstract: [Problem ] To prevent decreases in fatigue strength of a base material by relieving the residual stress of a weld.[Solution Means] A method for welding a deposit metal to a base material with reduced residual stress, comprising a step of welding a deposit metal to a base material; and a step of plastically deforming, into a recess, an area on the surface of the base material around a peripheral portion of the deposit metal. The invention is also directed to a welded block joint between a wire and a base material, characterized by comprising a deposit metal receiving an end portion of the wire and welded to the base material, wherein an area which is plastically deformed into a recess is formed on the base material surface at a peripheral portion of the deposit metal. Excerpt(s): The present invention relates to a method for welding a base material and a deposit metal, and particularly relates to a welding method for reducing the residual stress after welding a deposit metal to a base material, and increasing the fatigue strength of a base material and welded joint portion. Herebelow, a summary of the conventional art shall be described with the welding of a bond cable for a railroad rail. Thermit welding is a method wherein a mixed powder of aluminum and copper oxide (or iron oxide) is ignited near the surface of the base material, to melt and weld the copper (or iron) and a portion of the base material with the heat of the chemical reaction. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Electrical neuromuscular stimulator for measuring muscle responses to electrical stimulation pulses Inventor(s): Buhlmann, Felix; (Lausanne, CH), Muller, Pierre-Yves; (Hermance, CH), Rigaux, Pierre; (Liege, BE) Correspondence: Sughrue Mion, Pllc; 2100 Pennsylvania Avenue, N.W.; Washington; DC; 20037; US Patent Application Number: 20030195586 Date filed: May 6, 2003 Abstract: The electrical stimulator includes an electrical pulse generator arranged in a case, stimulation electrodes (7) to be placed on a user's skin on the motor points of the muscles to be stimulated, each electrode (7) being connected to an electric cable (5) connector, the other end of the cable being connected in a removable manner to a signal input and/or output socket of the case for receiving the electric pulses, at least one sensor (11) for measuring the muscle reactions caused by the electric pulses, and electronic means in the case for receiving the measurements from the sensor. The sensor (11) is intrinsically linked to one of the electrodes (7) or to the connector (6). At least one conductor wire (15) of the cable connects the electrode (7) independently of the sensor (11).The stimulator finds application in particular in the field of sports for the passive exercising of muscles stimulated by electric pulses, or in the re-education of atrophied muscles. In this case, the sensor (11) is used to provide data as to the reactivity of the stimulated muscles and their fatigue level. This data is seen on a display of the stimulator and is used to adjust the stimulation parameters manually or automatically. Excerpt(s): The invention concerns an electrical neuromuscular stimulator for measuring muscle reactions generated by electrical stimulation pulses. The stimulator includes an electrical pulse generator arranged in a case, at least one pair of stimulation electrodes intended to be placed on the skin of an user in the vicinity of the motor points of the muscles to be stimulated, each electrode being connected to one end of an electric cable, the other end of which is connected to the case to receive the electric pulses from the generator, at least one sensor sensitive to the muscle reactions caused by the electric stimulation pulses and arranged for transmitting electric measuring signals representative of said muscle reactions to electronic means in the stimulator case. The invention also concerns an electric cable and a stimulation electrode for a neuromuscular electric stimulator. The sensor supplies data regarding the useful muscle reactions in particular in order to know the fatigue level of the electrically stimulated muscles. The measurements obtained from the sensor allow the parameters of the electric stimulation pulses to be adjusted either manually by viewing the shape of the signals received by the sensor on a display or automatically by adjusting the electric stimulation parameters as a function of the muscle fatigue. Adjusting the parameters consists in correcting either the frequency of the pulses, or the amplitude or duration of the voltage or current pulses, or the duration of muscle contraction and relaxation, or the number of contraction/relaxation cycles, or any combination of the preceding parameters. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Elevator load bearing assembly having a ferromagnetic element that provides an indication of local strain Inventor(s): Baldwin, Neil R.; (Manchester, CT), Stucky, Paul A.; (Vernon, CT) Correspondence: Carlson, Gaskey & Olds, P.C.; 400 West Maple Road; Suite 350; Birmingham; MI; 48009; US Patent Application Number: 20030205434 Date filed: April 3, 2003 Abstract: An elevator load bearing assembly, such as a polymer cord, reinforced belt, includes at least one element of a ferromagnetic material associated with each cord that comprises one or more non-ferromagnetic materials. The ferromagnetic element is associated with the cord such that a physical characteristic of the ferromagnetic element changes responsive to strain on the non-ferromagnetic fibers. In one example, the ferromagnetic element is a steel wire that breaks in areas that are strained, caused by bending fatigue, for example. Detecting a number of changes (i.e., breaks) in the ferromagnetic element along the length of the load bearing assembly provides an indication of the belt condition. Excerpt(s): This application is a continuation-in-part of the copending application having Ser. No. 09/970,451, which was filed on Oct. 2, 2001. This invention generally relates to load bearing assemblies for elevator systems. More particularly, this invention relates to an arrangement for readily detecting localized strain in an elevator load bearing assembly. Elevator systems typically include a cab and counterweight that are coupled together using an elongated load bearing member. Typical load bearing members include steel ropes and, more recently, synthetic ropes and multi-element ropes such as polymer coated, steel or synthetic cord reinforced belts. Synthetic ropes and polymer coated, synthetic cord reinforced belts are particularly attractive for elevator applications due to their greater strength-to-weight ratio compared with steel ropes or belts. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Ergonomic handle assembly for dispenser of extrudable material Inventor(s): Watson, Jeffrey C.; (Franklin, TN) Correspondence: James M. Singer; Pepper Hamilton Llp; 50th Floor; 500 Grant Street; Pittsburgh; PA; 15219; US Patent Application Number: 20030192916 Date filed: April 11, 2003 Abstract: An ergonomic handle assembly is provided for dispensers of food, condiments and other extrudable material. The assembly includes a handle having a first portion adapted to be connected to an elongated dispenser and axially aligned with said dispenser at one end thereof. A second portion has a surface adapted to be gripped by the hand of an operator using the dispenser and is aligned at an angle within a range of from about 140 to about 160 degrees with respect to a direction normal to a longitudinal axis of said first portion. This enables said operator to hold the operator's elbow comfortably against the side of said operator when manipulating the dispenser by rotation of the operator's wrist, thereby reducing fatigue of said operator. A dispenser including the ergonomic handle assembly is also provided.
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Excerpt(s): This application claims the benefit of and priority to U.S. Provisional Application Serial No. 60/372,292, filed Apr. 12, 2002, entitled "Ergonomic Handle Assembly for Dispenser of Extrudable Material," which is incorporated herein by reference in its entirety. The present invention relates generally to dispensers of extrudable material. More particularly, the present invention relates to an ergonomic handle assembly for dispensers of extrudable material. Prior known dispensers of food, condiments or other extrudable material had a straight handle assembly which required a person using the dispenser to hold their elbow at about ninety degrees or so from their body when dispensing material from the dispenser. Thus, a person using such a dispenser would have to hold their arm in an awkward position resulting in considerable fatigue during operation of the dispenser. There is a need for an ergonomic handle assembly for dispensers of extrudable material that would not require a person using the dispenser to hold their arm in an awkward position during operation of the dispenser. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Ergonomic spring suspension carry handle for luggage Inventor(s): Schneider, Gregg; (Edina, MN) Correspondence: Gregg Schneider; P.O. Box 24895; Minneapolis; MN; 55424; US Patent Application Number: 20030200632 Date filed: April 8, 2002 Abstract: The invention is an ergonomic spring carry handle for luggage that reduces the strain imposed on the person carrying the article. The handle is useable over a wide load range without modification while producing a substantial reduction in user fatigue. The invention may be incorporated into new manufacture or retrofitted to repair or improve existing cases and bags. The invention includes a U-shaped handle having legs that pivot both parallel and perpendicular to the long axis of the graspable portion. The graspable portion includes a spring which may be a close-wound coil extension spring or other type, the ends of which are attached to the legs of the handle. Excerpt(s): This invention relates to graspable handles for carrying luggage, generally, and specifically to carrying handles for carrying briefcases, computer cases, carry-on luggage, and similar items. More particularly, the present invention is an ergonomic, strain-reducing carrying handle for briefcases, computer cases, sample cases, luggage, and other articles that are carried by hand. Previously known luggage handles have a variety of deficiencies that cause difficulties for the person who uses the luggage. Often, the handles are uncomfortable to grip. Handles may be too small and therefore cause pain to the user's hands. Some luggage handles lack sufficient strength and durability to withstand full loads or long-term use. People who travel frequently may require features in luggage that are unnecessary for persons who seldom travel. Business travelers often need to carry a briefcase with documents and other work-related items and a separate item of luggage containing clothing and other travel necessities. Such individuals may pack the briefcase rather heavily to contain the many items required to conduct work for a week or more while also minimizing the number of separate articles of luggage that are used during a trip. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Ferroelectric memory Inventor(s): Ho, Iu Meng Tom; (Milpitas, CA) Correspondence: Patton Boggs; PO Box 270930; Louisville; CO; 80027; US Patent Application Number: 20030206430 Date filed: May 6, 2002 Abstract: A ferroelectric memory including a bit line pair, a drive line parallel to and located between the bit lines, and an associated memory cell. The memory cell includes two capacitors, each capacitor connected to one of said bit lines via a transistor, and each capacitor is also connected to the drive line via a transistor. The gates of all three of the transistors are connected to a word line perpendicular to the bit lines and drive line, so that when the word line is not selected, the capacitors are completely isolated from any disturb. The bit lines may be complementary and the cell a one-bit cell, or the cell may be a two-bit cell. In the latter case, the memory includes a dummy cell identical to the above cell, in which the two dummy capacitors are complementary. A sense amplifier with three bit line inputs compares the cell bit line with a signal derived from the two dummy bit lines. The logic states of the dummy capacitors alternate in each cycle, preventing imprint and fatigue. The bit lines are partitioned into a plurality of second level bit lines, each connected to a top level bit line via a group select transistor. The memory includes a plurality of such cells, divided into groups, each group connected to one of the second level bit lines. The memory cells are read with a non-destructive read out method that differentiates between the different capacitances of a ferroelectric capacitor in different ferroelectric polarization states. Excerpt(s): The present invention relates in general to ferroelectric memories and in particular to such memories that include memory cells including ferroelectric capacitors and arranged in rows and columns to form an array. It is well known that ferroelectric materials are capable of retaining a polarization which can be used to store information in a non-volatile memory. For example, if a strong enough electric field or voltage is placed across a ferroelectric capacitor, when the voltage is removed, a polarization in the direction of the field remains. If the field is then placed across the same capacitor in the opposite direction, the ferroelectric material switches, and when the field is removed, a polarization in the opposite direction remains. Electronic circuits have been designed to associate the polarization in one direction with a digital logic "1" state, and polarization in the opposite direction with a logic "0" state. See, for example, the circuits described in U.S. Pat. No. 2,876,436 issued Mar. 3, 1959 to J. R. Anderson. Like other integrated circuit memories, these circuits include memory cells arranged in rows and columns, each memory cell including at least one switch, a capacitor having a pair of electrodes, and the memory also including plate lines, sometimes referred to as drive lines, connected to one electrode of the capacitor in each cell, and bit lines connected to the other electrode of the capacitor through the switch. In this disclosure, we shall refer to the "plate" line as a "drive" line, as is sometimes done in the art. In the Anderson patent cited above, the switch is a diode. As is known in the art, the switch can be a transistor having a gate, a source and a drain, and the memory includes word lines connected to the control gate of the transistor. See, for example, U.S. Pat. No. 4,873,664 issued Oct. 10, 1989 to S. Sheffield Eaton, Jr. The transistor acts as a switch controlled by its gate to connect the capacitor to the bit line. Information is written into a memory cell by placing either a high or a low voltage on the bit line, turning the transistor on to connect the bit line to the capacitor, and placing a predetermined voltage between the high and low voltage on the drive line. The high voltage causes the memory cell to assume one polarization state, and the low voltage causes the memory cell to assume the opposite polarization state. The
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memory cell is read by creating a voltage difference between the bit line and drive line, and connecting the bit line to the capacitor via the transistor. If the ferroelectric state changes due to the applied voltage, the bit line will assume a first voltage, and if the ferroelectric state does not switch, then the bit line will assume a second voltage. The bit line voltage is compared to a reference voltage that is about half-way between the first and second voltages; if the bit line voltage is below the reference voltage, a sense amp drives an output low, and if the bit line voltage is above the reference voltage, a sense amp drives an output high. In this way, the state of the ferroelectric capacitor prior to reading determines the output state when the cell is read. Up until recently, all ferroelectric materials tended to fatigue overtime, and the switching charge decreased to a point where the cell could no longer be read. About ten years ago, a class of materials, called layered superlattice compounds herein, had been discovered that do not fatigue. However, while the switching charge remains relatively stable in these materials, the materials still age, i.e., the magnitude of the first and second voltages generally depends on the history of the memory cell. For example, depending on the history, both the first and second voltages in one reading on a specific cell will differ by some voltage factor from the first and second voltages of a later reading of the same cell; or the hysteresis curve may drift overtime in the order of milliseconds due to redistribution of charge within the capacitor. Thus, while the reference voltage will be between the first and second voltages for one reading, in a later reading both the first and second voltages may be above the reference voltage. This generally results in a misreading of the memory cell. Thus, these memories are not "safe" in that the reading or sensing of the data is relatively unreliable. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
FINGER INSERTION TYPE WRITING DEVICE Inventor(s): Park, Jun-Hyoung; (Bucheon-si, KR) Correspondence: Jacobson Holman Pllc; 400 Seventh Street N.W.; Suite 600; Washington; DC; 20004; US Patent Application Number: 20030219301 Date filed: July 23, 2002 Abstract: Disclosed is a finger insertion type writing device that is capable of being used for writing something down in the state of being fixed by a user's index finger, while it is not held by the user's other fingers, whereby he or she can continue to write down for a relatively long period of time, with no fatigue and even in the case that he or she doesn't write it down, he or she can use his or her fingers freely to thereby carry out any work using his or her fingers. As shown in FIG. 1, the finger insertion type writing device includes a main body(10), a support part(20) coupled to the main body(10) and a finger insertion part(30), said main body(10) taking a hollow shape with symmetrical pattern wherein a writing means(11) is inserted into internal hollow, said support part(20) coupled to said main body(10) is formed with a symmetrically curved part supporting said writing device by contacting one side of inserted finger in the finger insertion part(30), said finger insertion part(30) taking a hollow shape with the front side and the rear side opened, said finger insertion part comprising a hollow part serving as a finger insertion cavity, a symmetrically incised part formed on the one side thereof, on opposite side part to said symmetrically incised part(32) coupled to said main body. Excerpt(s): The present invention relates to a finger insertion type writing device, and more particularly, to a finger insertion type writing device that is capable of being used
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for writing something down in the state of being fixed by a user's index finger, while it is not held by the user's other fingers, whereby he or she can continue to write it down for a relatively long period of time, with no fatigue and even in the case that he or she doesn't write it down, he or she can use his or her fingers freely to thereby carry out any work using his or her fingers. Writing devices are generally used for writing something down or drawing pictures, and examples of them are a pencil, a ball pen and a fountain pen, etc. Most of the writing devices are of a generally cylindrical shape and have to be supported by the thumb, index and long fingers for writing down. When the writing is carried out for a relatively long period of time with such conventional writing devices and according to its hand writing pattern, a user feels that his or her hand is very tired and especially, since a relatively strong force is applied on the side of the long finger during the writing, he or she can find out that his or her long finger is hardened on its side skin. In addition to the pattern of taking writing devices using the support of the three fingers, there are some other patterns of taking writing devices and it makes him or her having an undesirable writing habit. With the conventionally used writing devices, however, an undesirable writing habit may be caused in different forms. With conventionally used writing devices, moreover, no additional work using user's fingers can be carried out, while he or she writes something down. For example, in order to use the mouse or keyboard of a computer, after the user separates his or her fingers from the writing device, he or she should do an action for operating the mouse or keyboard. Then, he or she should hold the writing device by using his or her fingers for writing it down again. Unfortunately, this makes his or her work delayed. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Freight container and lift casting therefore and method for lifting and transporting same Inventor(s): Kelly, Thomas P.; (Colleyville, TX) Correspondence: James E. Walton; Hill & Hunn Llp; Suite 1440; 201 Main Street; Fort Worth; TX; 76102; US Patent Application Number: 20030198552 Date filed: May 29, 2003 Abstract: An improved freight container for use in intermodal freight transportation systems that includes lift castings having a top lift aperture located on the lift casting at an outboard position, such that when other containers are stacked on top of the improved container, loads are properly distributed through reinforcement beams of the improved container, thereby substantially reducing bending stresses in the improved container, substantially reducing the possibility fatigue failure of the improved container, and reducing the costs of maintenance and inspection of the improved container. Excerpt(s): The present invention relates generally large freight containers used in intermodal freight transportation systems, in which the freight containers are stacked upon each other and transported by truck, rail, ship, and combinations thereof. In particular, the present invention relates to a freight container having an improved lift casting that are compatible with existing lift mechanisms and existing freight containers. Large freight containers used in intermodal freight transportation systems are well known in the art. The intermodal freight transportation industry has always been very competitive. As with most competitive industries, any technological innovation that provides a competitive advantage is highly sought after. Thus, there is an ever-present
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need for faster, better, safer, and cheaper methods of transporting goods, both domestically and internationally. In an effort to achieve maximum strength at minimum weight, these large freight containers are typically made of steel frames and aluminum skins. Load-bearing steel reinforcement beams are integrated into the exterior of the container in the walls, ceiling, and floor at certain industry-recognized locations along the lengths of the containers. These reinforcement beams provide the necessary strength to allow the freight containers to be lifted and stacked on top of each other. The reinforcement beams are comprised of side posts integrated into the container walls, headers integrated into the container ceilings, and footers integrated into the container floors. The headers are connected to the side posts at "lift" castings. The footers are connected to the side posts at "stack" castings. Unfortunately, due to height restrictions and strength requirements, lift castings and stack castings must protrude into the interior of the container. This intrusion not only reduces the available storage volume of the container, but makes it difficult to load the container, as well. Operators must maneuver cargo around these intrusions to prevent damaging the cargo or the castings. This is costly both in the amount of cargo that can be shipped, and in the additional time required to load a container. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Hair dryer Inventor(s): Park, Su-Hong; (Inchon, KR) Correspondence: Park & Sutton Llp; 3255 Wilshire Blvd; Suite 1110; Los Angeles; CA; 90010; US Patent Application Number: 20030196344 Date filed: April 22, 2003 Abstract: Disclosed is the hair dryer. In the hair dryer, a hollow dryer housing has an inlet port, an outlet port and a front handle. An intake cover is coupled to a rear side of the dryer housing and has a rear handle protruding downwardly from the hollow dryer, for suctioning an outer air into the dryer housing. A nozzle is coupled to the outlet port of the dryer housing. A heating assembly is positioned in the dryer housing and in the intake cover, and includes a hollow assembly body, a support frame, a driving motor, a rotating shaft, and a blowing fan. A shielding member is installed along an inner side of the dryer housing, the intake cover, and the nozzle. Due to this structure, the hair dryer is capable of absorbing and shielding the magnetic wave not to cause human problems such as headache, dermatitis and chronic fatigue. Excerpt(s): The present invention relates to a hair dryer, more particularly, it relates to a hair dryer having a shielding function against magnetic wave, which is used for drying and styling hair. The hair dryer 100 further comprises a heating assembly 140 that is installed at the interior of the dryer housing 110 and the intake cover 120. The heating assembly 140 has an assembly body 142, a driving motor 144, and a blowing fan 148. A support frame 144 protrudes from the front side of the assembly body 142. The driving motor 146 is mounted on the interior of the assembly body 142, and a part of which is inserted into the support frame 144. A rotation shaft (not shown) projects out of the rear side of the driving motor 146. The blowing fan 148 is forcibly inserted into the rotation shaft (not shown) of the driving motor (146) so that the blowing fan 148 blows an outside air out of the inlet port 112 to the outlet port 114 by the rotation of the driving motor 146. Further, the hair dryer 100 includes an electrical cord 150, an electrical switch 152, and a heating wire 154. The electrical cord 150 supplies an electrical power to the
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driving motor 146. The electrical switch 152 is connected to the electrical cord 150, which controls the opening and closing of the electrical power. The heating wire 154 winds around the support frame 144 for heating a sucked air through the inlet port 112 of the dryer housing 110. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Information presentation controlling apparatus and method Inventor(s): Seto, Fumio; (Kanagawa, JP), Takahashi, Toshiaki; (Yokohama, JP), Yamamoto, Yasuhide; (Tokyo, JP) Correspondence: Mcdermott, Will & Emery; 600 13th Street, N.W.; Washington; DC; 20005-3096; US Patent Application Number: 20030182028 Date filed: February 14, 2003 Abstract: In information presentation controlling apparatus and method, a detecting section detects a running state of a mobile body and a running environment thereof, a mental fatigue calculating section calculates a mental fatigue that an operator of the mobile body (specifically, a vehicle driver) suffers due to an operation of the mobile body (an automotive vehicle) from a result of detection by the detecting section, a producing section produces the information to the operator of the mobile body, and an information presentation controlling section controls the information to be produced to the operator of the mobile body through the producing section in accordance with the mental fatigue calculated by the mental fatigue calculating section. Excerpt(s): The present invention relates to information presentation controlling apparatus and method for presenting various kinds of information so as to produce each of various kinds of information to an operator which operates a movable body (or mobile body such as an automotive vehicle). A Japanese Patent Application First Publication No. Heisei 7-277041 published on Oct. 24, 1996 exemplifies a previously proposed information presentation controlling apparatus which produces a vehicular run assistance information and a various kinds of information to a driver (the operator) that manipulates a vehicle in accordance with a vehicular running state and a vehicular running environment. In the previously proposed information presentation controlling apparatus, however, a control of the presentation of the information to be produced to the driver is not carried out, with a mental fatigue accumulated in the vehicle driver (or operator) in accordance with a change in the running environment taken into consideration. For example, the driver carries out the vehicular manipulation during a vehicular run on a freeway (or highway) from a departure point of location can easily recognize a plurality of information displayed through an information display image screen since the mental fatigue due to a vehicular manipulation number of times is not so high. However, the driver carries out many manipulations of the vehicle due to the vehicular run on national roadways from the departure point and the vehicle has passed through a plurality of traffic intersections and curved road so that the driver has accumulated a large amount of mental fatigues and requires more forces of concentrations to recognize the plurality of information displayed on the information producing display image. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Joined bodies, high pressure discharge lamps and assemblies therefor Inventor(s): Niimi, Norikazu; (Kasugai-city, JP) Correspondence: Oliff & Berridge, Plc; P.O. Box 19928; Alexandria; VA; 22320; US Patent Application Number: 20030209984 Date filed: May 2, 2003 Abstract: The present invention provides a joined body having a first member 7, a second member 4 and a joining material 14 interposed between the first and second members. The joining material has a porous bone structure 15 with open pores and made of a sintered product of metal powder and impregnated phase 10 impregnated into the open pores. The impregnated phase 10 includes an oxynitride glass. The joined body has improved resistance against fatigue and fracture, even when the body is subjected to thermal cycles between high and room temperatures and held at a high temperature over a long period of time. Excerpt(s): This application claims the benefits of Japanese Patent Applications P2002135672, filed on May 10, 2002, P2002-337387, filed on Nov. 21, 2002 and P2002-376017, filed on Dec. 26, 2002. the entireties of which are incorporated by reference. The present invention relates to a joined body, a high pressure discharge lamp and an assembly therefor. A high pressure discharge lamp has a ceramic discharge vessel with two end portions. Sealing members (usually referred to as a ceramic plug) are inserted, respectively, in the end portions to seal them. A through hole is formed in each sealing member. A metal member with an electrode system is inserted in the through hole. An ionizable light-emitting material is introduced and sealed in the inner space of the discharge vessel Known high pressure discharge lamps include high pressure sodium vapor and metal halide lamps, the latter exhibiting more superior color coordination. The lamp may be used in high temperature condition by forming the discharge vessel by a ceramic material. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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LEVEL ADJUSTER OF WATER SUPPLY OF WATER BOX Inventor(s): Huang, So-Mel; (Taichung, TW) Correspondence: So-mel Huang; 5f, NO. 141, TA KUANG. ST; Taichung; 408; TW Patent Application Number: 20030213053 Date filed: May 20, 2002 Abstract: A level adjuster of a water supply of a water box serves for adjusting the amount of water in a water box conveniently and easily. The level adjuster comprises a press, a supporting rod, an pressable button, a positioning seat, a pontoon, an inner water injecting tube and an outer water injecting tube of a water injector. The amount of water in the water box can be precisely controlled and the operation is easy without using any other auxiliary tool. No problem of element fatigue and change of water level occurs. Excerpt(s): The present invention relates to level adjusters, and particularly to a level adjuster of a water supply of a water box serves for adjusting the amount of water in a water box conveniently and easily. The amount of water in the water box can be precisely controlled and the operation is easy without any other auxiliary tool. No problem of element fatigue and change of water level. Stool has become a necessary
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device for the currently life, but generally, the water supplied to the stool is unadjustable and a large amount of water is supplied for each time the stool is used so that water is wasted. Tools are necessary for adjusting water supplied to the stool, however, this is inconvenient, and thus the user can not determine the water to flush a stool each time the stool is used. To achieve above objects, the present invention provides a level adjuster of a water supply of a water box comprising a press, a supporting rod, an pressable button, a positioning seat, a pontoon, an inner water injecting tube and an outer water injecting tube of a water injector. The user can press the pressable button to force the elastomer of the positioning seat to reduce backwards, and thereby, the positioning block will retract from the positioning groove of the supporting rod. Therefore, the user can adjust the level of the pontoon. After adjusting to a desire level, the pressable button is released. Then the elastomer of the positioning seat restores to drive the block to be buckled to the positioning groove of the supporting rod. After the level positioning operation is completed, and when it is stated to fill water into a water box, the pontoon will move to a predetermined height due to the buoyance of water, the pontoon will drive the press to press the water stop pin of the water supply. Thereby, by the present invention, the amount of water in the water box can be precisely controlled and the operation is easy without any other auxiliary tool. No problem of element fatigue and change of water level. The amount of water in the water box can be precisely controlled and the operation is easy without any other auxiliary tool. No problem of element fatigue and change of water level. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Metallic strain-absorbing layer for improved fatigue resistance of solder-attached devices Inventor(s): Tellkamp, John P.; (Denison, TX) Correspondence: Texas Instruments Incorporated; P O Box 655474, M/s 3999; Dallas; TX; 75265 Patent Application Number: 20030214037 Date filed: July 25, 2002 Abstract: An integrated circuit chip 501 has a plurality of contact pads (FIG. 5B) to be connected by reflow attachment 510 to outside parts. The chip comprises a deposited layer 505 of nickel/titanium alloy on each of the pads; the alloy has a composition and crystalline structure operable in reversible phase transitions under thermomechanical stress, whereby mechanical strain is absorbed by the alloy layer. Preferably, the alloy has between 55.0 and 56.0 weight % nickel, between 44.0 and 45.0 weight % titanium, and a thickness in the range from 0.3 to 6.0.mu.m, recrystallized after deposition in a temperature range from 450 to 600.degree. C. for a time period between 4 and 6 min. A layer 506 of solderable metal is on the alloy, operable as diffusion barrier after reflow attachment. Excerpt(s): The present invention is related in general to the field of semiconductor devices and processes and more specifically to the structure of metallurgical interconnection pads for flip-chip assembly of semiconductor devices. The structure of contact pad metallizations and solder bumps for connecting integrated circuit (IC) chips to semiconductor packages or outside parts, as well as the thermomechanical stresses and reliability risks involved, have been described in a series of detailed publications by the International Business Machines Corporation in 1969 (IBM J. Res. Develop., Vol. 13, pp. 226-296). During and after assembly of the IC chip to an outside part such as a
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substrate or circuit board by solder reflow, and then during device operation, significant temperature differences and temperature cycles appear between semiconductor chip and the substrate. The reliability of the solder joint is strongly influenced by the coefficients of thermal expansion of the semiconductor material and the substrate material. For example, there is more than one order of magnitude difference between the coefficients of thermal expansion of silicon and FR-4. This difference causes thermomechanical stresses, which the solder joints have to absorb. Detailed calculations, in the literature cited above and in other publications of the early 1980's, involving the optimum height and volume of the solder connection and the expected onset of fatigue and cracking proposed a number of solder design solutions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method and apparatus to pre-form two or more integrated connectorless cables in the flexible sections of rigid-flex printed circuit boards Inventor(s): Randall, Lee Curtis; (Tucson, AZ), Truman, Thomas Stanley; (Tucson, AZ), Winarski, Daniel James; (Tucson, AZ), Zamora, George G.; (Vail, AZ) Correspondence: Scully, Scott, Murphy & Presser; 400 Garden City Plaza; Garden City; NY; 11530; US Patent Application Number: 20030194913 Date filed: April 10, 2002 Abstract: A method for preforming of two or more flexible cables in an arrangement consisting of a combination of rigid printed circuit boards and flexible cable sections extending therebetween. Moreover, also provided is an apparatus for the preforming of two or more flexible cable sections of a combination of rigid printed circuit boards and therewith interposed flexible cable sections which are adapted to interconnect the rigid printed circuit boards. The apparatus consists of a tool constituted of an elongated cylindrical member having a tapered leading end which narrows into an ultra-thin flat end section of a blade-like configuration, and which is adapted to be pushed between the flexible cables and so as to preform the flexible cable sections and cause them to yield in a predetermined outwardly bowed permanently relationship between the rigid printed circuit boards at the opposite ends thereof to lengthen the fatigue life of the conductors in the flexible cable sections. Excerpt(s): The present invention relates to a method for preforming of two or more integrated connectorless flexible cables in flexible sections of a rigid-flex printed circuit board consisting of a combination of rigid printed circuit board sections and flexible printed circuit board sections extending therebetween. Moreover, the invention is also directed to an apparatus for the preforming of two or more integrated connectorless flexible cables in flexible sections of a rigid-flex printed circuit board consisting of a combination of rigid printed circuit board sections and therewith interposed flexible printed circuit board sections which are adapted to interconnect the rigid printed circuit board sections. In the electronic packaging industry, there are provided operatively joined wherein pluralities of rigid printed circuit board (PCB) sections which are essentially interconnected through the intermediary of flexible printed circuit board sections. In the case of numerous physical instances and applications, these combinations of rigid printed circuit board sections and flexible printed circuit board sections, referred to as rigid-flex printed circuit boards, are employed in order to solve three-dimensional space problems, reduce electrical noise by eliminating connectors and reducing the overall area of the printed circuit board. Basically, the flexible printed
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circuit board sections enable the therewith joined rigid printed circuit board sections to be folded and unfolded relative to each other through predetermined angular displacements, normally, although not necessarily angled, in 90.degree. segments, 180.degree. segments, or any arbitrary angle greater than 0.degree. up to 180.degree., in order to form a three-dimensional printed circuit board structure. Generally, in order to interconnect pluralities of printed circuit boards with each other, there are presently employed connectors and cables with connectors on each end, as is well known in the electronic packaging industry. However, the uses of such connectors are subject to limitations and disadvantages, in that these connectors add an expense to the printed circuit board structures, the connectors frequently cause electrical noise in the utilization of the electronic packages in which the printed circuit boards are installed, and moreover, such connectors represent points of failure in the overall packaging system. Consequently, it is highly desirable to provide a rigid-flex printed circuit board which combines rigid printed circuit board sections and flexible printed circuit board sections which extend therebetween in order to provide three-dimensional printed circuit board structures in which the presently employed connectors are eliminated, thereby substantially obviating or at least considerably ameliorating all of the foregoing limitations and drawbacks. Specifically, the rigid printed circuit board sections are for component and hardware placement. The flexible printed circuit board sections provide for three-dimensional forming, thereby eliminating the requirement for board-to-board connectors. The elimination of these unnecessary connectors frees up valuable surface area for hardware and component placement or reduces the size and cost of the rigidflex printed circuit board. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
METHOD OF FORMING AN APPARATUS TO REDUCE THERMAL FATIGUE STRESS ON FLIP CHIP SOLDER CONNECTIONS Inventor(s): Alcoe, David J.; (Vestal, NY), Johnson, Eric A.; (Greene, NY), Reiss, Matthew M.; (Endwell, NY), Woychik, Charles G.; (Vestal, NY) Correspondence: Salzman & Levy; Press Building - Suite 902; 19 Chenango Street; Binghamton; NY; 13901; US Patent Application Number: 20030210531 Date filed: April 9, 2003 Abstract: The present invention provides a package for a semiconductor chip that minimizes stresses and strains that arise from differential thermal expansion on chip-tosubstrate or chip-to-card interconnections. A collar element of one or more elements is provided. Adhesive material connects the collar element to the electric device and to the substrate that supports it, forming a unitary electrical package. Excerpt(s): This application is a divisional application of Serial No. 09/814,789, filed Mar. 22, 2001. The present invention relates to microelectronic packaging of semiconductor chips and, more specifically, to IC flip chip assemblies designed to reduce the structural damage to C4 interconnections due to thermal stress and the CTE mismatch of the chip and the packaging material. Advances in microelectronics technology tend to develop chips that occupy less physical space while performing more electronic functions. Conventionally, each chip is packaged for use in housings that protect the chip from its environment and provide input/output communication between the chip and external circuitry through sockets or solder connections to a circuit
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board or the like. Miniaturization results in generating more heat in less physical space, with less structure for transferring heat from the package. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Method of manufacturing flat wire coil springs to improve fatigue life and avoid blue brittleness Inventor(s): Bhagwat, Anand Waman; (Perrysburg, OH), Wray, Steven Shannon; (Findlay, OH) Correspondence: Howard M. Cohn; 21625 Chagrin BLVD. Suite 220; Cleveland; OH; 44122; US Patent Application Number: 20030172531 Date filed: November 25, 2002 Abstract: The present invention relates to a method of forming a coil of spring wire by winding a wire into a coil spring formed of a plurality of rings of the wire wherein each of the rings has a substantially constant strain rate. The forming speed of the wire being wound is controlled so that each of the rings has a substantially constant strain rate and minimum work hardening occurs. Excerpt(s): This application claims the benefit of U.S. Provisional Patent Application No. 60/363,970, filed Mar. 14, 2002 by Bhagwat and Wray. The present invention relates to the manufacture of wire coil springs and more particularly to the method of manufacture whereby dynamic strain aging of wire coil springs is reduced to provide improved fatigue life. Dynamic strain aging (rate of work hardening) of steel wire occurs when the impurity atoms and dislocations interact during wire deformation. The dynamic strain aging for a coil spring of steel wire includes two aspects. One aspect is that the coil spring is dynamically strained and the other aspect is that the coil spring is aged. Depending on the combination of operating conditions, dynamic strain aging can occur during the coiling process. The specified temperature range in which the dynamic strain aging occurs depends on the strain rate, i.e. corresponding to the speed that the wire is pulled into the coil spring machine where the coil is formed. Increasing the strain rate, i.e. by winding the steel wire into a coil at a faster rate, typically raises both the lower and upper temperature limits associated with the dynamic strain-aging phenomenon. For example, at a strain rate of about 560 meters/minute (m/min), dynamic strain aging in the coil occurs by heating the coil to a stress relieving temperature in the range from between about 450.degree. Centigrade (C.) to about 700.degree. C. However, at a strain-rate of about 10 m/min to about 50 m/min, dynamic strain aging in the coil occurs by heating the coil to a much lower temperature range from between about 260.degree. C. to about 300.degree. C. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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METHOD OF MANUFACTURING RIVETS HAVING HIGH STRENGTH AND FORMABILITY Inventor(s): Litwinski, Edward; (Mission Viejo, CA), Toosky, Rahmatollah F.; (San Clemente, CA) Correspondence: Alston & Bird Llp; Bank OF America Plaza; 101 South Tryon Street, Suite 4000; Charlotte; NC; 28280-4000 Patent Application Number: 20030218053 Date filed: May 14, 2002 Abstract: A rivet having improved formability is provided. The rivet has a shank having a head at one end. The shank and the head have a refined grain structure. The rivet is manufactured from the region of the workpiece having a refined grain structure by first forming a region having a refined grain structure in a workpiece and then forming the rivet. The refined grain structure results in improved mechanical properties, such as formability, strength, toughness, ductility, corrosion resistance, and fatigue resistance. The improved formability of the rivet reduces the formation and propagation of cracks during the manufacture and installation of the rivets. Excerpt(s): FIELD OF THE INVENTION The present invention relates to rivets and, more particularly, relates to a method of manufacturing rivets having high strength and formability. BACKGROUND OF THE INVENTION Structural assemblies are commonly formed by joining two or more structural members using fasteners, such as rivets. In the aerospace industry, where weight and strength are of critical concern, the joints of structural assemblies typically are subjected to repeated cycles of shear, compressive, and tensile stresses over the life of the assembly. As a result, the rivets must have good mechanical strength and fatigue resistance without adversely affecting the overall weight of the structural assemblies. In addition, because the structural assemblies may be exposed to the ambient environment, including moisture exposure and temperature fluctuations, the joints must be secured with rivets having good corrosion resistance and resistance to thermal stresses. To address the strength and weight requirements, conventional rivets are typically formed of materials having high strength-to-weight ratios, such as aluminum and aluminum alloys that have been hardened by cold working or precipitation hardening. Advantageously, a number of high strength aluminum alloys are available that are lightweight, and also have relatively high fatigue and corrosion resistance. Unfortunately, when in the hardened condition, high strength aluminum alloys tend to lack the formability that is necessary during manufacture and installation of the rivets, which can result in failure by necking, cracking or tearing. In seeking to solve the problems associated with poor formability, modifications to the manufacturing process for forming the rivets have been proposed. One such modification includes forming the rivets from an aluminum alloy that is in a soft condition and, thereafter, heat treating the rivet, such as by precipitation hardening, to thereby harden the rivet prior to installation and use. The increase in formability of aluminum alloys in a soft condition reduces the likelihood that the rivet will fail as a result of necking, cracking, or tearing during manufacture. However, heat treating reduces the formability of the rivets which, as noted above, can result in failure during installation. Heat treating also adds an additional step during manufacture, which increases the manufacturing costs of the rivets and resulting structural assemblies. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Methods for treating or inhibiting neurotoxin-mediated syndromes Inventor(s): Hudnell, H. Kenneth; (Pocomoke, MD), Shoemaker, Ritchie; (Pocomoke, MD) Correspondence: Mcdonnell Boehnen Hulbert & Berghoff; 300 South Wacker Drive; Suite 3200; Chicago; IL; 60606; US Patent Application Number: 20030219400 Date filed: February 10, 2003 Abstract: The present invention discloses methods of treating or inhibiting one or more of sick building syndrome (SBS), post-Lyme Disease Syndrome (PLDS), and chronic fatigue syndrome (CFS) by administering to a patient in need thereof an amount effective of cholestyramine and/or.alpha.-melanocyte stimulating hormone to treat or inhibit one or more of these syndromes. Excerpt(s): This application claims priority to U.S. provisional application serial No. 60/356,443, filed Feb. 13, 2002, and U.S. provisional application serial No. 60/356,539, filed Feb. 13, 2002. The present invention relates to the field of medicine, chronic illnesses, and pharmaceuticals. Human illness associated with neurotoxin-forming environmental microbial organisms has been reported. For instance, the human illness designated as possible estuarine-associated syndrome (PEAS) has been linked to exposure to estuaries inhabited by toxin-forming dinoflagellate. Humans may be exposed through direct contact with estuarine water or by inhalation of aerosolized or volatilized toxin(s) (Shoemaker, R C, (1997) Md Med J. 46:521; Shoemaker, R C et al. Environ Health Perspect (2001) 109:539) The acute and chronic symptoms associated with the disease include cough, secretory diarrhea, headache, fatigue, memory impairment, rash, difficulty in concentrating, light sensitivity, burning skin upon water contact, muscle ache, upper airway obstruction, shortness of breath, confusion, red or tearing eyes, weakness and vertigo. In the absence of a serological test, and the identification of a specific dinoflagellate neurotoxin, the diagnosis of PEAS and the link to neurotoxin relies on a neurotoxicological test, visual contrast sensitivity (VCS). A toxin-trapping agent, cholestyramine (CSM), has been used in patients diagnosed with PEAS that have a deficit in VCS (Shoemaker, R C et al. Environ Health Perspect (2001) 109:539). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Miniaturized contact spring Inventor(s): Chen, Yi-Hsing; (San Jose, CA), Chieh, Erh-Kong; (Cupertino, CA), Chong, Fu Chiung; (Saratoga, CA), Doan, David Thanh; (San Jose, CA), Haemer, Joseph M.; (San Jose, CA), Lahiri, Syamal Kumar; (Milpitas, CA), Lin, Chang-Ming; (San Jose, CA), Milter, Roman L.; (San Francisco, CA), Mok, Sammy; (Cupertino, CA), Swiatowiec, Frank; (San Jose, CA) Correspondence: Glenn Patent Group; 3475 Edison Way, Suite L; Menlo Park; CA; 94025; US Patent Application Number: 20030214045 Date filed: March 17, 2003 Abstract: This invention provides a solution to increase the yield strength and fatigue strength of miniaturized springs, which can be fabricated in arrays with ultra-small
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pitches. It also discloses a solution to minimize adhesion of the contact pad materials to the spring tips upon repeated contacts without affecting the reliability of the miniaturized springs. In addition, the invention also presents a method to fabricate the springs that allow passage of relatively higher current without significantly degrading their lifetime. Excerpt(s): This invention relates generally to the highly miniaturized springs. More particularly, this invention relates to a family of miniaturized contact springs and a family of methods for increasing the yield strength and fatigue strength of these springs. Methods of fabricating shorter springs using photo lithographically processes to add thicker metal coatings have been defined in the patent literature. One method is described in application WO 01/48870. This method uses electroplated photo resist to allow metal to be plated on the top of a free standing spring. However, at the dimensions needed to probe ICs with pad pitches below 150.mu.m the freestanding springs have insufficient strength to hold backside photo resist without significantly reducing the probe height required for compliance. Any non-uniformity in the photo process also translates to non-uniform spring heights that cannot meet the uniformity requirements necessary to stay on the IC pads while testing. The method described in application (WO 01/48870)) also has an additional problem in controlling lift height after plating. One of the purposes of having a freestanding spring is to provide a framework or structure to support the thicker plated metal. If one plates a spring on only one side, the spring curves to a different lift height based on the stress in the plated film. If the film is tensile it curves up and if it is compressive it pushes it down. Both of these stress conditions are difficult to control for the tolerances and spring lift uniformity needed to test ICs. In addition, compressive springs are stronger than tensile springs and the spring with a compressive plated film loses lift height to the point that there is not enough compliance for it to still be a useful probe. There is also a limit to how high a freestanding spring can be lifted prior to plating to compensate for this compression effect. The probe needs to make contact to the IC electrical pad at an angle less than 90 degrees. Increasing the lift height tends to cause the spring to wrap around itself creating a 360 degree circle to the substrate. As a result, the process taught by this patent application does not meet the requirements for controlling uniformity of the lift height of arrays of springs required for IC testing. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Motorized wheelbarrow with handle elevating feature Inventor(s): Hart, Richard D.; (Grass Valley, CA) Correspondence: John P. Costello; Weintraub Genshlea Chediak Sproul; 11th Floor; 400 Capitol Mall; Sacramento; CA; 95814; US Patent Application Number: 20030178801 Date filed: February 11, 2003 Abstract: An inventive wheelbarrow incorporating two inline wheels, front and rear, for supporting the weight of the wheelbarrow and any load placed thereon, is disclosed. The two inline wheels are preferably identical and can be interchanged between front and rear and can be fitted with a sprocket, or drive pulley, which, in turn, communicates with a motor through a drive belt or chain. The motor can be fuel or electric and can include a power-take-off (PTO) option for powering a number of exterior appliances such as a power generator or a water pump. The inventive wheelbarrow also includes a handle elevating feature which allows the handles to be raised or lowered, depending
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on operator preferences. By raising the handles, the load is supported on the inline wheels and not on the shoulders and arms of the operator. With the weight supported on the inline wheels, the operator's main function is to balance the load as the wheelbarrow travels forward. The inventive wheelbarrow results in a significant reduction in user fatigue and the carrying of heavy loads for several miles, by a single operator, is possible. Excerpt(s): This utility patent application claims the benefit of U.S. provisional serial No. 60/357,521 filed on Feb. 12, 2002. This invention relates to wheelbarrow devices generally, and more specifically, to motorized wheelbarrows. Wheelbarrows have been in use for many years and allow an operator a simple way to easily move a variety of weighty cargoes. The basic wheelbarrow is comprised of a frame coupled to a cargo bucket, a supporting wheel or wheels, support legs and a pair of handles for lifting and pushing the wheelbarrow forward. To overcome the inherent limits in human endurance, motors have been added to wheelbarrows to further increase their capabilities and usefulness. Examples of motorized wheelbarrow inventions can be seen in U.S. Pat. No. 5,878,827 (Fox), U.S. Pat. No. 5,489,000 (Hillbohm), U.S. Pat. No. 5,465,801 (Hoover), U.S. Pat. No. 4,811,988 (Immel), U.S. Pat. No. 4,589,508 (Hoover et al.), Des. No. 357,101 (Uyehara et al.) and in U.S. patent application Pub. No. 2002/0084119 (Brabetz et al.). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Mowing machines with ergonomic hand control levers Inventor(s): Bauer, Brian E.; (Holly Springs, NC), Korthals, Douglas D.; (Crestwood, KY), West, Ellis R.; (Dunn, NC) Correspondence: Bell, Boyd & Lloyd Llc; P.O. Box 1135; Chicago; IL; 60690-1135; US Patent Application Number: 20030213219 Date filed: May 15, 2002 Abstract: The present invention relates to hand control levers with ergonomic grip members. Such hand control levers are used on vehicles, preferably lever-operated mowing machines. The hand control levers can reduce anatomical stress, fatigue or discomfort experienced by users of such vehicles. Excerpt(s): The present invention generally relates to mowing machines. More specifically, the present invention relates to mowing machines which include ergonomic hand control levers which can reduce or eliminate certain anatomical stress associated with the operation of such mowing machines. Self-propelled mowing machines are well known. Certain self-propelled mowing machines include two hand control levers, each of which is separately associated with a drive wheel. By manipulating the hand control levers, a user can control the speed and direction of the mowing machine. Typically, when the user pushes or pulls the hand control levers 10 forward or backward, at some point the user moves his/her elbows apart from his/her body. When the elbow is obviated from the body, the wrists 14 and hands 20 become radially deviated. In other words, the wrists 14 and hands 20 are rotated counterclockwise in a plane horizontal to the driving surface. This radial deviation can form: (a) a wrist angle 22 between the force line 16 and the forearm axis 24; and (b) a wrist angle 22 between the force line 18 and the forearm axis 26. Pushing and pulling the hand control levers 10 at this wrist angle can create anatomical stress in the user's wrists 14, hands, arms and other parts of the body. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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SYNERGISTIC COMPOSITION OF BIOACTIVE FRACTION ISOLATED BARLERIA PRIONITIS LINN AND A METHOD OF TREATMENT FOR HEPATOTOXICITY, IMMUNO-DEFICIENCY AND FATIGUE AND A PROCESS THEREOF Inventor(s): Anand, A.S.; (Jammu, IN), Banerjee, S.K.; (Jammu, IN), Chandan, Bal Krishan; (Jammu, IN), Handa, Sukhdev Swami; (Jammu, IN), Jaggi, Bupinder Singh; (Jammu, IN), Prabhakar, Anil; (Jammu, IN), Saxena, A.K.; (Jammu, IN), Suri, J.L.; (Jammu, IN), Taneja, Subhash Chandra; (Jammu, IN) Correspondence: Foley And Lardner; Suite 500; 3000 K Street NW; Washington; DC; 20007; US Patent Application Number: 20030181397 Date filed: March 19, 2002 Abstract: The present invention provides a synergistic composition of bioactive fraction essentially constituting iridoid glucosides, acetyl barlerin and shanzhiside methyl ester isolated from a plant source Barleria prionitis linn along with a process for the isolation of the bioactive fraction, the present invention also relates to a method of treating mammals and humans for hepatotoxicity, stress and immuno-deficiency with the synergistic bioactive composition. Excerpt(s): The present invention relates to a synergistic composition of bioactive constituent essentially constituting iridoid glucosides, acetyl barlerin and shanzhiside methyl ester isolated from a plant source Barleria prionitis linn along with a process for the isolation of the bioactive fraction. The present invention also relates to a method of treating mammals and humans for hepatotoxicity, stress and immuno-deficiency with the synergistic bioactive composition. Barleria prionitis Linn. (Famly: Acanthaceae) is a well-known plant used in the indigenous system of medicine in India. Almost all its parts are used as medicine. The leaves are diuretic and are used in urinary infections and for the treatment of paralytic stroke, rheumatic pains and stomach disorders. The plant has antiseptic properties and its decoction is used as a wash in dropsy. The roots are used for toothache and for inflammatory disorders. The bark is given in whooping cough and as an expectorant [L. V. Asolkar et al; Glossary of Indian Medicinal Plants (second supplement), Council for Scientific and Industrial Research (CSIR), New Delhi, 1992, p. 115; Wealth of India: Raw Materials, CSIR, New Delhi, 1988, Vol. II B, p. 47]. The first report on chemical investigation of this plant appeared in 1970 when Moitra et al. reported the presence of.beta.-sitosterol [Moitra, S. K. et al. (Bull. Calcutta Sch. Trop. Med; 1970, 18,7]. Harborne et al. reported the isolation of scutellarein-7-rhamnosyl glucoside from fresh flowers [Harborne, J. B. et al; phytochemistry, 1971, 10, 2822]. The structure of this compound is later modified as 5,6,4'-trihydroxy-7-0neohesperidosylflavone [Nair, A. G. Ramchandran et al., Ind. J. Chem. 1982, 21 B, 1135]. The leaves and stems showed the presence of five iridoid glucosides. Four of them, acetylbarlerin (6,8-di-O-acetyl shanzhiside methyl ester), barlerin (8-O-acetyl shanzhiside methyl ester), shanzhiside methyl ester and 6-0-acetyl shanzhiside methyl ester have been characterized [Taneja, S. C. and Tiwari, H. P. Tetrahedron Lett, 1975, 1995; Damtoft, S. et al., ibid, 1982, 23, 4155; Emary, N. A. et al. Bull Pharm. Sci. Assuit Univ. 1990, 13 (1), 65-72]. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Treatment methods using homeopathic preparations of growth factors Inventor(s): Brewitt, Barbara A.; (Seattle, WA) Correspondence: Speckman Law Group; 1501 Western Ave; Suite 100; Seattle; WA; 98101; US Patent Application Number: 20030191061 Date filed: November 26, 2002 Abstract: The present invention comprises homeopathic preparations of growth factors, cyclins, and methods for their use. Disorders which may be effectively treated with the compositions of the present invention include chronic viral disorders, such as HIV, AIDS, chronic fatigue syndrome and Epstein-Barr viral infections, cancer, diabetes, depression, and autism. Homeopathic preparations of growth factors and/or cyclins are preferably administered orally. In an alternative embodiment, patients are treated with radio frequency signals corresponding to homeopathic dilutions of growth factors. Excerpt(s): This application is a continuation-in-part of prior U.S. patent application Ser. No. 09/499,230, filed Sep. 7, 2000, issuing on Nov. 26, 2002 as U.S. Pat. No. 6,485,480, which is a divisional application of U.S. patent application Ser. No. 08/855,096, filed May 13, 1997, issued Feb. 15, 2000 as U.S. Pat. No. 6,024,734, which is a continuation-inpart of U.S. patent application Ser. No. 08/710,040, filed Sep. 10, 1996, issued May 13, 1997 as U.S. Pat. No. 5,629,286, which is a continuation of U.S. patent application Ser. No. 08/488,722, filed Jun. 8, 1995, now abandoned, which is a continuation-in-part of U.S. patent application Ser. No. 08/221,365 filed Mar. 31, 1994, now abandoned. This application is also a continuation-in-part of prior U.S. patent application Ser. No. 10/001,367, filed Oct. 30, 2001, which is a continuation-in-part of U.S. patent application Ser. No. 09/870,132, filed May 29, 2001, which is a continuation of U.S. patent application Ser. No. 09/251,820, filed Feb. 17, 1999, issued May 29, 2001 as U.S. Pat. No. 6,239,105, which is a continuation-in-part of U.S. patent application Ser. No. 08/855,096 filed May 13, 1997, issued Feb. 15, 2000 as U.S. Pat. No. 6,024,734, which is a continuation-in-part of prior U.S. patent application Ser. No. 08/710,040, filed Sep. 10, 1996, issued May 13, 1997 as U.S. Pat. No. 5,629,286, which is a continuation of U.S. patent application Ser. No. 08/488,722, filed Jun. 8, 1995, now abandoned, which is a continuation-in-part of U.S. patent application Ser. No. 08/221,365 filed Mar. 31, 1994, now abandoned. Each of these applications and U.S. patents is incorporated herein by reference in its entirety. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Treatment of fibromyalgia and chronic fatigue syndrome Inventor(s): Marshall, Robert Clyde; (Mattawan, MI), McCall, Robert B.; (Kalamazoo, MI) Correspondence: Austin W Zhang; Pharmacia & Upjohn Company; Global Intellectual Property; 301 Henrietta Street; Kalamazoo; MI; 49001; US Patent Application Number: 20030212085 Date filed: October 18, 2002 Abstract: The present invention relates to the treatment of neuromuscular disorders and, more specifically, to the use of apomorphine, bromocriptine, pergolide, ropinirole, octahydropyrazolo[3,4-g]quinolines, and trans-(.+-.)-substituted-5,5a,6,7,8,9-,9a,10-
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octahydropyrimido[4,5g]quino- lines, and their pharmaceutically acceptable salts to treat, or to prepare a medicament for treating, symptoms of fibromyalgia syndrome and chronic fatigue syndrome. Excerpt(s): The present invention relates to the treatment of neuromuscular disorders and, more specifically, to the use of apomorphine, bromocriptine, pergolide, ropinirole, octahydropyrazolo[3,4-g]quinolines, and trans-(.+-.)-substituted-5,5a,6,7,8,9-,9a, 10octahydropyrimido[4,5-g- ]quinolines, and their pharmaceutically acceptable salts to treat, or to prepare a medicament for treating, symptoms of fibromyalgia syndrome and chronic fatigue syndrome. Chronic fatigue syndrome (CFS), also referred to as chronic fatigue immune disorders, chronic fatigue immune disorders syndrome, yuppie flu, fatigue-chronic, and chronic fatigue and immune dysfunction syndrome, is a clinically defined condition characterized by profound tiredness or fatigue. In addition, patients with CFS generally report various nonspecific symptoms, including weakness, muscle aches and pains, excessive sleep, malaise, fever, sore throat, tender lymph nodes, impaired memory and/or mental concentration, insomnia, and depression. The exact cause of CFS is unknown and, to date, there are no specific tests to confirm the diagnosis of CFS, though a variety of tests are usually done to exclude other possible causes of the symptoms. Fibromyalgia syndrome (FMS), also referred to as fibromyalgia, fibromyositis, fibrositis, or myofasica pain syndrome, is a rheumatic condition generally characterized by widespread pain in fibrous tissues, muscles, tendons, and other connective tissues, fatigue, headaches, lack of restorative sleep, and numbness. Thus, FMS shares many clinical features with CFS. Similar to CFS, there are no specific diagnostic tests for FMS. Because of the similarity in clinical features between CFS and FMS, CFS and FMS are often treated similarly. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
Keeping Current In order to stay informed about patents and patent applications dealing with fatigue, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “fatigue” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on fatigue. You can also use this procedure to view pending patent applications concerning fatigue. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.
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CHAPTER 7. BOOKS ON FATIGUE Overview This chapter provides bibliographic book references relating to fatigue. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on fatigue include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “fatigue” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on fatigue: •
50 Things You Should Know About the Chronic Fatigue Syndrome Epidemic Contact: TNM, Incorporated, PO Box 1475, New York, NY, 10008, (212) 627-2120. Summary: The author of this book discusses Chronic Fatigue Syndrome (CFS), which he views as an AIDS-like illness that is of epidemic, and even pandemic, proportions. CFS is an illness of immune dysfunction that is contagious and has been overlooked by health authorities, says the author. He discusses symptoms that can develop in CFS, including blindness, skin problems, brain lesions, and loss of fingerprints. He says that CFS shares many characteristics with AIDS, such as immune dysfunction, nervous system problems, and high antibodies against cytomegalovirus (CMV), Epstein-Barr Virus, and Human Herpes Virus 6 (HHV-6). The author urges people to write their Congressional representatives to voice their concerns about this growing public health problem.
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Chronic Fatigue and Related Immune Deficiency Syndromes Contact: American Psychiatric Press, Inc., 1400 K St NW, Washington, DC, 20005, (800) 368-5777. Summary: This book presents a synthesis of the research into disorders of chronic fatigue. The contributing authors examine the relationship between chronic fatigue and immune deficiency syndromes and major biological depression. This includes a discussion of their cause, psychopathology, neuroendocrinology, neurochemistry, and treatment. The papers consider the immunological correlates, viral etiology, neuroendocrine research, and psychological and cognitive aspects of chronic fatigue syndrome. The chapters on treatment review current treatment approaches and set the scene for future developments in antivirals and antidepressants.
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Essential Arthritis Cookbook: Kitchen Basics for People with Arthritis, Fibromyalgia and Other Chronic Pain and Fatigue Source: Mankato, MN: Appletree Press, Inc. 1995. 286 p. Contact: Available from Appletree Press, Inc. 151 Good Counsel Drive, Suite 125, Mankato, MN 56001. (800) 322-5679 or (507) 345-4848. Fax (507) 345-3002. PRICE: $24.95 plus shipping and handling. ISBN 0962047163. Summary: This cookbook for people with arthritis, fibromyalgia, and other chronic pain and fatigue explains how nutrition affects arthritis and other musculoskeletal diseases and uses this information to provide guidelines and recipes for good health. Chapters cover topics such as the relationship between diet and arthritis; the impact of diet on the reduction of pain, swelling, and stiffness; and the effect of various arthritis medications on vitamin and mineral levels in the body. Other chapters offer suggestions for developing an energy-saving plan, making cooking more relaxing, protecting joints from damaging forces, selecting appropriate tools, and planning meals. In addition, the book provides more than 120 recipes in the categories of appetizers, soups, salads, main dishes, vegetables, side dishes, breads, and desserts. The recipes are easy to prepare and require few ingredients and minimal cleanup. Appendixes offer suggestions for making eating easier for people whose illness or condition has made eating difficult, and provide advice for using convenience foods. 14 figures. 25 tables. 7 references.
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America's Biggest Cover - Up: 50 More Things Everyone Should Know About the Chronic Fatigue Syndrome Epidemic and Its Link to AIDS Contact: TNM, Incorporated, PO Box 1475, New York, NY, 10008, (212) 627-2120. Summary: This monograph explores similarities between Chronic Fatigue Syndrome (CFS) and AIDS, concluding that they are part of the same epidemic. The author, a reporter who has investigated CFS, hypothesizes that both illnesses are probably caused by Human Herpes Virus-6 (HHV-6). She charges that AIDS researchers have made a major error in calling HIV the cause of AIDS, indicating there are now many cases of AIDS without HIV. She argues that throat lesions found in CFS patients are related to Kaposi's sarcoma, and warns that those with CFS are at high risk for cancer and tuberculosis due to loss of immunity caused by HHV-6. The book reports that Federal Government officials and researchers are covering up the fact that they made a mistake in informing the public about HIV and AIDS, and are doing nothing to prevent HHV-6 from being spread in the nation's blood supply.
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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 “fatigue” at online booksellers’ Web sites, you may discover nonmedical books that use the generic term “fatigue” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “fatigue” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
A Clinician's Guide to Controversial Illnesses: Chronic Fatigue Syndrome, Fibromyalgia, and Multiple Chemical Sensitivities by Renee R. Taylor, et al (2001); ISBN: 156887068X; http://www.amazon.com/exec/obidos/ASIN/156887068X/icongroupinterna
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A Meditaiton to Help With Fibromyalgia & Chronic Fatigue by Belleruth Naparstek (2002); ISBN: 1881405575; http://www.amazon.com/exec/obidos/ASIN/1881405575/icongroupinterna
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A Parent's Guide to Cfids: How to Be an Advocate for Your Child With Chronic Fatigue Immune Dysfunction by David S. Bell, et al (1999); ISBN: 0789007118; http://www.amazon.com/exec/obidos/ASIN/0789007118/icongroupinterna
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Adolescence and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Journeys with the Dragon by Naida Edgar Brotherston (2001); ISBN: 0789008742; http://www.amazon.com/exec/obidos/ASIN/0789008742/icongroupinterna
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Adrenal Fatigue, a Desk Reference by Dr Salmaan Dalvi (2003); ISBN: 0755200934; http://www.amazon.com/exec/obidos/ASIN/0755200934/icongroupinterna
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Advances in Fatigue Crack Closure Measurement and Analysis: Second Volume (Astm Special Publication, 1343.) by Symposium on Advances in Fatigue Crack Closure Measurement and Analysi, et al (1999); ISBN: 0803126115; http://www.amazon.com/exec/obidos/ASIN/0803126115/icongroupinterna
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Alternative Medicine Guide to Chronic Fatigue, Fibromyalgia and Environmental Illness by Burton Goldberg, Editors of Alternative Medicine Digest (1998); ISBN: 1887299114; http://www.amazon.com/exec/obidos/ASIN/1887299114/icongroupinterna
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Atlas of Stress Corrosion and Corrosion Fatigue Curves by A.J. McEvily (Editor), ASM (2000); ISBN: 0871703742; http://www.amazon.com/exec/obidos/ASIN/0871703742/icongroupinterna
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Beat Fatigue With Yoga: The Simple Step-By-Step Way to Restore Energy by Fiona Agombar (2002); ISBN: 0007133022; http://www.amazon.com/exec/obidos/ASIN/0007133022/icongroupinterna
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Biaxial/Multiaxial Fatigue and Fracture (Elsevier Intl Series on Structural Integrity) by Andrea Carpinteri (Editor), et al (2003); ISBN: 0080441297; http://www.amazon.com/exec/obidos/ASIN/0080441297/icongroupinterna
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Chronic Fatigue Syndrome (Diseases and Disorders) by Liesa Abrams (2003); ISBN: 1590180399; http://www.amazon.com/exec/obidos/ASIN/1590180399/icongroupinterna
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Chronic Fatigue Syndrome and the Body's Immune Defense System by Roberto, Md, PhD Patarca-Montero (2002); ISBN: 0789015307; http://www.amazon.com/exec/obidos/ASIN/0789015307/icongroupinterna
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Chronic Fatigue Syndrome, Genes, and Infection: The Eta-1/Op Paradigm by Roberto Patarca-Montero (2003); ISBN: 0789017938; http://www.amazon.com/exec/obidos/ASIN/0789017938/icongroupinterna
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Chronic Fatigue Syndrome: A Patient-Centered Approach by Murdoch, Denz-Penhey (2002); ISBN: 1857759079; http://www.amazon.com/exec/obidos/ASIN/1857759079/icongroupinterna
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Chronic Fatigue Syndrome: A Special Issues of Applied Neuropsychology by John Deluca (Editor) (2001); ISBN: 0805897135; http://www.amazon.com/exec/obidos/ASIN/0805897135/icongroupinterna
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Chronic Fatigue Syndrome: Critical Reviews and Clinical Advances by K. De Meirleir (Editor), et al (2000); ISBN: 0789009986; http://www.amazon.com/exec/obidos/ASIN/0789009986/icongroupinterna
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Chronic Fatigue Syndrome: Living With the Unknown by Brian E. Voncannon (2002); ISBN: 0595241824; http://www.amazon.com/exec/obidos/ASIN/0595241824/icongroupinterna
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Chronic Fatigue Syndrome: Overview Abstracts and Bibliography by Karl Bondi (Editor) (2003); ISBN: 1590335740; http://www.amazon.com/exec/obidos/ASIN/1590335740/icongroupinterna
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Chronic Fatigue Syndrome: There Is a Cure by Patricia J. Taylor (2002); ISBN: 159113191X; http://www.amazon.com/exec/obidos/ASIN/159113191X/icongroupinterna
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Chronic Fatigue Unmasked 2000: This Pioneering Classic Has Been Completely Revised to Encompass the Latest Successful Therapies and Concepts of What Dr. Poesnecker Originally called by Gerald E. Poesnecker (1999); ISBN: 0916285618; http://www.amazon.com/exec/obidos/ASIN/0916285618/icongroupinterna
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Chronic Fatigue, Fibromyalgia, and Lyme Disease by Burton Goldberg, Larry, Jr. Trivieri (2003); ISBN: 1587611910; http://www.amazon.com/exec/obidos/ASIN/1587611910/icongroupinterna
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Clinical Neurophysiology of Disorders of Muscle and Neuromuscular Junction, Including Fatigue (Handbook of Clinical Neurophysiology (Amsterdam, Netherlands), V. 2.) by Erik Stalberg (Editor) (2003); ISBN: 0444508678; http://www.amazon.com/exec/obidos/ASIN/0444508678/icongroupinterna
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Compassion Fatigue [DOWNLOAD: MICROSOFT READER] by Susan D. Moeller (1999); ISBN: B0000E691I; http://www.amazon.com/exec/obidos/ASIN/B0000E691I/icongroupinterna
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Component Reliability Under Creep-Fatigue Conditions (Cism International Centre for Mechanical Sciences , No 389) by Janos Ginsztler (Editor), R. Peter Skelton (Editor) (1998); ISBN: 3211829148; http://www.amazon.com/exec/obidos/ASIN/3211829148/icongroupinterna
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Conquering Chronic Fatigue: Answers to America's Most Misunderstood Epidemic by Jonathan Forester (2003); ISBN: 0830732578; http://www.amazon.com/exec/obidos/ASIN/0830732578/icongroupinterna
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Coping With Chronic Fatigue by Trudie Chalder (2003); ISBN: 0859696855; http://www.amazon.com/exec/obidos/ASIN/0859696855/icongroupinterna
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Coping With Fatigue by Claude R. Maranda (2001); ISBN: 1891929526; http://www.amazon.com/exec/obidos/ASIN/1891929526/icongroupinterna
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Dazed and Fatigued in the Toxic 21st Century by Mark Llewellyn Hall (1998); ISBN: 0965653528; http://www.amazon.com/exec/obidos/ASIN/0965653528/icongroupinterna
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Depression-Free, Naturally: 7 Weeks to Eliminating Anxiety, Despair, Fatigue, and Anger from Your Life by Joan Mathews-Larson, Joan Mathews Larson (2001); ISBN: 0345435176; http://www.amazon.com/exec/obidos/ASIN/0345435176/icongroupinterna
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Disability and Chronic Fatigue Syndrome: Clinical, Legal and Patient Perspectives by Nancy G. Klimas (Introduction), Roberto Patarca (Editor) (1998); ISBN: 0789005018; http://www.amazon.com/exec/obidos/ASIN/0789005018/icongroupinterna
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Energize Your Life: Overcoming Fatigue and Stress by Dwight L. Carlson (2003); ISBN: 1857928644; http://www.amazon.com/exec/obidos/ASIN/1857928644/icongroupinterna
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Energy For Life: How to Overcome Chronic Fatigue by George, Dr., Ph., N.D Redman, George L., PH.D. Redmon (2000); ISBN: 1890612146; http://www.amazon.com/exec/obidos/ASIN/1890612146/icongroupinterna
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Engineering Against Fatigue: Proceedings of an International Conference, Sheffield, Uk, 17-21 March 1997 by R.A. Smith (Editor), et al (1999); ISBN: 9054109696; http://www.amazon.com/exec/obidos/ASIN/9054109696/icongroupinterna
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Fatigue and Cancer/Fatigue Und Krebs: 2. Internationales Symposium, Koln, Februar 2001: Abstracts (Supplement Issue: Onkologie 2001) by H. Flechtner (Editor), J.-U. Ruffer (Editor) (2001); ISBN: 380557231X; http://www.amazon.com/exec/obidos/ASIN/380557231X/icongroupinterna
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Fatigue and Fracture Mechanics (A S T M Special Technical Publication.// Stp, 1360) by Jerina (Editor), Paris (Editor) (2001); ISBN: 0803126174; http://www.amazon.com/exec/obidos/ASIN/0803126174/icongroupinterna
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Fatigue and Fracture Mechanics (A S T M Special Technical Publication.// Stp, 1389) by Gary R. Halford (Editor) (2001); ISBN: 0803128681; http://www.amazon.com/exec/obidos/ASIN/0803128681/icongroupinterna
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Fatigue and Fracture of Ordered Intermetallic Materials II by W.O. Soboyejo (Editor), et al (1998); ISBN: 087339299X; http://www.amazon.com/exec/obidos/ASIN/087339299X/icongroupinterna
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Fatigue Assessment of Welded Joints by Local Approaches by D. Radaj, C. M. Sonsino (1999); ISBN: 1855734036; http://www.amazon.com/exec/obidos/ASIN/1855734036/icongroupinterna
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Fatigue Crack Growth Thresholds, Endurance Limits, and Design (Astm Special Technical Publication.//Stp, 1372.) by J. C. Newman (Editor), et al (2000); ISBN: 0803126247; http://www.amazon.com/exec/obidos/ASIN/0803126247/icongroupinterna
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Fatigue Design Concepts by C. M. Sonsino (2003); ISBN: 1878954911; http://www.amazon.com/exec/obidos/ASIN/1878954911/icongroupinterna
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Fatigue Free by William J., Ph.D. Green, Ralph N. Wharton (2003); ISBN: 0738208744; http://www.amazon.com/exec/obidos/ASIN/0738208744/icongroupinterna
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Fatigue in Aviation: A Guide to Staying Awake at the Stick by John A. Caldwell, J. Lynn Caldwell (2004); ISBN: 0754633004; http://www.amazon.com/exec/obidos/ASIN/0754633004/icongroupinterna
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Fatigue in Composite Materials: Science and Technology of the Fatigue Response of Fibre-Reinforced Plastics by Bryan Harris (Editor) (2003); ISBN: 0849317673; http://www.amazon.com/exec/obidos/ASIN/0849317673/icongroupinterna
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Fatigue in Ferroelectric Ceramics and Related Issues (Springer Series in Materials Science, 61) by Doru C. Lupascu (Editor) (2004); ISBN: 3540402357; http://www.amazon.com/exec/obidos/ASIN/3540402357/icongroupinterna
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Fatigue Life Prediction of Solder Joints in Electronic Packages With Ansys (Kluwer International Series in Engineering and Computer Science, 719) by Erdogan Madenci, et al (2003); ISBN: 1402073305; http://www.amazon.com/exec/obidos/ASIN/1402073305/icongroupinterna
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Fatigue of Materials by Subra Suresh (Author) (1998); ISBN: 0521578477; http://www.amazon.com/exec/obidos/ASIN/0521578477/icongroupinterna
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Fatigue of Structures and Materials by Jaap Schijve (2001); ISBN: 0792370147; http://www.amazon.com/exec/obidos/ASIN/0792370147/icongroupinterna
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Fatigue Under Thermal and Mechanical Loading: Mechanism, Mechanics and Modelling: Proceedings of the Symposium Held at Petten, the Netherlands, 22-24 May 1995 by J. Bressers (Editor), et al (2002); ISBN: 0792339932; http://www.amazon.com/exec/obidos/ASIN/0792339932/icongroupinterna
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Fatigue, Fracture, and Damage Analysis by K. K. Yoon (Editor) (2000); ISBN: 0791818853; http://www.amazon.com/exec/obidos/ASIN/0791818853/icongroupinterna
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Fatigue, Fracture, and Residual Stresses: Presented at the 1998 Asme/Jsme Joint Pressure Vessels and Piping Conference, San Diego, California, July 26-30, 1998 (Pvp, Vol 373) by Sharif Rahman (Editor), et al (1998); ISBN: 0791818691; http://www.amazon.com/exec/obidos/ASIN/0791818691/icongroupinterna
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Fatigue: David L. Davidson Symposium: Proceedings Held at the 2002 Tms Annual Meeting Seattle, Washington, USA February 17-21, 2002 by K. S. Chan (Editor), et al (2002); ISBN: 0873395182; http://www.amazon.com/exec/obidos/ASIN/0873395182/icongroupinterna
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Finite Element Applications: Linear, Non-Linear, Optimization and Fatigue and Fracture (Pvp, Vol 370) by James F. Cory (Editor), et al (1998); ISBN: 0791818667; http://www.amazon.com/exec/obidos/ASIN/0791818667/icongroupinterna
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Fracture and Fatigue Emanating from Stress Concentrators by Guy Pluvinage (2003); ISBN: 1402016093; http://www.amazon.com/exec/obidos/ASIN/1402016093/icongroupinterna
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Fracture and Fatigue in Wood by Ian Smith (Author), et al (2003); ISBN: 0471487082; http://www.amazon.com/exec/obidos/ASIN/0471487082/icongroupinterna
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Fretting Fatigue: Current Technology and Practices (Astm Special Technical Publication.//Stp 1367) by David W. Hoeppner (Editor), et al (2000); ISBN: 0803128517; http://www.amazon.com/exec/obidos/ASIN/0803128517/icongroupinterna
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From Fatigued to Fantastic!: A Proven Program to Regain Vibrant Health, Based on a New Scientific Study Showing Effective Treatment for Chronic Fatigue and Fibromyalgia by Jacob Teitelbaum (2001); ISBN: 1583330976; http://www.amazon.com/exec/obidos/ASIN/1583330976/icongroupinterna
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Handbook of Cancer-Related Fatigue by Roberto Patarca-Montero (2004); ISBN: 0789021676; http://www.amazon.com/exec/obidos/ASIN/0789021676/icongroupinterna
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Handbook of Chronic Fatigue Syndrome by Leonard A. Jason (Author), et al (2003); ISBN: 047141512X; http://www.amazon.com/exec/obidos/ASIN/047141512X/icongroupinterna
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Hiatal Hernia & Chronic Fatigue Syndrome by Patricia Ann Hellinger (2003); ISBN: 0974251003; http://www.amazon.com/exec/obidos/ASIN/0974251003/icongroupinterna
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High-Frequency Fatigue of Materials by A. Puskar (2003); ISBN: 1898326584; http://www.amazon.com/exec/obidos/ASIN/1898326584/icongroupinterna
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If There s Nothing Wrong With Me, Then Why Do I Feel So Bad: The Neurologic Basis of Fibromyalgia, Chronic Fatigue Syndrome and Related Disorders by Martin A. Duclos (2002); ISBN: 0595248497; http://www.amazon.com/exec/obidos/ASIN/0595248497/icongroupinterna
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Innovations in Chronic Fatigue Syndrome Research and Clinical Practice (Monograph Published Simultaneously As Journal of Chronic Fatigue Syndrome, 3/4) by Roberto, Md., Ph.D. Patarca-Montero (Editor) (2001); ISBN: 0789014254; http://www.amazon.com/exec/obidos/ASIN/0789014254/icongroupinterna
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Living Well with Chronic Fatigue Syndrome and Fibromyalgia : What Your Doctor Doesn't Tell You.That You Need to Know by Mary J. Shomon (Author) (2004); ISBN: 0060521252; http://www.amazon.com/exec/obidos/ASIN/0060521252/icongroupinterna
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Living With M.E. - Chronic Post-Viral Fatigue Syndrome by Charles Shepherd, Dr. Charles Shepherd (1999); ISBN: 0091816793; http://www.amazon.com/exec/obidos/ASIN/0091816793/icongroupinterna
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M. E.: Chronic Fatigue Syndrome: A Practical Guide by Anne MacIntyre, Gill Jacobs (2001); ISBN: 0722535392; http://www.amazon.com/exec/obidos/ASIN/0722535392/icongroupinterna
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Medical Etiology, Assessment, and Treatment of Chronic Fatigue and Malaise: Clinical Differentiation and Intervention by Roberto Patarca-Montero (2004); ISBN: 0789021951; http://www.amazon.com/exec/obidos/ASIN/0789021951/icongroupinterna
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Metal Fatigue by N. E. Frost (Author), et al (2000); ISBN: 0486409279; http://www.amazon.com/exec/obidos/ASIN/0486409279/icongroupinterna
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Metal Fatigue in Engineering by Ralph I. Stephens, et al (2000); ISBN: 0471510599; http://www.amazon.com/exec/obidos/ASIN/0471510599/icongroupinterna
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Multiaxial Fatigue by Darrell F. Socie, Gary B. Marquis (2000); ISBN: 0768004535; http://www.amazon.com/exec/obidos/ASIN/0768004535/icongroupinterna
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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols: A Consensus Document by Kenny
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De Meirleir (Editor), et al (2003); ISBN: 0789022079; http://www.amazon.com/exec/obidos/ASIN/0789022079/icongroupinterna •
Natural Woman: How to Beat Fatigue, Look Radiant, and Take Control of Your Health by Penelope Sach (2003); ISBN: 158394091X; http://www.amazon.com/exec/obidos/ASIN/158394091X/icongroupinterna
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One & the Same: Connecting Fibromyalgia, Chronic Fatigue Syndrome, Candidiasis & Immune System Dysfunction by Teresa L. Eakman (2003); ISBN: 1412003474; http://www.amazon.com/exec/obidos/ASIN/1412003474/icongroupinterna
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Phytotherapy of Chronic Fatigue Syndrome: Evidence-Based and Potentially Useful Botanicals in the Treatment of Cfs by Roberto Patarca-Montero (2001); ISBN: 0789009099; http://www.amazon.com/exec/obidos/ASIN/0789009099/icongroupinterna
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Positive Energy : 10 Extraordinary Prescriptions for Transforming Fatigue, Stress, and Fear intoVibrance, Strength, and Love by Judith Orloff (Author) (2004); ISBN: 0609610104; http://www.amazon.com/exec/obidos/ASIN/0609610104/icongroupinterna
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Problems of Fracture Mechanics and Fatigue: A Solution Guide by Emmanuel E. Gdoutos (2003); ISBN: 1402017596; http://www.amazon.com/exec/obidos/ASIN/1402017596/icongroupinterna
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Properties of Aluminum Alloys: Tensile, Creep, and Fatigue Data at High and Low Temperatures (#09813G) by J. G. Kaufman (Editor) (2000); ISBN: 0871706326; http://www.amazon.com/exec/obidos/ASIN/0871706326/icongroupinterna
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Steps to Fight Chronic Fatigue Syndrome for the Modern Woman by Anthony Martin (1999); ISBN: 0968419704; http://www.amazon.com/exec/obidos/ASIN/0968419704/icongroupinterna
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Stop Feeling Tired! 10 Mind-Body Steps to Fight Fatigue and Feel Your Best by George D. Zgourides, Christie S. Zgourides (2003); ISBN: 1572243139; http://www.amazon.com/exec/obidos/ASIN/1572243139/icongroupinterna
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Stress, Workload, and Fatigue by Peter A. Hancock (Editor), Paula A. Desmond (Editor) (2001); ISBN: 0805831789; http://www.amazon.com/exec/obidos/ASIN/0805831789/icongroupinterna
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Stricken: Voices from the Hidden Epidemic of Chronic Fatigue Syndrome by Peggy Munson (Editor) (2000); ISBN: 0789008955; http://www.amazon.com/exec/obidos/ASIN/0789008955/icongroupinterna
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The Bible Cure For Chronic Fatigue And Fibromyalgia by Don Colbert (2000); ISBN: 0884196801; http://www.amazon.com/exec/obidos/ASIN/0884196801/icongroupinterna
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The Chronic Fatigue Healing Diet by Christine Craggs-Hinton, Steve Taylor (2003); ISBN: 0859698785; http://www.amazon.com/exec/obidos/ASIN/0859698785/icongroupinterna
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The Chronic Fatigue Story (2011); ISBN: 9991047336; http://www.amazon.com/exec/obidos/ASIN/9991047336/icongroupinterna
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The Cure for Soul Fatigue: Spiritual Healing for the Worn Out, Stressed Out, and Burned Out by Karl Haffner (2001); ISBN: 0816318409; http://www.amazon.com/exec/obidos/ASIN/0816318409/icongroupinterna
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The Emotional Energy Factor: The Secrets High-Energy People Use to Beat Emotional Fatigue by Mira Kirshenbaum (2003); ISBN: 0385336098; http://www.amazon.com/exec/obidos/ASIN/0385336098/icongroupinterna
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The Food Allergy Cure: A New Solution to Food Cravings, Obesity, Depression, Headaches, Arthritis, and Fatigue by Ellen W. Cutler (2001); ISBN: 0609606395; http://www.amazon.com/exec/obidos/ASIN/0609606395/icongroupinterna
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The Longevity Solution: Compelling Proof That Royal Jelly Has the Power to Eliminate Fatigue, Provide Greater Energy and Extend Life by Cass, Dr Ingram (2002); ISBN: 1931078017; http://www.amazon.com/exec/obidos/ASIN/1931078017/icongroupinterna
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The Polio Paradox: Understanding and Treating "Post-Polio Syndrome" and Chronic Fatigue by H.D. Richard L. Bruno Ph.D (Author) (2003); ISBN: 0446690694; http://www.amazon.com/exec/obidos/ASIN/0446690694/icongroupinterna
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The Psychopathology of Functional Somatic Syndromes: Neurobiology and Illness Behavior in Chronic Fatigue Syndrome, Fibromyalgia, Gulf War Illness, Irritable Bowel Syndrome, and Premenstrual Syndrome by Peter, Md. Manu (2004); ISBN: 078901260X; http://www.amazon.com/exec/obidos/ASIN/078901260X/icongroupinterna
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Theophrastus of Eresus: On Sweat, on Dizziness and on Fatigue (Philosophia Antiqua, 93) by William W. Fortenbaugh, et al (2003); ISBN: 9004128905; http://www.amazon.com/exec/obidos/ASIN/9004128905/icongroupinterna
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Thermal Shock and Thermal Fatigue Behavior of Advanced Ceramics (NATO Asi Series E: Applied Sciences, Vol 241) by Gunter Petzow (Editor), Gerold Schneider (Editor) (2002); ISBN: 0792323610; http://www.amazon.com/exec/obidos/ASIN/0792323610/icongroupinterna
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Thermo-Mechanical Fatigue Behavior of Materials (Astm Special Technical Publication, 1371.) by Huseyin Sehitoglu (Editor), et al (2000); ISBN: 0803128533; http://www.amazon.com/exec/obidos/ASIN/0803128533/icongroupinterna
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Tiger Patterns: A Guide to the Vietnam War's Tigerstripe Combat Fatigue Patterns and Uniforms (Schiffer Military/Aviation History) by Richard Denis Johnson (1999); ISBN: 0764307568; http://www.amazon.com/exec/obidos/ASIN/0764307568/icongroupinterna
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Treating Compassion Fatigue by Charles R. Figley (Editor) (2002); ISBN: 1583910530; http://www.amazon.com/exec/obidos/ASIN/1583910530/icongroupinterna
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Understanding Chronic Fatigue Syndrome: An Empirical Guide to Assessment and Treatment by Fred Friedberg, Leonard Jason (1998); ISBN: 1557985111; http://www.amazon.com/exec/obidos/ASIN/1557985111/icongroupinterna
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Using Powder Metallurgy in Design Wear, Corrosion, and Fatigue Resistance by United Nations Publications (2000); ISBN: 1860583032; http://www.amazon.com/exec/obidos/ASIN/1860583032/icongroupinterna
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What Your Doctor May Not Tell You About Autoimmune Disorders: The Revolutionary, Drug-Free Treatments for Thyroid Disease, Lupus, MS, IBD, Chronic Fatigue; Rheumatoid Arthritis, and Other Diseases by Stephen B./Mitchell Edelson (Author), et al (2003); ISBN: 0446679240; http://www.amazon.com/exec/obidos/ASIN/0446679240/icongroupinterna
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What Your Doctor May Not Tell You About Fibromyalgia Fatigue [DOWNLOAD: ADOBE READER] by M. D. R. Paul St Amand, Claudia Craig Marek (2003); ISBN: B0000TW2NY; http://www.amazon.com/exec/obidos/ASIN/B0000TW2NY/icongroupinterna
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What Your Doctor May Not Tell You About Fibromyalgia Fatigue: The Powerful Program That Helps You Boost Your Energy and Reclaim Your Life by M.D. R. Paul St. Amand (Author), Claudia Craig Marek (2003); ISBN: 0446677302; http://www.amazon.com/exec/obidos/ASIN/0446677302/icongroupinterna
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Yoga Turns Back the Clock: The Unique Total-Body Program that Fights Fat, Wrinkles and Fatigue by Glenda Twining, Mark Seal (2003); ISBN: 1592330061; http://www.amazon.com/exec/obidos/ASIN/1592330061/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “fatigue” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 •
Auditory fatigue, by R. Caussé and P. Chevasse. Author: Caussé, Raoul,; Year: 2003; Chicago [1968]
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Defining and managing chronic fatigue syndrome Author: Mulrow, Cynthia D. (Cynthia Diane),; Year: 1964; Rockville, Md.: The Agency, [2001]
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Fatigue and boredom in repetitive work, by S. Wyatt and J. N. Langdon (assisted by F. G. L. Stock). Author: Wyatt, Stanley.; Year: 1935; London, H. M. Stationery off., 1937
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Fatigue and efficiency in the iron and steel industry. Author: Great Britain. Industrial fatigue research board.; Year: 1967; London, H. M. Stationery off., 1920
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Fatigue and Stress Symposium, 24-26 January 1952 at Operations Research Office, Chevy Chase, Maryland. Condensed and summarized by Sally M. Field [and] Stanley W. Davis. Participants: Arthur G. Bills [and others].; Year: 1966; Chevy Chase, Operations Research Office, Johns Hopkins Univ. [1953]
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Fatigue countermeasures, Jan. 1967-May 1970. 142 citations. Author: National Library of Medicine (U.S.); Year: 2002; [Bethesda, Md.] 1970
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Management of cancer symptoms: pain, depression, and fatigue Author: Carr, Daniel B.; Year: 1961; Rockville, MD: U.S. Dept. of Health and Human Services, Public Health Service, Agency for Healthcare Research and Quality, [2002]; ISBN: 1587631172
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Methodology in human fatigue assessment, edited by K. Hashimoto, K. Kogi [and] E. Grandjean. Proceedings of the symposium held in Kyoto, Japan, under the auspices
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In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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of the Industrial Fatigue Research Committee of Japan Association of Industrial Health, 29-30 September 1969. Author: Grandjean, E. (Etienne); Year: 1964; London, Taylor; Francis, 1971; ISBN: 0850660491 http://www.amazon.com/exec/obidos/ASIN/0850660491/icongroupinterna •
Practice, fatigue and oscillation, a study of work at high pressure, by J. C. Flügel. Author: Flugel, J. C. (John Carl),; Year: 1967; Cambridge [Eng.] The University press, 1928
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Problems of the physiology of the processes of fatigue and recovery. [Tr. by M. Roublev. Author: Instytut fiziolohiï im. O.O. Bohomol'tsia.; Year: 1967; Washington, National Science Foundation, 1960]
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Reading and visual fatigue [by] Leonard Carmichael [and] Walter F. Dearborn. Author: Carmichael, Leonard,; Year: 1947; Boston, Houghton Mifflin [c1947]
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Studies in auditory fatigue and adaptation. Author: Hood, J. D.; Year: 1960; London, 1950
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The Harvard Fatigue Laboratory; its history and contributions [by] Steven M. Horvath [and] Elizabeth C. Horvath. Author: Horvath, Steven M.; Year: 1967; Englewood Cliffs, N. J., Prentice-Hall [c1973]; ISBN: 0133841561 http://www.amazon.com/exec/obidos/ASIN/0133841561/icongroupinterna
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The influence of concomitant activity and fatigue upon certain forms of reciprocal hand movement and its fundamental components, by David P. Boder. Author: Boder, David Pablo,; Year: 1966; Baltimore, Md., The Johns Hopkins press [1935]
Chapters on Fatigue In order to find chapters that specifically relate to fatigue, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and fatigue 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 “fatigue” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on fatigue: •
Fatigue in the Primary Biliary Cirrhosis Patient Source: in Lindor, K.D.; Heathcote, E.J.; Poupon, R., eds. Primary Biliary Cirrhosis: From Pathogenesis to Clinical Treatment. Boston, MA: Kluwer Academic Publishers. 1998. p. 102-107. Contact: Available from Kluwer Academic Publishers. Customer Service Deparment, P.O. Box 358, Accord Station, Hingham, MA 02018-0358. (781) 871-6600. Fax (781) 6819045. E-mail:
[email protected]. Website: www.wkap.nl. Summary: Primary biliary cirrhosis (PBC) is a chronic cholestasic (lack of bile flow) liver disease of unknown etiology (Cause), although the association with a large number of autoimmune disorders suggests that the disease may be of autoimmune origin. The disease usually affects middle aged women and progresses from asymptomatic disease with only laboratory abnormalities to a severe cholestatic disease with deep jaundice, xanthomas (fatty tumors in the skin), portal hypertension (high blood pressure), and eventually liver failure. This chapter on fatigue in patients with PBC is from a
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monograph that reprints papers from a conference held in November 1997 in Chicago, Illinois, on the clinical features (symptoms), pathogenesis, and treatment of PBC. The complaint of fatigue is common in patients with PBC, occurring in anywhere from 68 to 86 percent of patients. Fatigue in these patients has a significant impact on their quality of life, constituting the worst symptom in almost one half of PBC patients and ascribed to causing severely disabling effects on daily life in 25 percent of PBC patients. The etiology (Cause) of fatigue in PBC patients is not understood, but does not appear to correlated with stage of disease, liver biochemistry, Mayo risk score, duration of, or response to ursodeoxycholic acid (UDCA) therapy. However, fatigue in PBC is strongly associated with depression and obsessive compulsive somatization behavior. The author considers a number of theoretical causes of central fatigue that may be responsible: neuroendocrine causes, neurotransmitters, and immune activation or cytokines. The bulk of the article considers animal (rat) studies in these three areas. The author concludes that the specific targeting of these defects may provide novel therapeutic interventions for treating fatigue in PBC patients. 29 references. •
Chronic Fatigue Syndrome in Singers Source: in Sataloff, R.T., ed. Professional Voice: The Science and Art of Clinical Care. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1997. p. 447-456. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail:
[email protected]. Website: www.singpub.com. PRICE: $325.00 plus shipping and handling. ISBN: 1565937287. Summary: This chapter, from a book on the clinical care of the professional voice, discusses chronic fatigue syndrome in singers. Chronic fatigue syndrome (CFS) is defined as a chronic illness of uncertain etiology characterized by at least six months of debilitating fatigue and associated symptoms. Topics include the historical perspective, manifestations of CFS, and patient care strategies. The authors conclude that although the etiology of CFS is unknown, and many still debate whether CFS is a psychiatric concomitant or organic in etiology, CFS continues to affect many people. However, the professional voice user may be more affected by this syndrome than others because of the physical, mental, and artistic demands that are required in vocal performance. When the diagnosis is established, singing skills should be maintained through short, frequent practice sessions, and with regular supervision by a laryngologist. 1 table. 23 references.
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Day Seven: Managing Your Fatigue Source: in Green, W.F. First Year: Hepatitis B. New York, NY: Marlowe and Company. 2002. p. 72-84. Contact: Available from Marlowe and Company. 161 William Street, 16th Floor, New York, NY 10038. PRICE: $15.95 plus shipping and handling. ISBN: 1569245339. Summary: Viral hepatitis B (liver infection) is one of the most preventable medical conditions due to the availability of a hepatitis B vaccine, yet an estimated 100,000 people in the United States are infected each year, and 6,000 die from complications. When the author of this book was diagnosed in 1993, he decided to be proactive in his quest to understand and manage his illness. In this chapter, the author focuses on fatigue management. The chapter is in two parts: first, a focus on the psychosocial aspects that the reader might experience, followed by a section of instructional material. In nontechnical language, the author discusses the symptoms of fatigue, the mental and physical aspects of fatigue, causes of fatigue, the role of adequate sleep, and nutrition
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and nutrients. The second section of the chapter reviews the liver biopsy, including the biopsy procedure itself, pre and post procedure care, and understanding the results. The author stresses that having a biopsy is not as painful as it sounds, and it is absolutely essential for determining the exact condition of the liver.
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CHAPTER 8. MULTIMEDIA ON FATIGUE Overview In this chapter, we show you how to keep current on multimedia sources of information on fatigue. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.
Video Recordings An excellent source of multimedia information on fatigue is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “fatigue” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “fatigue” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on fatigue: •
Hepatitis C: A Viral Mystery Source: Boston, MA: Fanlight Productions. 2000. (videocassette). Contact: Available from Fanlight Productions. 4196 Washington Street, Boston, MA 02131. (800) 937-4113 or (617) 469-4999. Fax (617) 469-3379. E-mail:
[email protected]. Website: www.fanlight.com. PRICE: $195.00 plus shipping and handling. Summary: Hepatitis C is a viral disease of the liver which affects nearly four million Americans. The virus is primarily spread through blood contamination. There is no vaccine and no definite cure for the infection. This documentary videotape profiles several individuals who are living with this serious, chronic illness. In addition to discussing the available medical treatments, the program explores alternative options for treatment, including dietary changes, herbal therapies, meditation, guided imagery, and Qi Gong. The program reviews the modes of transmission of hepatitis C virus (HCV), including through blood transfusions, IV drug use, unsafe sex practices or
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multiple sexual partners, and tattooing and body piercing. The program interviews Dr. Stephen Steady, a hepatologist (liver specialist) who reminds viewers that many people with HCV infections are asymptomatic, but complications can be rampant, affecting other organ systems and overall quality of life (primarily through fatigue). The program reviews the drug therapy options (interferon and ribavirin, predominantly), noting that these treatments are effective only in 40 percent of the patients with hepatitis C, yet they can cause many side effects of their own. The program concludes with a look at the need for liver transplantation for some patients with hepatitis C, the important role of hepatitis C education for prevention, and support groups for patients with the illness. •
Caring Families Coping With Alzheimer's Disease Source: Chicago, IL: Alzheimer's Disease and Related Disorders Association, Inc. March 1988. Contact: Alzheimer's Association. 919 North Michigan Avenue, Suite 1000, Chicago, IL 60611-1676. (800) 272-3900; (312) 335-8700; (312) 335-8882 (TDD); FAX (312) 335-1110. PRICE: Single copy free. Summary: This film shows the daily lives of three families struggling with Alzheimer's disease. Each patient has a different degree of impairment and thus presents a different set of problems for the family caregiver. Yet there are also many common threads running through the three stories, and each caregiver is shown sharing similar feelings of love, disappointment, frustration, fatigue, and even humor as they cope with Alzheimer's disease from day to day.
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Someone You Know Source: Jenkintown, PA: Hepatitis B Foundation. 1997. (videocassette). Contact: Available from Hepatitis B Foundation. 101 Greenwood Avenue, Suite 570, Jenkintown, PA 19046. (215) 884-8786. Fax (215) 887-1931. E-mail:
[email protected]. Website: http://www.hepb.org. PRICE: $6.00 for shipping. Summary: This general health education videotape program educates viewers about the hepatitis B virus (HBV) and its present status as an 'epidemic' in the U.S. The program begins with a brief overview of liver functions (energy generation, detoxification of drugs and poisons, and making blood proteins and clotting factors) and the pathology caused by HBV infections. The program stresses that there is no cure for hepatitis B, although a preventive vaccine is available. Dr. Thomas London reviews the symptoms of acute illness, including nausea, vomiting, fever, jaundice, and extreme fatigue; and explains how the virus is transmitted through blood contact (including that from sharing toothbrushes or razors), through sexual contact, and from infected mother to her child during childbirth. Other topics covered include child care issues, the use of universal precautions, classroom supplies to prevent transmission, the percentages of infected persons who go on to chronic carrier status, the role of the World Health Organization, the long term complications of carrying HBV, and the costs of health care associated with HBV. The program includes an interview with Dr. Baruch Blumberg, the scientist who won the Nobel prize for developing the HBV vaccine. Another physician interviewed, Dr. Timothy Block, emphasizes the importance of universal immunization, the problems with assuming safety if one is not a member of a supposed 'high risk' group, and the need for chronic carriers to take very good care of their health and be screened twice per year to prevent morbidity and mortality. The program features numerous interviews with patients who are chronic carriers of HBV; they focus on the psychosocial aspects, including the stigma of having the disease, the long-term effects of
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constant fatigue, and worries about infecting their children and loved ones. The program concludes with a brief summary of the Hepatitis B Foundation. •
Helping Hand Video Guide Source: Thousand Oaks, CA: Amgen. 1997. (videocassette). Contact: Available from COMPASS Program, Amgen, Inc. 1 Amgen Center Drive, Professional Services, Mailstop 36-2-A, Thousand Oaks, CA 91362. (888) 508-8088. Website: www.infergen.com. PRICE: Single copy free. Summary: This patient education videotape describes hepatitis C viral infections and the use of Infergen (interferon alfacon 1) therapy to help treat this disease. The first section of the program explains hepatitis C, its risk factors, symptoms, transmission, and complications. The program features scenes of a patient receiving her diagnosis, and narration by a physician, Dr. Melissa Palmer. The program emphasizes the importance of treating hepatitis C, as it can cause long term complications if left untreated. In the second section, the focus is on Infergen: how the drug works, how to inject Infergen, and potential side effects and how to manage them. The video explains in clear terms, with graphics, the differences between bacteria and viruses and why viruses can be so difficult to eradicate from the body's cells. The video includes a section on the process of injecting Infergen, supplies, recordkeeping, places to inject, preparation of the syringe, storage of the drug, and the use of containers for sharps. Potential side effects and strategies to manage each of them are outlined. The side effects can include flulike symptoms, upset stomach, fatigue, loss of appetite, weight loss, depression, and a local reaction at the injection site. The program concludes by describing the COMPASS program of patient education and support provided by the Amgen company. COMPASS includes patient supplies, a patient support and information telephone line, and assistance with financial concerns, including insurance and reimbursement.
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Diabetes: Multiple Ways to Gain Control Source: Calhoun, KY: NIMCO. 1994. (videocassette). Contact: Available from NIMCO. P.O. Box 9, 117 Highway 815, Calhoun, KY 423270009. (800) 962-6662 or (502) 273-5050. Fax (502) 273-5844. PRICE: $39.95. Order number: NIM-SM-CD2-V. Summary: This video which focuses on new developments in the treatment of diabetes, explains what diabetes is and reviews common symptoms and risk factors. Symptoms include excessive thirst, hunger, fatigue, blurred vision, frequent urination, and tingling in the hands and feet. Risk factors include being overweight and over 40 years old, having a family history of diabetes, and experiencing stress. The video then explains the team concept of care, which involves the patient interacting with a physician, dietitian, diabetes educator, pharmacist, and podiatrist. In addition, the video stresses meal planning, physical activity, medications, education, and self monitoring as ways to gain control of the disease.
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Now That You Know: Living Healthy With HIV; Part 4 - Understanding Treatment Contact: Kaiser Permanente, National Video Communications, 825 Colorado Blvd Ste 301, Los Angeles, CA, 90041, (323) 259-4776, http://www.kaiserpermanente.org/locations/index.html. Summary: This videorecording tells persons with Human immunodeficiency virus (HIV) infection about symptoms, opportunistic infections, and available treatment.
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Narrators Bob Goen and Susan Campos introduce the material by saying that infected persons need to take control of their own health, become educated, and become informed. The main portion of the videorecording opens with a segment on azidothymidine (AZT). It discusses early intervention and when it is appropriate to begin treatment. A model demonstrates how antiviral treatment, such as AZT intervention, slows the rate of growth. Viewers are warned that being on antiviral therapy does not prevent them from being infectious. Possible side effects of the medication are discussed. After turning to general background information on opportunistic infections, that videorecording takes a detailed look at some of the most common. It classifies symptoms into infections that do not lead to an AIDS diagnosis, such as candida, shingles, and weight loss; nonspecific symptoms, such as fatigue, fever, and night sweats; and opportunistic infections that lead to an AIDS diagnosis. Of those, it takes the most detailed looks at Pneumocystis carinii pneumonia (PCP), cytomegalovirus retinitis (CMV) infection, toxoplasmosis, and mycobacterium avium intracellulare (MAI). Holistic therapies are considered briefly at the conclusion of the videorecording. •
Coping Skills Source: Nashville, TN: Lifeview Resources, Inc. 1998. Contact: Available from Lifeview Resources. PO Box 290787, Nashville, TN 37229-0787; (800) 395-5433; FAX: (615) 781-969. Internet: http://www.lifeviewresources.com. PRICE: $19.95 plus $6.00 shipping and handling. Also available as part of AZAV08189, a 3-video set (price for set: $49.95). Summary: This videotape explores the emotional impact of caring for an elderly loved one with dementia or another medical condition. Interviews with actual caregivers and discussions led by health professionals, provide suggestions for coping with difficult emotions such as helplessness, anger, resentment, guilt, and fatigue, and then stress the importance of caring for oneself throughout the caregiving experience. They also discuss how resources, such as support groups can benefit caregivers. Other topics covered include gaining control over a demanding daily routine, spirituality, preparing for a loved one to leave home, and adjusting to loss.
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Your Liver Source: Bronx, NY: Latin Organization for Liver Awareness. 199x. (videocassette). Contact: Available from Latino Organization for Liver Awareness (LOLA). 1560 Mayflower Avenue, Bronx, New York, NY 10465. (718) 892-8697. Fax (718) 918-0527. (888) 367-LOLA. PRICE: $10.00; plus shipping and handling. Summary: This videotape program reviews the physiology of the liver, and describes different types of liver disease, focusing on hepatitis. Narrated by Debbie Delgado-Vega, a liver transplant recipient and advocate and educator in the field, the program first summarizes the functions of the liver. The liver stores vitamins and minerals, makes bsoleilwelile to help digestion, detoxifies chemicals, stores energy, removes poisons and pollutants that may be ingested from the air, makes clotting factors, and defends against germs that cause disease. The program then lists the types of liver disease, including liver disorders in children, alcohol related liver disease, liver cancer, cirrhosis (scarring), and viral hepatitis (inflammation of the liver due to viral infection). The program discusses hepatitis in depth, explaining the differences between acute disease (less than 6 months in duration) and chronic disease; the numbers of people in the United States with hepatitis B (1.2 million) and hepatitis C (4.8 million); the complications of chronic
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hepatitis that can lead to cirrhosis (inflammation, scarring and nodules); symptoms, notably fatigue; how hepatitis B and C are transmitted in blood and other body fluids; other risk factors, including the use of intranasal cocaine, intravenous drugs, tattoos or body piercing, pre 1992 blood transfusion, unprotected sex, and having served time in jail; treatment options, including interferons and ribavirin; and why it is important to get tested and treated, even if there are no apparent symptoms. The narrator stresses that more Latinos die from liver disease than any other minority group and chronic liver disease is the third leading cause of death among Latinos. The conclusion of the program shows clips and materials from educational programs and public health and advocacy activities conducted by LOLA (Latino Organization for Liver Awareness). The program is narrated in English, with some clips at the end in Spanish. •
Living with Diabetes: Making the Diagnosis Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1999. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 071899A. Summary: This videotape, part of a series on living with diabetes, focuses on the diagnosis of diabetes. A moderator discusses the new criteria for the diagnosis and classification of diabetes, the rise in the incidence of diabetes, the symptoms of diabetes, and the prevention of diabetes with an endocrinologist. The videotape begins with a discussion of what diabetes is, how insulin works, the types of diabetes, and risk factors for diabetes. Type 1 diabetes, which was formerly known as insulin dependent diabetes, usually develops quickly, whereas type 2 diabetes, which was formerly known as noninsulin dependent diabetes, usually has a gradual onset. The symptoms of diabetes, which are generally the same regardless of the type, are related to high blood sugar. They include excessive urination and thirst, fatigue, hunger, weight loss, and blurred vision. Risk factors for type 1 diabetes include a genetic predisposition for developing the disease. Risk factors for type 2 diabetes include being overweight, sedentary, and over 45 years old; having a history of stillbirth or gestational diabetes; having high blood pressure and high cholesterol; being African American, Hispanic, or Native American; and having previously been identified with impaired glucose tolerance. The acute complications of diabetes include ketoacidosis, nonketotic hyperosmolar syndrome, and hypoglycemia. The chronic complications are divided into microvascular and macrovascular complications. Microvascular complications include retinopathy, neuropathy, and nephropathy. Macrovascular complications include heart attack, stroke, and peripheral vascular disease. Early diagnosis is important in preventing complications. Diagnosis is based on blood sugar levels obtained from a blood glucose test, a fasting plasma glucose test, or an oral glucose tolerance test. The risk of developing type 2 diabetes may be reduced by eating properly, maintaining an ideal weight, and exercising. The videotape includes a self test that viewers can take to assess their risk of developing type 2 diabetes.
•
AIDS: A Matter of Life Contact: Philadelphia Department of Public Health, AIDS Activities Coordinating Office, 1101 Market 9th Fl, Philadelphia, PA, 19107, (215) 685-5600, http://www.phila.gov/departments/health/AIDS/AIDS.html.
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Summary: Through interviews with Persons with AIDS (PWA's) from diverse backgrounds, this videorecording presents a macroview of Human immunodeficiency virus (HIV) transmission. It examines the physical, emotional, and psychological implications of the disease for patients and family. The videorecording addresses modes of contagion involving needle sharing, bisexual and multiple sex partners, and blood transfusions. It also stresses methods of prevention including safer sexual conduct and use of condoms. It mentions symptoms and illnesses that arise from the Acquired immunodeficiency syndrome (AIDS), such as nausea and fatigue, often followed by brain damage, pneumonia, and thrush. The role of the church as a support system is also examined.
Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “fatigue” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on fatigue: •
AIDS Caregiving: Lessons for the Second Decade Contact: Sounds True Audio, 735 Walnut St, Dept ACG1, Boulder, CO, 80302, (303) 4496229. Impact AIDS, 1069 Dutton Ave, Santa Rosa, CA, 95407, (707) 542-6297, http://www.journeyhome.com/impactaids. Summary: These cassettes contain personal anecdotes and advice for individuals who are caregivers to Person's with AIDS (PWA's). Each individual describes his or her personal experiences in the caregiving process. Topics include: the uniqueness of AIDS caregiving; coping with everyday concerns; capacity for deepening relationships; and problems and concerns of diverse communities. The tapes continue with a focus on the caregiver; addressing burnout and compassion fatigue; and personal growth and discovering spirituality.
•
Makers of Psychologic Distress Gay Men in HIV Epidemiologic Study; the 16th National Lesbian & Gay Health Conference & 12th Annual AIDS/HIV Forum, New York, NY, June 21 - 26, 1994 Contact: Encore Cassettes, PO Box 231340, San Diego, CA, 92194, (619) 596-8402. Summary: This speech, presented at the 1994 National Lesbian and Gay Health Conference, describes a psychologic, epidemiological study of gay men. The difficulty of obtaining evidence for a psychological assessment in a cohort study is noted. From October 1992 to March 1993, 688 interviews of gay men were conducted. A questionnaire asked about sexual history, clinical treatment, mental health, counseling, and costs. The patients were interviewed on a 6-month cycle. Of the 688 interviews, 268 or 39 percent were HIV-positive and 12 percent were diagnosed with depression. Over half of those with depression are HIV positive. The speaker concludes that HIV-positive men appear more likely to use medications, such as sleeping pills and mood elevators, to treat stress and anxiety as well as fatigue and loss of enjoyment in life. In addition, this chemotherapy is more likely to be taken without the support of psychological personnel. Questions from the audience follow the speech.
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Bibliography: Multimedia on Fatigue The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in fatigue (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on fatigue: •
Abdominal discomfort and fatigue [videorecording] Source: Marshfield Medical Foundation, in cooperation with Marshfield Clinic & St. Joseph's Hospital; Year: 1984; Format: Videorecording; Marshfield, WI: Marshfield Regional Video Network, [1984]
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Bus driver fatigue and stress issues study [electronic resource] Source: prepared by Arrowhead Space & Telecommunications, Inc; Year: 1999; Format: Electronic resource; Fall Church, VA: Arrowhead Space & Telecommunications, [1999]
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Chronic fatigue in children [videorecording]: a tiring topic for the pediatrician Source: [presented by] Children's Hospital, Boston; Year: 1994; Format: Videorecording; Boynton Beach, FL: Universal Health Communications, [1994]
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Chronic fatigue syndrome [videorecording]: current issues Source: CDC, Centers for Disease Control and Prevention; Public Health Training Network; produced for Department of Health and Human Services, Office of Public Health and Science; produced by Divisio; Year: 1997; Format: Videorecording; [Atlanta, Ga.?]: U.S. Dept. of Health & Human Services, Public Health Service, Centers for Disease Control and Prevention, [1997?]
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Chronic fatigue syndrome [videorecording]: the facts Source: a joint production of. Audio Visual Center and Staff Education; Year: 1991; Format: Videorecording; [Oakland, Calif.]: Kaiser Foundation Health Plan, c1991
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Chronic viral fatigue syndrome [videorecording]: a real disease? Source: with Anthony Komaroff; Year: 1989; Format: Videorecording; Secaucus, N.J.: Network for Continuing Medical Education, c1989
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Combat fatigue [motion picture]: psychosomatic disorders Source: Navy Department, United States of America; Year: 1946; Format: Motion picture; United States: Pathescope Company of America, 1946
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Combat fatigue irritability [motion picture] Source: Bureau of Aeronautics, United States of America Navy Department; Year: 1945; Format: Motion picture; United States: Navy Dept., 1945
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Fatigue and overtraining [videorecording] Source: a Hahnemann Medical College & Hospital and World Video Corp. production; Year: 1981; Format: Videorecording; [S.l.]: Therapeutic CME Group, c1981
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Introduction to combat fatigue [motion picture] Source: Bureau of Aeronautics, United States of America, Navy Department; Year: 1944; Format: Motion picture; United States: Navy, 1944
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Mystery diseases [videorecording]: multiple sclerosis and chronic fatigue Source: [presented by] the Medical University of South Carolina, College of Pharmacy and Health Communications Network; Year: 1995; Format: Videorecording; Charleston, S.C.: The University, c1995
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Symptom management in cancer [electronic resource]: pain, depression, and fatigue: January 1900 through June 2002, plus selected earlier citations: 1,803 citations Source:
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prepared by Marcia Zorn, Julia H. Rowland, Claudette G. Varricchio; Year: 2002; Format: Electronic resource; Bethesda, Md. (8600 Rockville Pike): U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Library of Medicine, Reference Section, [2002] •
The Human energy crisis [videorecording]: solutions to chronic fatigue Source: [presented by] Dharma Productions; Year: 1990; Format: Videorecording; Portland, Or.: Institute for Traditional Medicine, c1990
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The sleep famine [videorecording]: the effects of sleep deprivation and chronic fatigue Source: a presentation of Films for the Humanities and Sciences; produced and distributed by the Canadian Broadcasting Corporation; Year: 2001; Format: Videorecording; Princeton, N.J.: Films for the Humanities & Sciences, c2001
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Treating chronic fatigue syndrome with homeopathy [sound recording] Source: Nat'l. Center for Homeopathy, Los Angeles 1990; Year: 1990; Format: Sound recording; [United States: The Center?, 1990?]
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CHAPTER 9. PERIODICALS AND NEWS ON FATIGUE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover fatigue.
News Services and Press Releases One of the simplest ways of tracking press releases on fatigue 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 “fatigue” (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 fatigue. 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 “fatigue” (or synonyms). The following was recently listed in this archive for fatigue: •
Unusual fatigue, sleep disturbance often precede AMI in women Source: Reuters Medical News Date: November 03, 2003
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Fatigue often precedes heart attacks in women Source: Reuters Health eLine Date: November 03, 2003
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Virus-related muscle damage tied to chronic fatigue Source: Reuters Health eLine Date: October 31, 2003
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Enterovirus-related myopathy documented in some chronic fatigue patients Source: Reuters Medical News Date: October 31, 2003
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T cell elevation linked with fatigue in breast cancer survivors Source: Reuters Medical News Date: August 05, 2003
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Immune cells tied to fatigue in cancer survivors Source: Reuters Health eLine Date: August 05, 2003
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Treating cancer-related fatigue may reduce anxiety and depression Source: Reuters Medical News Date: July 09, 2003
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Patients complaining of severe fatigue often do not have chronic fatigue syndrome Source: Reuters Medical News Date: May 30, 2003
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Mystery fatigue often not chronic fatigue syndrome Source: Reuters Health eLine Date: May 30, 2003
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Chronic fatigue estimated to cost Britain ú3.5 billion a year Source: Reuters Industry Breifing Date: May 12, 2003
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Chronic fatigue costs UK billions a year: study Source: Reuters Health eLine Date: May 12, 2003
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Heart problem potential cause of chronic fatigue Source: Reuters Health eLine Date: April 15, 2003
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Yoga, exercise beats fatigue in multiple sclerosis Source: Reuters Health eLine Date: April 10, 2003
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Hospital doctors in Germany overworked, stressed and fatigued Source: Reuters Industry Breifing Date: January 28, 2003 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.
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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 “fatigue” (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 “fatigue” (or synonyms). If you know the name of a company that is relevant to fatigue, 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 “fatigue” (or synonyms).
Newsletters on Fatigue Find newsletters on fatigue using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “fatigue.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “fatigue” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •
Kidney Disease Source: Sarcoidosis Networking. 8(3): 2. May-June 2000.
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Contact: Available from Sarcoid Network Association. Sarcoidosis Networking, 13925 80th Street East, Puyallup, WA 98372-3614. Email:
[email protected]. Summary: Sarcoidosis is a chronic, progressive systemic granulomatous (Causing lesions) disease of unknown cause (etiology), involving almost any organ or tissue, including the skin, lungs, lymph nodes, liver, spleen, eyes, and small bones of the hands or feet. This brief article, from a newsletter for patients with sarcoidosis, reviews kidney disease, its types, diagnosis, and management. The article begins with a summary of the anatomy and function of the kidneys, which filter the blood (removing waste and excess body fluids), and maintain the balance of some essential nutrients helping to regulate blood pressure, red blood cells, and elements such as potassium and calcium. Without functioning kidneys, one cannot live without dialysis, the mechanical filtration of the blood. Kidneys fail for a variety of reasons, including trauma to the kidney, toxins, heart failure, obstruction (kidney stones), overuse of some medications, and diseases that invade the kidney, such as sarcoidosis. Diabetes and high blood pressure are the most common causes for loss of kidney function. Warning signs of kidney disease are high blood pressure (hypertension), blood or protein in the urine, creatinine level greater than 1.2 in women or 1.4 in men, more frequent urination (especially at night), difficult or painful urination, and puffy eyes or swelling of the hands or feet (especially in children). Loss of kidney function can produce symptoms including fatigue, weakness, nausea, vomiting, diarrhea or constipation, headaches, loss of appetite, increased edema (fluid retention), and fever or chills. Kidney failure is characterized as acute kidney failure, chronic kidney insufficiency, and chronic kidney failure. The need to put a person on dialysis depends upon the levels of creatinine and urea nitrogen in the blood and the evaluation of body parameters such as fluid status, and symptoms of toxicity. The author encourages readers to practice preventive measures which include drinking 8 to 10 glasses of water per day, preventing or treating diabetes and high blood pressure, avoiding tobacco, eating a well balanced diet, practicing good hygiene, treating wounds and infections, limiting exposure to heavy metals and toxic chemicals, and avoiding unnecessary over the counter drug use. •
Myopathic Diseases Source: Bulletin on the Rheumatic Diseases. 51(3): 1-4. 2002. Contact: Available from Arthritis Foundation. 1330 West Peachtree Street, Atlanta, GA 30309. (800) 268-6942 or (404) 872-7100. Fax (404) 872-9559. Website: www.arthritis.org. Summary: This newsletter provides health professionals with information on myopathic diseases. Various diseases and conditions affect skeletal muscle and result in symptoms, including weakness, fatigue, and muscle cramping. Myopathies can be classified as idiopathic inflammatory myopathies (IIMs) and metabolic myopathies. IIMs are a heterogeneous group of disorders characterized by symmetric proximal muscle weakness and elevated serum levels of enzymes derived from skeletal muscle. IIMs include polymyositis and dermatomyositis in adults, juvenile dermatomyositis, IIM with an associated malignancy, and inclusion body myositis. Metabolic myopathies are the result of known biochemical defects that alter the ability of muscle to maintain adequate levels of adenosine triphosphate. Eleven different diseases caused by an underlying defect in glycogen synthesis, glycogenolysis, or glycolysis have been identified, including McArdle's disease, phosphofructokinase deficiency, and acid maltase deficiency. Various disorders of fatty acid and mitochondrial metabolism can cause myopathy. Other causes of myopathic symptoms include neuropathic infectious agents, neoplasms, and certain drugs. Tests may be needed to diagnose a patient with myopathic symptoms. Tests that measure serum levels of creatine phosphokinase,
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aldolase, SGOT, SGPT, and LDH may be useful. Electromyography can be used to determine the classification, distribution, and severity of diseases affecting skeletal muscle. Other useful tests include forearm ischemic exercise testing, imaging techniques, and muscle biopsy. Treatment of a myopathic process is dependent on the diagnosis. Glucocorticoids are the standard treatment for the inflammatory myopathies. Other drugs that may be used include methotrexate, azathioprine, cyclosporine, cyclophosphamide, and cholorambucil. 1 table and 16 references.
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 “fatigue” (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 fatigue: •
Anemia-Related Fatigue: Feeling Tired Isn't Always Normal Source: PKR Progress. 15(3): 10. Fall-Winter 2000. Contact: PKD Foundation. 4901 Main Street, Suite 200, Kansas City, MO 64112-2634. (800) 753-2873. E-mail:
[email protected]. Summary: This article from a newsletter for patients with polycystic kidney disease (PKD) explores the problem of anemia related fatigue in patients with kidney diseases. The author notes that since basic treatments are available for PKD, health care providers and researchers are now turning their attention to quality of life medical issues such as anemia. Anemia develops in virtually all patients with renal failure during the course of their disease. Health care providers now know that by intervening earlier in the disease process (in patients with chronic kidney disease who are not yet on dialysis), patients can realize a number of benefits and enhance their overall well being. The kidneys produce about 90 percent of the body's supply of the hormone erythropoietin (EPO); EPO is a major catalyst in the production of red blood cells in the bone marrow, so a reduction in EPO due to kidney disease usually results in fewer red blood cells and insufficient oxygen reaching the body tissues. The author explains the two primary diagnostic tests used to check for anemia, hematocrit (HCT) and hemoglobin. Anemia related fatigue is often described as a total lack of energy or debilitating exhaustion that can last days, weeks, or months. Fatigue can also have mental and emotional effects. The author cautions that because of its gradual onset and insidious nature, fatigue is often overlooked, underrecognized, and undertreated. Readers are encouraged to work with their physicians to address any problems or symptoms of fatigue.
•
Coping With Fatigue Source: Fibromyalgia Aware. p. 58-61. May-August 2002. Contact: Available from National Fibromyalgia Association. 2238 N. Glassell Street, Orange, CA 92865. (714) 921-0150.
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Summary: This newsletter article discusses fatigue in patients with fibromyalgia and medications that may help treat it. Fatigue is a common symptom in fibromyalgia. Fatigue can be related to other symptoms such as disrupted sleep and depression, or medical conditions like thyroid disorder or anemia. In addition to prescribing medication, patient education, exercise, social interaction, and psychological intervention are advised. One of the most encouraging drugs in the treatment of fatigue is modafanil (Provigil). This drug was originally used to alleviate sleepiness in patients with narcolepsy but has had positive results in patients with fibromyalgia and multiple sclerosis. Doctors often prescribe off-label medications (those medications FDA approved for other conditions) because no drugs have been approved by the FDA for fatigue. Doctors need to consider the side effects and benefits of any drug they prescribe. It is important to follow-up with the patient after six weeks on any medication. Side effects for drugs used for fatigue include anxiety, jitters, sleeplessness, headache, nausea, and rapid heart rate. •
Managing Lupus Fatigue Source: Lupus News. 21(1): 5. Spring 2001. Contact: Available from Lupus Foundation of America. 1300 Piccard Drive, Suite 200, Rockville, MD 20850-4303. (800) 558-0121 or (301) 670-9292. Fax (301) 670-9486. Website: www.lupus.org/lupus. Summary: This newsletter article provides people who have lupus with information on managing fatigue. Many people who have a chronic condition such as lupus report that fatigue is one of their most disabling symptoms. Goals for the management of fatigue include resolving the underlying problem, increasing understanding of fatigue, and reducing or alleviating it. Fatigue management strategies may include conducting a self appraisal of fatigue, gaining optimal control of disease activity, reinterpreting symptoms, practicing energy conservation behaviors, and improving sleep and rest behaviors. 2 references.
Academic Periodicals covering Fatigue Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to fatigue. In addition to these sources, you can search for articles covering fatigue that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for fatigue. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI® Advice for the Patient® can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with fatigue. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The
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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to fatigue: Amantadine •
Systemic - U.S. Brands: Symmetrel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202024.html
Hepatitis A Vaccine Inactivated •
Systemic - U.S. Brands: Havrix; Vaqta http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202902.html
Hepatitis B Vaccine Recombinant •
Systemic - U.S. Brands: Engerix-B http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202281.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult™ Mosby’s Drug Consult™ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.
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Researching Orphan Drugs Although the list of orphan drugs is revised on a daily basis, you can quickly research orphan drugs that might be applicable to fatigue by using the database managed by the National Organization for Rare Disorders, Inc. (NORD), at http://www.rarediseases.org/. Scroll down the page, and on the left toolbar, click on “Orphan Drug Designation Database.” On this page (http://www.rarediseases.org/search/noddsearch.html), type “fatigue” (or synonyms) into the search box, and click “Submit Query.” When you receive your results, note that not all of the drugs may be relevant, as some may have been withdrawn from orphan status. Write down or print out the name of each drug and the relevant contact information. From there, visit the Pharmacopeia Web site and type the name of each orphan drug into the search box at http://www.nlm.nih.gov/medlineplus/druginformation.html. You may need to contact the sponsor or NORD for further information. NORD conducts “early access programs for investigational new drugs (IND) under the Food and Drug Administration’s (FDA’s) approval ‘Treatment INDs’ programs which allow for a limited number of individuals to receive investigational drugs before FDA marketing approval.” If the orphan product about which you are seeking information is approved for marketing, information on side effects can be found on the product’s label. If the product is not approved, you may need to contact the sponsor. The following is a list of orphan drugs currently listed in the NORD Orphan Drug Designation Database for fatigue: •
Poly I: poly C12U (trade name: Ampligen) http://www.rarediseases.org/nord/search/nodd_full?code=404
If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute12: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
12
These publications are typically written by one or more of the various NIH Institutes.
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•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:14 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
13
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 14 See http://www.nlm.nih.gov/databases/databases.html.
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•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database
A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “fatigue” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “fatigue” (or synonyms) into the “For these words:” box. The following is a sample result: •
Carnitine in Dialysis Source: in Exceptional Parent. End Stage Renal Disease: A Practical Guide for Physicians, Dietitians, Nurses, Patients, Families, and Caregivers. Englewood Cliffs, NJ: Exceptional Parent. 1999. p. 18-19. Contact: Available from Exceptional Parent. P.O. Box 1807, Englewood Cliffs, NJ 07632. (800) 535-1910. Fax (201) 947-9376. E-mail:
[email protected]. Website: www.eparent.com. PRICE: $5.95. Summary: Carnitine is a substance necessary for production of energy. It occurs naturally in foods (meat and dairy products) and also is produced by the body. In certain illnesses, the normal dietary intake of carnitine may not be enough. This article is from a monograph written to soften the blow of receiving the diagnosis of kidney failure by providing patients, caregivers, and their families some practical, easy to read information. The articles are written to be practical enough for patients to use, yet informative enough that professionals can refer to them as well. This article considers the use of carnitine supplementation for patients on dialysis therapy for chronic kidney failure. A person with impaired energy production is easily fatigued, weak, and has poor endurance. The author reports on studies of patients on dialysis who were treated with carnitine supplementation, noting that the results have been mixed. Some researchers report improvement in both muscle structure and function with carnitine supplementation; other studies did not find any significant improvement. The author concludes that carnitine is not necessary for all dialysis patients, but may be of some use for certain conditions, such as muscle weakness and fatigue; weakness of the heart muscle; anemia that does not respond to erythropoietin; and severe muscle cramps or low blood pressure experienced during dialysis sessions. Before initiating carnitine supplementation, however, these problems should be thoroughly investigated by a physician, and other more common and well understood treatments should be tried. 1 figure.
•
Testimony on Acupuncture As A Treatment for AIDS. Testimony Presented to the New York City Council by Michael O. Smith, M.D., May 13, 1988 Contact: Lincoln Hospital, 349 E 140th St, Bronx, NY, 10454, (212) 579-5000.
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Summary: The use of acupuncture to relieve HIV-related symptoms (night sweats, fatigue, diarrhea, and acute skin reactions) and as a detoxifying and stress-relieving procedure is described. On the theory that acupuncture enhances the immune system, it is claimed that Acquired immunodeficiency syndrome (AIDS) patients treated during early stages of Kaposi's sarcoma were symptom-free 3 years later and that acupuncture used on substance abusers reduced their craving and relieved stress. •
Importance of Exercise in End Stage Renal Disease Source: in Exceptional Parent. End Stage Renal Disease: A Practical Guide for Physicians, Dietitians, Nurses, Patients, Families, and Caregivers. Englewood Cliffs, NJ: Exceptional Parent. 1999. p. 20-22. Contact: Available from Exceptional Parent. P.O. Box 1807, Englewood Cliffs, NJ 07632. (800) 535-1910. Fax (201) 947-9376. E-mail:
[email protected]. Website: www.eparent.com. PRICE: $5.95. Summary: This article on the importance of exercise in end stage renal disease (ESRD) is from a monograph written to soften the blow of receiving the diagnosis of kidney failure by providing patients, caregivers, and their families some practical, easy to read information. The articles are written to be practical enough for patients to use, yet informative enough that professionals can refer to them as well. This article first describes the consequences of inactivity, then reviews special considerations and the role of exercise in ESRD. The author notes that most of the research conducted on exercise and patients with ESRD were conducted before the use of erythropoietin (EPO) became common. Now that patients have a good treatment for anemia (and its associated fatigue), exercise is a more appropriate and likely option. The article concludes with a brief description of how patient care team members can encourage and otherwise support the patient's exercise efforts. One sidebar reviews the components of an effective exercise program, including cardiopulmonary fitness, strength training, and flexibility; each component is described and recommendations for duration and frequency are provided.
•
Tuberculosis Awareness Contact: Coastal Training Technologies Corporation, 500 Studio Dr, Virgina Beach, VA, 23542, (800) 725-3418, http://www.coastal.com. Summary: This brochure for employees and employers provides general information about tuberculosis (TB). TB is an infection/disease that has been on the rise since 1985. TB spreads through the air when a person infected with TB coughs, speaks, sings, sneezes, or spits. It usually takes multiple exposures to someone with TB for the infection to occur. There are two forms of TB: active TB and TB infection. Persons with TB infection have TB bacilii in their bodies, but are not contagious and exhibit no symptoms. Preventive therapy can help keep persons with TB infection from developing active TB. Active TB may develop when the immune system is weakened, in times of high stress, or from poor nutrition, substance abuse, or sickness. The symptoms of the active, contagious form of TB are coughing, fever, fatigue, night sweats, and weight loss. TB can be detected by a physician or a clinic using the Mantoux PPD skin test. Persons diagnosed with active TB should adhere to their prescribed medical regimens to prevent the development of the multidrug-resistant TB (MDRTB), which is harder to treat. High-risk groups include immunocompromised persons, persons in depressed socio-economic conditions, foreign-born persons from countries with high TB rates, anyone living with someone who has active TB, or anyone in regular contact with a
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member of the high-risk groups. Immunocompromised persons, such as those with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), are most vulnerable to TB as their immune systems cannot effectively fight the infection. MDRTB poses a particular threat to immunocompromised persons because they may succumb to the disease before effective medication is found. At the end of this brochure there is a quiz that tests the readers' knowledge of TB. •
Positive Eating: Taking Control Contact: Commonwealth Department of Health, Housing &, Community Services, AIDS Education Group, GPO Box 9848, Canberra. Summary: This manual addresses the nutritional problems of HIV-positive people. It describes the nutritional effects of HIV infection, principles of a healthy lifestyle and good nutrition, and advice on symptom control. It discusses the importance of food and nutrition to HIV-positive individuals, modifying accepted dietary guidelines, planning food preparation and avoiding food poisoning, looking after the mouth and teeth, multivitamin, mineral, and nutritional supplements, and the effects of recreational drug use. The guide offers suggestions for treating fever, taste changes, weight loss with and without fat intolerance, anorexia, chewing difficulties or painful mouth, nausea, diarrhea, and fatigue associated with HIV infection. It lists organizations that provide HIV/AIDS information, education or treatment.
•
Positive Eating, Continuing Care: A Guide to Nutrition and HIV for Health Care Providers Contact: Commonwealth Department of Health, Housing and, Community Services, AIDS Policy and Programs Branch, GPO Box 9848, Canberra. Summary: This monograph provides information on nutrition and HIV for health care providers. It discusses the nutritional effects of HIV infection, focusing on wasting, changes in body composition, and drug-nutrient interactions. A section on managing nutrition in HIV infection covers the following topics: basic nutrition information, monitoring nutritional status, excluding treatable conditions, oral health, recreational drug use, multi-vitamin and mineral supplements, regular exercise, pediatric HIV infection, avoiding food poisoning, alternative nutritional therapies, and nutritional supplements. Advice is given for symptom control for fever, taste changes, weight loss, weight loss with fat intolerance, poor appetite (anorexia), nausea, diarrhea, fatigue, and chewing difficulties or painful mouth. An appendix presents nutrition and HIV guidelines for Australia, to provide guidance on nutritional intervention in HIV infection for HIV-positive adults and children.
•
Adult T-Cell Leukemia Associated With Human T-Lymphotropic Virus Type I (HTLV-I) Infection - North Carolina Source: Morbidity and Mortality Weekly Report; Vol. 36, no. 49. Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Massachusetts Medical Society, Medical Publishing Group, CSPO Box 9121, Waltham, MA, 02254, (800) 843-6356. Summary: This report contains epidemiologic notes and reports related to adult T-Cell Leukemia/Lymphoma associated with Human T-cell lymphotropic virus type I (HTLV I) infection in North Carolina. The article focuses on a patient who developed jaundice
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in December 1986 after several weeks of anorexia, fatigue, and fever. The patient's history throughout hospitalization is then reported. •
AIDS - Related Cryptococcal Meningitis Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Allergy and Infectious Diseases, 31 Center Dr MSC 2520, Bethesda, MD, 20892-2520, (301) 496-5717, http://www.niaid.nih.gov. Summary: This report describes cryptococcal meningitis that is related to Acquired immunodeficiency syndrome (AIDS). It says that cryptococcal disease accounts for 5-8 percent of all opportunistic infections, and that it is caused by cryptococcus neoformans, a yeastlike fungus found in soil contaminated with bird excrement. Exposure is quite common, but it only manifests as a disease in those individuals with compromised immune systems. The fungus may infect numerous organs, particularly the skin, lungs, and meninges. As meningitis, it has the following symptoms: Fever, headache, fatigue, nausea, and vomiting. It may also cause changes in behavior or personality, memory loss or confusion, and difficulty with coordination. Unless maintenance therapy continues, the relapse rate after initial treatment is 50-90 percent. Standard treatment consists of Amphotericin B intravenously for 10 weeks, possibly combined with oral flucytosine. Side effects may include kidney damage, high fever, severe chills, low blood pressure, a decrease in potassium levels, and depressed levels of red and white blood cells, and platelets. Another drug called fluconazole was recently approved for oral or intravenous use, and one called SCH 39304 is under study. At present, the National Institute of Allergy and Infectious Diseases (NIAID) has four meningitis clinical trials underway.
•
Philanthropy and AIDS: Assessing the Past, Shaping the Future: A Report on a Funders Concerned About AIDS (FCAA)/Gallup Survey Contact: Funders Concerned About AIDS, 50 E 42nd St 19th Fl, New York, NY, 10017, (212) 573-5533. CDC National Prevention Information Network, PO Box 6003, Rockville, MD, 20849-6003, (800) 458-5231, http://cdcnpin.org. Summary: This report summarizes key findings from a national Gallup survey of grantmakers active or interested in the human immunodeficiency virus, which was commissioned by the Funders Concerned About AIDS (FCAA), along with the results of other primary and secondary research commissioned by FCAA. Key findings that have resulted from these research efforts follow: (1) The FCAA Gallup survey revealed the existence of a relatively small group of funders who have provided a significant portion of the philanthropic response to HIV/AIDS in the United States. Twenty-seven percent of HIV/AIDS grantmakers surveyed made grants totaling $50,000 or more in their most current fiscal year. They are described in the report as the 'core group,' and the characteristics they possess are described. (2) The philanthropic response in this core group is weakening. (3) The number of all funders committed to HIV/AIDS grantmaking is declining. (4) There continues to be a significant sense of urgency in the philanthropic community regarding HIV/AIDS, yet this urgency does not always translate into increased support. (5) The FCAA Gallup survey was not able to elicit a single explanation for the current trend in HIV/AIDS funding, but instead suggested many related and sometimes contradictory contributing factors. (6) There is a great sense of urgency regarding the international HIV/AIDS pandemic, yet few grantmakers are funding in this arena. The authors conclude that a combination of modest domestic progress in addressing the epidemic, general 'AIDS fatigue,' the growing endemic
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nature of the problem, and the sheer explosion of the crisis globally are all contributing to a diminution in the philanthropic response to HIV/AIDS. •
Changing Issues in the Management of HIV Infection: Chronic Therapy of Early HIV Infection Contact: World Health Communications Incorporated, 41 Madison Ave 40th Fl, New York, NY, 10010, (212) 679-6200, http://www.whci.com. British Overseas Development Administration, 94 Victoria St, London. Summary: This report summarizes the discussion of a panel of physicians, nurses, and healthcare professionals involved in clinical studies of azidothymidine (AZT), also known as retrovir. The report opens with a section looking at the effectiveness of therapy with AZT. Side effects, including anemia, myopathy, lymphoma, headache, nausea, and fatigue are studied in the second section. The final two sections look at maintaining patients on continued therapy and tracking clinical and other information during therapy.
•
AIDS : Palliative Care: UNAIDS Technical Update Contact: World Health Organization, Joint United Nations Programme on HIV/AIDS, 20 Avenue Appia, CH-1211 Geneva, http://www.unaids.org. Summary: This report, for health professionals, governmental agencies, and international organizations, discusses palliative care for individuals with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). Palliative care is a combination of therapies with the aim of achieving the best quality of life for patients (and their families) suffering from life-threatening and ultimately incurable illnesses. This report describes the following symptoms for people with HIV/AIDS: (1) pain; (2) diarrhea and constipation; (3) nausea, vomiting, anorexia, and weight loss; (4) cough and shortness of breath; (5) malaise, weakness, and fatigue; (6) fever, (7) skin problems; and (8) brain impairment. Psychological support through voluntary testing and counseling, spirituality, preparation for death, challenges HIV/AIDS poses to palliative care, and ways to overcome these challenges are discussed. These challenges include perceptions and recognition of palliative care; organizing palliative care training and; providing quality palliative care services. The report discusses current projects initiatives in Zambia, Uganda, the United Kingdom, Cambodia, and India.
The NLM Gateway15 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “fatigue” (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.
15 16
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).
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Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 29651 721 1047 388 21 31828
HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.19 Simply search by “fatigue” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
Coffee Break: Tutorials for Biologists20 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.21 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
17
Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.
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The HSTAT URL is http://hstat.nlm.nih.gov/.
19
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. 20 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 21 The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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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/.
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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 fatigue 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 fatigue. 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 fatigue. 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 “fatigue”:
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•
Other guides Alzheimer's Disease http://www.nlm.nih.gov/medlineplus/alzheimersdisease.html Chickenpox http://www.nlm.nih.gov/medlineplus/chickenpox.html Child Day Care http://www.nlm.nih.gov/medlineplus/childdaycare.html Chronic Fatigue Syndrome http://www.nlm.nih.gov/medlineplus/chronicfatiguesyndrome.html Fibromyalgia http://www.nlm.nih.gov/medlineplus/fibromyalgia.html Gastroenteritis http://www.nlm.nih.gov/medlineplus/gastroenteritis.html Head and Neck Cancer http://www.nlm.nih.gov/medlineplus/headandneckcancer.html Lupus http://www.nlm.nih.gov/medlineplus/lupus.html Metabolic Disorders http://www.nlm.nih.gov/medlineplus/metabolicdisorders.html Multiple Sclerosis http://www.nlm.nih.gov/medlineplus/multiplesclerosis.html Sleep Disorders http://www.nlm.nih.gov/medlineplus/sleepdisorders.html
Within the health topic page dedicated to fatigue, the following was listed: •
General/Overviews CFS Information Source: National Center for Infectious Diseases http://www.cdc.gov/ncidod/diseases/cfs/info.htm
•
Diagnosis/Symptoms Brief Explanation of How CFS Patients are Evaluated by a Physician Source: National Center for Infectious Diseases http://www.cdc.gov/ncidod/diseases/cfs/defined/defined4.htm
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Treatment Steroid Medication No Help to CFS Patients Who Get that Faint Feeling Source: National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/newsroom/releases/cfsnmh.htm
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Coping Chronic Fatigue Syndrome: Support Groups Source: Centers for Disease Control and Prevention http://www.cdc.gov/ncidod/diseases/cfs/support/index.htm
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Specific Conditions/Aspects What's in a Name: Fibromyalgia Versus Chronic Fatigue Syndrome (CFS) Source: Arthritis Foundation http://www.arthritis.org/resources/news/news_fibro_cfs.asp
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Organizations National Center for Infectious Diseases http://www.cdc.gov/ncidod/index.htm National Institute of Allergy and Infectious Diseases http://www.niaid.nih.gov/
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Research Chronic Fatigue Research: Challenges and Opportunities Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/hi/topics/fatigue/fatigue.htm
•
Statistics Demographics Source: Centers for Disease Control and Prevention http://www.cdc.gov/ncidod/diseases/cfs/demographics.htm
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on fatigue. 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: •
FMS/CFS (Fibromyalgia Syndrome/Chronic Fatigue Syndrome) in Young People Information Packet: A Guide for Parents Source: Tucson, AZ: Fibromyalgia Network. 1994. 41 p.
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Contact: Available from Fibromyalgia Network. P.O. Box 31750, Tucson, AZ 85751-1750. (800) 853-2929 or (520) 290-5508. Fax (520) 290-5550. Website: www.fmnetnews.com. PRICE: Single copy free. Summary: This booklet provides children who have fibromyalgia syndrome (FMS)/chronic fatigue syndrome (CFS), their parents, and their caregivers with basic information on FMS/CFS and suggests ways of managing these syndromes. The booklet begins with a section on understanding FMS/CFS. Topics include the symptoms and diagnosis of FMS/CFS, FMS and CFS diagnostic criteria, difficulties in diagnosing children, the need for a diagnosis, and signs that prompt parents to seek a diagnosis. The booklet then focuses on treatment issues. The treatment of FMS/CFS begins by helping family members understand the diagnosis and be aware of what the symptoms entail. Possible therapies that may help minimize symptoms include rest, relaxation therapy, physical therapy, digestive aids, and medications for improving sleep. Managing the illness involves helping a child find new pastimes that can be enjoyed despite limits on activity, knowing when to protect a child and knowing when to stand back, encouraging visits from friends, involving the family, and participating in a child or partner self help group. In addition, the booklet addresses the issue of education. Topics include testing for special education purposes, scheduling, giving students who have FMS/CFS special classroom considerations, maintaining student involvement with the school, tutoring a child, keeping school records, communicating with the school, and getting outside help. 3 appendices. •
Getting the Most Out of Your Medicines: A Guide for Patients With FMS/CFS (Fibromyalgia Syndrome/Chronic Fatigue Syndrome) Source: Tucson, AZ: Fibromyalgia Network. 2000. 82 p. Contact: Available from Fibromyalgia Network. P.O. Box 31750, Tucson, AZ 85751-1750. (800) 853-2929 or (520) 290-5508. Fax (520) 290-5550. Website: www.fmnetnews.com. PRICE: $10.00. Summary: This booklet provides people who have fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS) with information on medications used to improve sleep, reduce pain, and minimize fatigue. The booklet explains the role of the central nervous system in controlling pain, sleep, and neuroendocrine/stress functions. This is followed by a discussion of the mechanism of action, dosage, and side effects of various drugs, including tricyclic antidepressants, benzodiazepines, muscle relaxants, sleeping aids, selective serotonin reuptake inhibitors, mild stimulants and neuromodulating drugs, nonsteroidal anti-inflammatory drugs, immune system modulators, calcium and sodium channel blockers, pain relievers, and antiyeast regimens. Other treatment modalities discussed include combination therapies, trigger point injections, and nutritive supplements. In addition, the booklet describes common associated syndromes and their treatment, including temporomandibular dysfunction syndrome, chronic headaches, irritable bowel and bladder syndromes, and dysautonomia. The booklet concludes with information on medicines for the future. A list of additional information resources is included. 6 figures, 4 tables, and 82 references.
•
Managing Your Fatigue Source: Atlanta, GA: Arthritis Foundation. 1998. 16 p. Contact: Available from Arthritis Foundation. P.O. Box 1616, Alpharetta, GA 300091616. (800) 207-8633. Fax (Credit card orders only) (770) 442-9742. http://www.arthritis.org. PRICE: Single copy free from local Arthritis Foundation
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chapter (Call 800-283-7800 for closest local chapter); bulk orders may be purchased from address above. Summary: This brochure for people with arthritis and related conditions uses a question and answer format to provide information on fatigue and how to manage it. Fatigue is a frequent symptom of many types of arthritis and other rheumatic diseases. The brochure identifies the physical, emotional, and environmental causes of fatigue. It offers suggestions for managing it, among them balancing rest and activity, getting enough sleep, exercising, following an arthritis treatment plan, and using a fatigue chart. The brochure also provides information on the Arthritis Foundation and its services. 1 chart and 1 figure. •
Everything You Wanted to Know About HIV-Related Fatigue But Were Afraid to Ask Contact: Ortho Pharmaceutical Corporation, Biotech Division, PO Box 300, Raritan, NJ, 08869-0602, (908) 218-7010. Summary: This brochure provides information to persons with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) about the causes of and the treatments available for HIV-related fatigue. The brochure describes fatigue, its symptoms, and its commonality among persons with HIV/AIDS. It identifies a number of causes for fatigue such as improper rest and diet, one's psychological state, alcohol, tobacco, substance abuse, infections, endocrine abnormalities, and anemia. It also explains fatigue as a side effect of anti-HIV medications. The brochure explains how these therapeutic drugs inhibit the production of red blood cells and may cause their weakness or destruction. To curb the effects of fatigue, or to eliminate it altogether, the brochure recommends a healthy diet, exercise, sleep, and medical treatments. The medical treatments are summarized and include hormonal/steroid therapy, stimulants, therapies to cure infections, blood transfusions, therapeutic drugs such as Procrit, and complementary/non-pharmaceutical therapies.
•
HIV Treatment, Fatigue, and Anemia : What's the Connection? Contact: Ortho Pharmaceutical Corporation, Biotech Division, PO Box 300, Raritan, NJ, 08869-0602, (908) 218-7010. Summary: This fact sheet explains human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS)-related fatigue and anemia, and how the therapeutic drug, Procrit, assists in relieving these conditions. The fact sheet discusses that one of the side effects of the drug AZT is that it reduces the production of red blood cells; thereby depriving the body of oxygen leading to fatigue and anemia. It states that Procrit helps to keep AZT from suppressing the production of red blood cells in the bone marrow, and that adverse reactions are mainly found to be disease-related rather than a side effect of Procrit itself.
•
Lupus Guide Patient Information Handouts: Preventing Fatigue Due to Lupus Source: Bethesda, MD: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1998. 1 p. Contact: Available from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1 AMS Circle, Bethesda, MD 20892-3675. (877) 226-4267 or (301) 495-4484. Fax (301) 718-6366. TTY (301) 565-2966. E-mail:
[email protected]. Website: www.niams.nih.gov. PRICE: Available only as part of
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a package of patient information sheets; single copy of package free. Order Number: AR-205. Summary: This fact sheet provides people who have systemic lupus erythematosus (SLE) and the patient care team with information about preventing fatigue due to lupus. Fatigue is a very common problem for people with SLE and is so extreme that it may interfere with many aspects of daily life. Health professionals may ask patients about their lifestyle and patterns of daily living so that they can advise patients about how to reduce their fatigue. People who have lupus need to remember that they need to get enough rest, maintain physical fitness, and keep stress under control. The fact sheet offers self-care tips and provides space for making additional notes. •
Fatigue, Stress, Responsibility Source: Portland, OR: Vestibular Disorders Association (VEDA). 199x. 4 p. Contact: Available from Vestibular Disorders Association (VEDA). P.O. Box 4467, Portland, OR 97208-4467. (503) 229-7705. Fax (503) 229-8064. E-mail:
[email protected]. Website: www.vestibular.org. PRICE: $0.50 plus shipping and handling. Order number S-1. Summary: This fact sheet provides readers who have vestibular disorders with suggestions for coping with fatigue, stress, and responsibility. Information on fatigue includes fatigue that can accompany any chronic illness; learning to recognize early indicators of fatigue; and factors that contribute to fatigue, including stress, pain, and guilt. The fact sheet discusses setting priorities and developing healthy nutrition and exercise patterns. The fact sheet then describes steps to master stress, including recognizing the symptoms of stress, identifying the sources of stress, and taking action. The fact sheet is written by patients, for patients, and focuses on practical suggestions that can be implemented on a variety of levels.
•
Fatigue Contact: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center, Beth Israel Hospital, 330 Brookline Ave Libby Bldg 317, Boston, MA, 02215, (617) 667-5520, http://www.natip.org. Summary: This fact sheet, for individuals with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), discusses fatigue. Fatigue is common in persons with HIV/AIDS and can be long lasting or brief, causing HIVpositive individuals to be unable to perform usual activities because of a lack of muscle strength. Medical, psychiatric, or lifestyle factors and side effects from medicines can cause fatigue. Medical causes of fatigue include viral illnesses and opportunistic diseases. Psychiatric causes of fatigue include depression and anxiety disorders. Some of the lifestyle-related causes of fatigue include overwork, insufficient sleep, excessive or inadequate exercise, poor dietary habits, and substance abuse. Drugs that may cause side effects include efavirenz, interferon, central nervous system medications, and betablocker drugs. Fatigue is evaluated through a physical examination, medical history, and laboratory testing. Fatigue is managed by identifying and addressing its underlying causes. A table is provided that identifies the common causes of fatigue in HIV-positive individuals.
•
Chronic Fatigue Syndrome: How To Help Yourself Source: American Family Physician. 65(6): 1095. March 15, 2002.
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Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237 or (913) 906-6000. E-mail:
[email protected]. Website: www.aafp.org. Summary: This journal article uses a question and answer format to provide people who have chronic fatigue syndrome (CFS) with information on ways to feel better. Although the cause of CFS is unknown, the symptoms may be the result of an improperly functioning immune system or a virus. Steps that people who have CFS can take to improve their health include exercising within their limits, eating a well balanced diet that is low in fat but high in fiber and complex carbohydrates, going to bed and getting up at the same time every day, reducing stress, and obtaining information about CFS. The article includes good Internet sources for information and support. •
Dimensions of Caring: Understanding and Overcoming Fatigue Contact: Ortho Pharmaceutical Corporation, Ortho Biotech, Claims Office, 1250 Bayhill Dr, San Bruno, CA, 94066, (800) 553-3851. Summary: This package provides a support program for persons with cancer who are experiencing fatigue. A number of men and women discuss their various feelings of fatigue and how their daily lifestyles have changed since they began chemotherapy treatments. The package explains that symptoms resulting from chemotherapy may include weakness in the legs, inability to concentrate, psychological weakness, or depression. The package urges persons with cancer to pay attention the way they feel emotionally and physically, and to communicate frequently with their doctor or nurse. The importance of support groups is stressed. The video addresses the significance of blood cell counts in terms of a person's response to treatment. The video also reminds persons with cancer that their doctor can take measures to help them feel less fatigued. A resource catalog includes listings of organizations that serve the medical, emotional, and cosmetic needs of persons with cancer. The National Guideline Clearinghouse™
The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “fatigue” (or synonyms). The following was recently posted: •
VHA/DoD clinical practice guideline for the management of medically unexplained symptoms: chronic pain and fatigue Source: Department of Defense - Federal Government Agency [U.S.]; 2002 August; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3415&nbr=2641&a mp;string=fatigue Healthfinder™
Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database:
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•
Chronic Fatigue Syndrome Summary: This fact sheet on chronic fatigue syndrome describes the illness and its causes, symptoms, diagnosis, and management. Source: National Institute of Allergy and Infectious Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=240
•
Chronic Fatigue Syndrome (CFS) Home Page - Centers for Disease Control and Prevention (CDC) Summary: The cause of Chronic Fatigue Syndrome (CFS) has not been identified, but there are several theories. Source: National Center for Infectious Diseases, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=1385
•
Chronic Fatigue Syndrome: Clinical Aspects and Demographics Summary: General information about CFS -- a description, its causes and prognosis, treatment options, disease management and more. Source: National Center for Infectious Diseases, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2354
•
Drowsy Driving and Automobile Crashes Summary: This report presents results of a literature review and opinions of the Expert Panel on Driver Fatigue and Sleepiness regarding key issues involved in the problem. Source: National Center on Sleep Disorders Research, National Heart, Lung, and Blood Institute http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2923
•
Glossary of Medical and Scientific Terms Related to Chronic Fatigue Syndrome Summary: An online glossary of scientific and medical terms associated with CFS and related disorders. Source: National Center for Infectious Diseases, Centers for Disease Control and Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=2137
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Hemochromatosis Summary: This fact sheet presents a general overview on Hemochromatosis -- a hereditary disease with symptoms that include fatigue, abdominal pain, jaundice (yellowing of skin and eyes), and a change in skin Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=994
•
Managing Daily Life When Coping With Chronic Fatigue Syndrome Summary: Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) or Chronic Fatigue Syndrome (CFS), is characterized by fatigue, pain, and cognitive disturbances. Source: American Occupational Therapy Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7313
•
Providing Medical Evidence To The Social Security Administration For Individuals With Chronic Fatigue Syndrome: A Guide For Health Professionals Summary: When an individual with Chronic Fatigue Syndrome (CFS), also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), applies for Social Security disability benefits, we must decide whether Source: Social Security Administration http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=740
•
What to Expect During Your EMG Test Summary: This fact sheet provides an overview of EMG (electromyography) testing and explains its usefulness in evaluating the causes of numbness, tingling, pain, weakness, fatigue, and muscle cramping. Source: American Association of Electrodiagnostic Medicine http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=4849
•
Young Persons With CFIDS (YPWCs) Website Summary: This site presents information, research & encouragement for young persons with Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) and related disorders. Source: CFIDS Association of America http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5047 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
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in some way to fatigue. 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/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMD®Health: http://my.webmd.com/health_topics
Associations and Fatigue The following is a list of associations that provide information on and resources relating to fatigue: •
National Chronic Fatigue Syndrome and Fibromyalgia Association Telephone: (816) 313-2000 Fax: (816) 524-6782 Email:
[email protected] Web Site: www.ncfsfa.org Background: The National Chronic Fatigue Syndrome and Fibromyalgia Association is a voluntary health organization that was incorporated in 1988. The Association was formed to educate and inform the public about the nature and impact of Chronic Fatigue Syndrome and related disorders. In 1993, Fibromyalgia was added to the organization's educational efforts. The primary focus of The National Chronic Fatigue Syndrome and Fibromyalgia Association is to offer scientifically accurate information to people with Chronic Fatigue Syndrome and Fibromyalgia. Brochures, booklets, and videos are available from the organization. A periodic newsletter and fact sheet are also produced and distributed by the organization.
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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to fatigue. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with fatigue. 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 fatigue. 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 “fatigue” (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 “fatigue”. 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 “fatigue” (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 “fatigue” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.23
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
23
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)24: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
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Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
24
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
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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
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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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/
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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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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
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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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
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on fatigue: •
Basic Guidelines for Fatigue Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm
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Signs & Symptoms for Fatigue Anemia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000560.htm Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm
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Erythema Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Fatigue Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Insomnia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Lethargy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Malaise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Obesity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003101.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Tiredness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm •
Diagnostics and Tests for Fatigue Blood differential Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm Thyroid function tests Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003444.htm Urinalysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003579.htm
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Nutrition for Fatigue Balanced diet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002449.htm Vitamins Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002399.htm
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Background Topics for Fatigue Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Malignancy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002253.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Relieved by Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002288.htm Stimulants Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002308.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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FATIGUE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 3-dimensional: 3-D. A graphic display of depth, width, and height. Three-dimensional radiation therapy uses computers to create a 3-dimensional picture of the tumor. This allows doctors to give the highest possible dose of radiation to the tumor, while sparing the normal tissue as much as possible. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Ablation: The removal of an organ by surgery. [NIH] Abrasion: 1. The wearing away of a substance or structure (such as the skin or the teeth) through some unusual or abnormal mechanical process. 2. An area of body surface denuded of skin or mucous membrane by some unusual or abnormal mechanical process. [EU] Absenteeism: Chronic absence from work or other duty. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acclimation: Adaptation of animals or plants to new climate. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetone: A colorless liquid used as a solvent and an antiseptic. It is one of the ketone bodies produced during ketoacidosis. [NIH] Acetylcarnitine: An acetic acid ester of carnitine that facilitates movement of acetyl CoA into the matrices of mammalian mitochondria during the oxidation of fatty acids. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylcysteine: The N-acetyl derivative of cysteine. It is used as a mucolytic agent to reduce the viscosity of mucous secretions. It has also been shown to have antiviral effects in patients with HIV due to inhibition of viral stimulation by reactive oxygen intermediates. [NIH] Acetylgalactosamine: The N-acetyl derivative of galactosamine. [NIH] Acetylglucosamine: The N-acetyl derivative of glucosamine. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Acrylonitrile: A highly poisonous compound used widely in the manufacture of plastics, adhesives and synthetic rubber. [NIH] Actin: Essential component of the cell skeleton. [NIH]
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Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Activity Cycles: Bouts of physical irritability or movement alternating with periods of quiescence. It includes biochemical activity and hormonal activity which may be cellular. These cycles are shorter than 24 hours and include sleep-wakefulness cycles and the periodic activation of the digestive system. [NIH] Acuity: Clarity or clearness, especially of the vision. [EU] Acute Disease: Disease having a short and relatively severe course. [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] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the
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nervous system. [NIH] 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 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] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Obstruction: Any hindrance to the passage of air into and out of the lungs. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alternative nutrition: One of two or more host species that may form the food base for a parasite but is not essential for the completion of the latter's life history. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH]
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Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. [NIH] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anaplastic: A term used to describe cancer cells that divide rapidly and bear little or no resemblance to normal cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH]
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Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [NIH]
Anode: Electrode held at a positive potential with respect to a cathode. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble
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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] Antihypertensive: An agent that reduces high blood pressure. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] 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] Antimony: A metallic element that has the atomic symbol Sb, atomic number 51, and atomic weight 121.75. It is used as a metal alloy and as medicinal and poisonous salts. It is toxic and an irritant to the skin and the mucous membranes. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipruritic: Relieving or preventing itching. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apnoea: Cessation of breathing. [EU] Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Approximate: Approximal [EU]
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Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatic: Having a spicy odour. [EU] Arrhythmia: Any variation from the normal rhythm or rate of the heart beat. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Aseptic: Free from infection or septic material; sterile. [EU] Aspartate: A synthetic amino acid. [NIH] Aspartic: The naturally occurring substance is L-aspartic acid. One of the acidic-amino-acids is obtained by the hydrolysis of proteins. [NIH] Aspartic Acid: One of the non-essential amino acids commonly occurring in the L-form. It is found in animals and plants, especially in sugar cane and sugar beets. It may be a neurotransmitter. [NIH] Asthenia: Clinical sign or symptom manifested as debility, or lack or loss of strength and energy. [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] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atopic: Pertaining to an atopen or to atopy; allergic. [EU] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition,
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or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [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] Auditory Fatigue: Loss of sensitivity to sounds as a result of auditory stimulation, manifesting as a temporary shift in auditory threshold. The temporary threshold shift, TTS, is expressed in decibels. [NIH] Aural: Pertaining to or perceived by the ear, as an aural stimulus. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] 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] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Barbiturate: A drug with sedative and hypnotic effects. Barbiturates have been used as sedatives and anesthetics, and they have been used to treat the convulsions associated with epilepsy. [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] Baroreflex: A negative feedback system which buffers short-term changes in blood pressure. Increased pressure stretches blood vessels which activates pressoreceptors (baroreceptors) in the vessel walls. The net response of the central nervous system is a reduction of central sympathetic outflow. This reduces blood pressure both by decreasing peripheral vascular resistance and by lowering cardiac output. Because the baroreceptors are tonically active, the baroreflex can compensate rapidly for both increases and decreases in blood pressure. [NIH]
Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located
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in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Beta Rays: A stream of positive or negative electrons ejected with high energy from a disintegrating atomic nucleus; most biomedically used isotopes emit negative particles (electrons or negatrons, rather than positrons). Cathode rays are low-energy negative electrons produced in cathode ray tubes, also called television tubes or oscilloscopes. [NIH] Bewilderment: Impairment or loss of will power. [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] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biodegradation: The series of processes by which living organisms degrade pollutant chemicals, organic wastes, pesticides, and implantable materials. [NIH]
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Biogenesis: The origin of life. It includes studies of the potential basis for life in organic compounds but excludes studies of the development of altered forms of life through mutation and natural selection, which is evolution. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biomechanics: The study of the application of mechanical laws and the action of forces to living structures. [NIH] Biomedical Engineering: Application of principles and practices of engineering science to biomedical research and health care. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] 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] Bismuth: A metallic element that has the atomic symbol Bi, atomic number 83 and atomic weight 208.98. [NIH] Bladder: The organ that stores urine. [NIH] Blister: Visible accumulations of fluid within or beneath the epidermis. [NIH] Blister pack: A package consisting of a clear plastic overlay affixed to a cardboard backing for protecting and displaying a product. [EU] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Coagulation Factors: Endogenous substances, usually proteins, that are involved in the blood coagulation process. [NIH] Blood Flow Velocity: A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. [NIH] Blood Glucose: Glucose in blood. [NIH]
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Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood Proteins: Proteins that are present in blood serum, including serum albumin, blood coagulation factors, and many other types of proteins. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Remodeling: The continuous turnover of bone matrix and mineral that involves first, an increase in resorption (osteoclastic activity) and later, reactive bone formation (osteoblastic activity). The process of bone remodeling takes place in the adult skeleton at discrete foci. The process ensures the mechanical integrity of the skeleton throughout life and plays an important role in calcium homeostasis. An imbalance in the regulation of bone remodeling's two contrasting events, bone resorption and bone formation, results in many of the metabolic bone diseases, such as osteoporosis. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Boron: A trace element with the atomic symbol B, atomic number 5, and atomic weight 10.81. Boron-10, an isotope of boron, is used as a neutron absorber in boron neutron capture therapy. [NIH] Boron Neutron Capture Therapy: A technique for the treatment of neoplasms, especially gliomas and melanomas in which boron-10, an isotope, is introduced into the target cells followed by irradiation with thermal neutrons. [NIH] Bottle Feeding: Use of nursing bottles for feeding. Applies to humans and animals. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH]
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Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Brain metastases: Cancer that has spread from the original (primary) tumor to the brain. [NIH]
Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Breast Feeding: The nursing of an infant at the mother's breast. [NIH] Bromocriptine: A semisynthetic ergot alkaloid that is a dopamine D2 agonist. It suppresses prolactin secretion and is used to treat amenorrhea, galactorrhea, and female infertility, and has been proposed for Parkinson disease. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Buffers: A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. [NIH]
Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Channels: Voltage-dependent cell membrane glycoproteins selectively permeable to calcium ions. They are categorized as L-, T-, N-, P-, Q-, and R-types based on the activation and inactivation kinetics, ion specificity, and sensitivity to drugs and toxins. The L- and T-types are present throughout the cardiovascular and central nervous systems and the N-, P-, Q-, & R-types are located in neuronal tissue. [NIH] Camptothecin: An alkaloid isolated from the stem wood of the Chinese tree, Camptotheca acuminata. This compound selectively inhibits the nuclear enzyme DNA topoisomerase. Several semisynthetic analogs of camptothecin have demonstrated antitumor activity. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a
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systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboplatin: An organoplatinum compound that possesses antineoplastic activity. [NIH] Carboxy: Cannabinoid. [NIH] Carboxylic Acids: Organic compounds containing the carboxy group (-COOH). This group of compounds includes amino acids and fatty acids. Carboxylic acids can be saturated, unsaturated, or aromatic. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardioselective: Having greater activity on heart tissue than on other tissue. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual
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patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Causal: Pertaining to a cause; directed against a cause. [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 Count: A count of the number of cells of a specific kind, usually measured per unit volume of sample. [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 Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [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] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cell Transplantation: Transference of cells within an individual, between individuals of the same species, or between individuals of different species. [NIH]
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Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [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] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chelating Agents: Organic chemicals that form two or more coordination bonds with a central metal ion. Heterocyclic rings are formed with the central metal atom as part of the ring. Some biological systems form metal chelates, e.g., the iron-binding porphyrin group of hemoglobin and the magnesium-binding chlorophyll of plants. (From Hawley's Condensed Chemical Dictionary, 12th ed) They are used chemically to remove ions from solutions, medicinally against microorganisms, to treat metal poisoning, and in chemotherapy protocols. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chenodeoxycholic Acid: A bile acid, usually conjugated with either glycine or taurine. It acts as a detergent to solubilize fats for intestinal absorption and is reabsorbed by the small intestine. It is used as cholagogue, a choleretic laxative, and to prevent or dissolve gallstones. [NIH]
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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 between the neck and the abdomen. [NIH] Chickenpox: A mild, highly contagious virus characterized by itchy blisters all over the body. [NIH] Child Care: Care of children in the home or institution. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholangitis: Inflammation of a bile duct. [NIH] Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [NIH] Choleretic: A choleretic agent. [EU] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholestyramine: Strongly basic anion exchange resin whose main constituent is polystyrene trimethylbenzylammonium as Cl(-) anion. It exchanges chloride ions with bile salts, thus decreasing their concentration and that of cholesterol. It is used as a hypocholesteremic in diarrhea and biliary obstruction and as an antipruritic. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (Chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [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
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to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Citalopram: A selective neuronal serotonin reuptake inhibitor and a clinically effective antidepressant with tolerable side effects. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia (TD) in preference to tricyclic antidepressants, which aggravate this condition. [NIH]
Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (Case reports) or many patients (Case series or clinical trials). [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] Clonic: Pertaining to or of the nature of clonus. [EU] 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] Coal: A natural fuel formed by partial decomposition of vegetable matter under certain environmental conditions. [NIH] Cobalt: A trace element that is a component of vitamin B12. It has the atomic symbol Co, atomic number 27, and atomic weight 58.93. It is used in nuclear weapons, alloys, and pigments. Deficiency in animals leads to anemia; its excess in humans can lead to erythrocytosis. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]
Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive behavior therapy: A system of psychotherapy based on the premise that distorted or dysfunctional thinking, which influences a person's mood or behavior, is common to all psychosocial problems. The focus of therapy is to identify the distorted
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thinking and to replace it with more rational, adaptive thoughts and beliefs. [NIH] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Cognitive Therapy: A direct form of psychotherapy based on the interpretation of situations (Cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Combination chemotherapy: Treatment using more than one anticancer drug. [NIH] Communicable disease: A disease that can be transmitted by contact between persons. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (Collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1,
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IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (Complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [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] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [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] Concomitant: Accompanying; accessory; joined with another. [EU] Condiments: Aromatic substances added to food before or after cooking to enhance its flavor. These are usually of vegetable origin. [NIH] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Cone: One of the special retinal receptor elements which are presumed to be primarily concerned with perception of light and color stimuli when the eye is adapted to light. [NIH]
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Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [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] Consolidation: The healing process of a bone fracture. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Contrast Sensitivity: The ability to detect sharp boundaries (stimuli) and to detect slight changes in luminance at regions without distinct contours. Psychophysical measurements of this visual function are used to evaluate visual acuity and to detect eye disease. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (Control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (Control) group. [NIH] Convulsants: Substances that act in the brain stem or spinal cord to produce tonic or clonic convulsions, often by removing normal inhibitory tone. They were formerly used to stimulate respiration or as antidotes to barbiturate overdose. They are now most commonly used as experimental tools. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH]
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Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corrosion: Irreversible destruction of skin tissue. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU]
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Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]
Creatine Kinase: A transferase that catalyzes formation of phosphocreatine from ATP + creatine. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic isoenzymes have been identified in human tissues: MM from skeletal muscle, MB from myocardial tissue, and BB from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. EC 2.7.3.2. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Criterion: A standard by which something may be judged. [EU] Crowns: A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (Covering three or more surfaces of a tooth) or complete (Covering all surfaces). It is made of gold or other metal, porcelain, or resin. [NIH] Cryptococcosis: Infection with a fungus of the species Cryptococcus neoformans. [NIH] Cryptococcus: A mitosporic Tremellales fungal genus whose species usually have a capsule and do not form pseudomycellium. Teleomorphs include Filobasidiella and Fidobasidium. [NIH]
Cryptococcus neoformans: A species of the fungus Cryptococcus, which causes cryptococcosis. Its teleomorph is Filobasidiella neoformans. [NIH] Crystallization: The formation of crystals; conversion to a crystalline form. [EU] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclins: Regulatory proteins that function in the cell cycle to activate maturation promoting factor. They complex with p34cdc2 (PROTEIN P34CDC2), the catalytic subunit of maturation-promoting factor, and modulate its protein kinase activity. Cyclins themselves have no enzymatic activity. [NIH] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH]
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Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] Cytomegalovirus Retinitis: Infection of the retina by cytomegalovirus characterized by retinal necrosis, hemorrhage, vessel sheathing, and retinal edema. Cytomegalovirus retinitis is a major opportunistic infection in AIDS patients and can cause blindness. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (Cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytosine: A pyrimidine base that is a fundamental unit of nucleic acids. [NIH] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]
Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (Chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH]
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Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [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] Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Alloys: A mixture of metallic elements or compounds with other metallic or metalloid elements in varying proportions for use in restorative or prosthetic dentistry. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Depth Perception: Perception of three-dimensionality. [NIH] Dermatitis: Any inflammation of the skin. [NIH] DES: Diethylstilbestrol. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] DEXA: A method (dual energy X-ray absortiometry) used to estimate total body fat and percent of body fat. Potential disadvantages include whole body radiation and the long time required for scanning while the subject lies on a hard table. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant
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and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] DHEA: Dehydroepiandrosterone. A substance that is being studied as a cancer prevention drug. It belongs to the family of drugs called steroids. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastolic: Of or pertaining to the diastole. [EU] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [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 system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilution: A diluted or attenuated medicine; in homeopathy, the diffusion of a given quantity of a medicinal agent in ten or one hundred times the same quantity of water. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disease Susceptibility: A constitution or condition of the body which makes the tissues react in special ways to certain extrinsic stimuli and thus tends to make the individual more than usually susceptible to certain diseases. [NIH]
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Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH] Dispenser: Glass, metal or plastic shell fitted with valve from which a pressurized formulation is dispensed; an instrument for atomizing. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuretic: A drug that increases the production of urine. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Docetaxel: An anticancer drug that belongs to the family of drugs called mitotic inhibitors. [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] Doping: The action of administering a drug to someone before a sports event (originally to a horse before a race); the substance thus administered. [EU] 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] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Dosimeter: In nuclear science and radiotherapy, a device used for the detection and measurement of radiation absorbed dose or any dose-related ionizing radiation received by the individual; a radiation meter intended to measure absorbed dose. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] 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]
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Drug Toxicity: Manifestations of the adverse effects of drugs administered therapeutically or in the course of diagnostic techniques. It does not include accidental or intentional poisoning for which specific headings are available. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dysarthria: Imperfect articulation of speech due to disturbances of muscular control which result from damage to the central or peripheral nervous system. [EU] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elastomers: A generic term for all substances having the properties of natural, reclaimed, vulcanized, or synthetic rubber, in that they stretch under tension, have a high tensile strength, retract rapidly, and recover their original dimensions fully. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [NIH]
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Electron microscope: A microscope (device used to magnify small objects) that uses electrons (instead of light) to produce an enlarged image. An electron microscopes shows tiny details better than any other type of microscope. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]
Emetic: An agent that causes vomiting. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]
Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalomyelitis: A general term indicating inflammation of the brain and spinal cord, often used to indicate an infectious process, but also applicable to a variety of autoimmune and toxic-metabolic conditions. There is significant overlap regarding the usage of this term and encephalitis in the literature. [NIH] Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinologist: A doctor that specializes in diagnosing and treating hormone disorders. [NIH]
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Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]
Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxic: Of, relating to, or acting as an endotoxin (= a heat-stable toxin, associated with the outer membranes of certain gram-negative bacteria. Endotoxins are not secreted and are released only when the cells are disrupted). [EU] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energetic: Exhibiting energy : strenuous; operating with force, vigour, or effect. [EU] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epoetin alfa: A colony-stimulating factor that is made in the laboratory. It increases the production of red blood cells. [NIH] Ergonomics: Study of the relationships between man and machines; adjusting the design of machines to the need and capacities of man; study of the effect of machines on man's behavior. [NIH] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Erythrocyte Indices: Quantification of size and cell hemoglobin content or concentration of
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the erythrocyte, usually derived from erythrocyte count, blood hemoglobin concentration, and hematocrit. Includes the mean cell volume (MCV), mean cell hemoglobin (MCH), and mean cell hemoglobin concentration (MCHC). Use also for cell diameter and thickness. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythropoietin: Glycoprotein hormone, secreted chiefly by the kidney in the adult and the liver in the fetus, that acts on erythroid stem cells of the bone marrow to stimulate proliferation and differentiation. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ethanolamine: A viscous, hygroscopic amino alcohol with an ammoniacal odor. It is widely distributed in biological tissue and is a component of lecithin. It is used as a surfactant, fluorimetric reagent, and to remove CO2 and H2S from natural gas and other gases. [NIH] Euphoria: An exaggerated feeling of physical and emotional well-being not consonant with apparent stimuli or events; usually of psychologic origin, but also seen in organic brain disease and toxic states. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (Called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excrete: To get rid of waste from the body. [NIH] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs
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and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]
Expiration: The act of breathing out, or expelling air from the lungs. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]
External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] 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] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Eye socket: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Facial: Of or pertaining to the face. [EU] Family Characteristics: Size and composition of the family. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciculation: A small local contraction of muscles, visible through the skin, representing a spontaneous discharge of a number of fibres innervated by a single motor nerve filament. [EU]
Fat: Total lipids including phospholipids. [NIH] Fathers: Male parents, human or animal. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical,
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characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fatty Liver: The buildup of fat in liver cells. The most common cause is alcoholism. Other causes include obesity, diabetes, and pregnancy. Also called steatosis. [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] Feeding Behavior: Behavioral responses or sequences associated with eating including modes of feeding, rhythmic patterns of eating, and time intervals. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Nerve: A nerve originating in the lumbar spinal cord (usually L2 to L4) and traveling through the lumbar plexus to provide motor innervation to extensors of the thigh and sensory innervation to parts of the thigh, lower leg, and foot, and to the hip and knee joints. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibrositis: Aching, soreness or stiffness of muscles; often caused by inexpedient work postures. [NIH] Filler: An inactive substance used to make a product bigger or easier to handle. For example, fillers are often used to make pills or capsules because the amount of active drug is too small to be handled conveniently. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH]
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Flexion: In gynaecology, a displacement of the uterus in which the organ is bent so far forward or backward that an acute angle forms between the fundus and the cervix. [EU] Flexor: Muscles which flex a joint. [NIH] Fluconazole: Triazole antifungal agent that is used to treat oropharyngeal candidiasis and cryptococcal meningitis in AIDS. [NIH] Flucytosine: A fluorinated cytosine analog that is used as an antifungal agent. [NIH] Fludrocortisone: A synthetic mineralocorticoid with anti-inflammatory activity. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Flush: Transient, episodic redness of the face and neck caused by certain diseases, ingestion of certain drugs or other substances, heat, emotional factors, or physical exertion. [EU] Fold: A plication or doubling of various parts of the body. [NIH] Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. [NIH]
Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [NIH] Fossil Fuels: Any hydrocarbon deposit that may be used for fuel. Examples are petroleum, coal, and natural gas. [NIH] Fovea: The central part of the macula that provides the sharpest vision. [NIH] Free Radical Scavengers: Substances that influence the course of a chemical reaction by ready combination with free radicals. Among other effects, this combining activity protects pancreatic islets against damage by cytokines and prevents myocardial and pulmonary perfusion injuries. [NIH] Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Fundus: The larger part of a hollow organ that is farthest away from the organ's opening. The bladder, gallbladder, stomach, uterus, eye, and cavity of the middle ear all have a fundus. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU]
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Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body 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] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH]
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Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Ginseng: An araliaceous genus of plants that contains a number of pharmacologically active agents used as stimulants, sedatives, and tonics, especially in traditional medicine. [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] Glare: Scatter from bright light that decreases vision. [NIH] Glioblastoma: A malignant form of astrocytoma histologically characterized by pleomorphism of cells, nuclear atypia, microhemorrhage, and necrosis. They may arise in any region of the central nervous system, with a predilection for the cerebral hemispheres, basal ganglia, and commissural pathways. Clinical presentation most frequently occurs in the fifth or sixth decade of life with focal neurologic signs or seizures. [NIH] Glioblastoma multiforme: A type of brain tumor that forms from glial (supportive) tissue of the brain. It grows very quickly and has cells that look very different from normal cells. Also called grade IV astrocytoma. [NIH] Glioma: A cancer of the brain that comes from glial, or supportive, cells. [NIH] Gliosarcoma: A type of glioma. [NIH] Gliosis: The production of a dense fibrous network of neuroglia; includes astrocytosis, which is a proliferation of astrocytes in the area of a degenerative lesion. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [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] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH]
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Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycolysis: The pathway by which glucose is catabolized into two molecules of pyruvic acid with the generation of ATP. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [NIH] Gold Alloys: Alloys that contain a high percentage of gold. They are used in restorative or prosthetic dentistry. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grading: A system for classifying cancer cells in terms of how abnormal they appear when examined under a microscope. The objective of a grading system is to provide information about the probable growth rate of the tumor and its tendency to spread. The systems used to grade tumors vary with each type of cancer. Grading plays a role in treatment decisions. [NIH]
Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU]
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Haematemesis: The vomiting of blood. [EU] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost. [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (health care costs) and may or may not be shared among the patient, insurers, and/or employers. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heart Valves: Flaps of tissue that prevent regurgitation of blood from the ventricles to the atria or from the pulmonary arteries or aorta to the ventricles. [NIH] Hematocrit: Measurement of the volume of packed red cells in a blood specimen by centrifugation. The procedure is performed using a tube with graduated markings or with automated blood cell counters. It is used as an indicator of erythrocyte status in disease. For example, anemia shows a low hematocrit, polycythemia, high values. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated
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hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobin A: Normal adult human hemoglobin. The globin moiety consists of two alpha and two beta chains. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatologist: A doctor who specializes in liver diseases. [NIH] Hepatomegaly: Enlargement of the liver. [NIH] Hepatotoxicity: How much damage a medicine or other substance does to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes virus: A member of the herpes family of viruses. [NIH] Herpes Zoster: Acute vesicular inflammation. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (C) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also
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called endocrine therapy. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Human Activities: Activities performed by humans. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hydration: Combining with water. [NIH] Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [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] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hyperphagia: Ingestion of a greater than optimal quantity of food. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypersensitivity, Immediate: Hypersensitivity reactions which occur within minutes of exposure to challenging antigen due to the release of histamine which follows the antigenantibody reaction and causes smooth muscle contraction and increased vascular permeability. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthyroidism: Excessive functional activity of the thyroid gland. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypoglossal Nerve: The 12th cranial nerve. The hypoglossal nerve originates in the
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hypoglossal nucleus of the medulla and supplies motor innervation to all of the muscles of the tongue except the palatoglossus (which is supplied by the vagus). This nerve also contains proprioceptive afferents from the tongue muscles. [NIH] Hypoglycemia: Abnormally low blood sugar [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hypovolemia: An abnormally low volume of blood circulating through the body. It may result in hypovolemic shock. [NIH] Hypoxemia: Deficient oxygenation of the blood; hypoxia. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hysterectomy: Excision of the uterus. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Illusion: A false interpretation of a genuine percept. [NIH] Immersion: The placing of a body or a part thereof into a liquid. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunocompromised: Having a weakened immune system caused by certain diseases or treatments. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH]
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Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]
Immunogenic: Producing immunity; evoking an immune response. [EU] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infectious Mononucleosis: A common, acute infection usually caused by the Epstein-Barr virus (Human herpesvirus 4). There is an increase in mononuclear white blood cells and other atypical lymphocytes, generalized lymphadenopathy, splenomegaly, and occasionally hepatomegaly with hepatitis. [NIH]
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Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]
Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [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] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlays: Restorations of metal, porcelain, or plastic made to fit a cavity preparation, then cemented into the tooth. Onlays are restorations which fit into cavity preparations and overlay the occlusal surface of a tooth or teeth. Onlays are retained by frictional or mechanical factors. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insecticides: Pesticides designed to control insects that are harmful to man. The insects may be directly harmful, as those acting as disease vectors, or indirectly harmful, as destroyers of crops, food products, or textile fabrics. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] 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] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intercostal: Situated between the ribs. [EU] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH]
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Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interphase: The interval between two successive cell divisions during which the chromosomes are not individually distinguishable and DNA replication occurs. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervention Studies: Epidemiologic investigations designed to test a hypothesized causeeffect relation by modifying the supposed causal factor(s) in the study population. [NIH] Intervertebral: Situated between two contiguous vertebrae. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intrinsic Factor: A glycoprotein secreted by the cells of the gastric glands that is required for the absorption of vitamin B 12. Deficiency of intrinsic factor results in pernicious anemia. [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] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, 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
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positive charge are known as cations; those with a negative charge are anions. [NIH] Irinotecan: An anticancer drug that belongs to a family of anticancer drugs called topoisomerase inhibitors. It is a camptothecin analogue. Also called CPT 11. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Isometric Contraction: Muscular contractions characterized by increase in tension without change in length. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]
Job Satisfaction: Personal satisfaction relative to the work situation. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] 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] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent
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that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Kinetic: Pertaining to or producing motion. [EU] Knee Injuries: Injuries to the knee or the knee joint. [NIH] Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Lanthanum: The prototypical element in the rare earth family of metals. It has the atomic symbol La, atomic number 57, and atomic weight 138.91. Lanthanide ion is used in experimental biology as a calcium antagonist; lanthanum oxide improves the optical properties of glass. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] 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] Lassitude: Weakness; exhaustion. [EU] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [NIH] Lens: The transparent, double convex (outward curve on both sides) structure suspended between the aqueous and vitreous; helps to focus light on the retina. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukotrienes: A family of biologically active compounds derived from arachidonic acid by oxidative metabolism through the 5-lipoxygenase pathway. They participate in host defense reactions and pathophysiological conditions such as immediate hypersensitivity and inflammation. They have potent actions on many essential organs and systems, including the cardiovascular, pulmonary, and central nervous system as well as the gastrointestinal
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tract and the immune system. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]
Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [NIH] Linkages: 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] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipopolysaccharides: 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] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (Cancer) cells are found in the tissues of the liver. [NIH]
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Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Lung volume: The amount of air the lungs hold. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph
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nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [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] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malformation: A morphologic developmental process. [EU]
defect
resulting
from
an
intrinsically
abnormal
Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]
Mammary: Pertaining to the mamma, or breast. [EU] Mammogram: An x-ray of the breast. [NIH] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mannans: Polysaccharides consisting of mannose units. [NIH] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Maturation-Promoting Factor: Protein kinase that drives both the mitotic and meiotic cycles in all eukaryotic organisms. In meiosis it induces immature oocytes to undergo meiotic
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maturation. In mitosis it has a role in the G2/M phase transition. Once activated by cyclins, MPF directly phosphorylates some of the proteins involved in nuclear envelope breakdown, chromosome condensation, spindle assembly, and the degradation of cyclins. The catalytic subunit of MPF is protein P34CDC2. [NIH] Measles Virus: The type species of morbillivirus and the cause of the highly infectious human disease measles, which affects mostly children. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]
Mechanical ventilation: Use of a machine called a ventilator or respirator to improve the exchange of air between the lungs and the atmosphere. [NIH] Mechlorethamine: A vesicant and necrotizing irritant destructive to mucous membranes. It was formerly used as a war gas. The hydrochloride is used as an antineoplastic in Hodgkin's disease and lymphomas. It causes severe gastrointestinal and bone marrow damage. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Glycoproteins: Glycoproteins found on the membrane or surface of cells. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into
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immediate, recent, and remote memory. [NIH] Memory Disorders: Disturbances in registering an impression, in the retention of an acquired impression, or in the recall of an impression. Memory impairments are associated with dementia; craniocerebraltrauma; encephalitis; alcoholism (see also alcohol amnestic disorder); schizophrenia; and other conditions. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Fatigue: Fatigue arising in consequence of mental effort. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methanol: A colorless, flammable liquid used in the manufacture of formaldehyde and acetic acid, in chemical synthesis, antifreeze, and as a solvent. Ingestion of methanol is toxic and may cause blindness. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [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]
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Mice Minute Virus: The type species of parvovirus prevalent in mouse colonies and found as a contaminant of many transplanted tumors or leukemias. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Midodrine: An ethanolamine derivative that is an adrenergic alpha agonist. It is used as a vasoconstrictor agent in the treatment of hypotension. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (Cc) of liquid are the same. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [NIH] Mineralocorticoid: 1. Any of the group of C21 corticosteroids, principally aldosterone, predominantly involved in the regulation of electrolyte and water balance through their effect on ion transport in epithelial cells of the renal tubules, resulting in retention of sodium and loss of potassium; some also possess varying degrees of glucocorticoid activity. Their secretion is regulated principally by plasma volume, serum potassium concentration and angiotensin II, and to a lesser extent by anterior pituitary ACTH. 2. Of, pertaining to, having the properties of, or resembling a mineralocorticoid. [EU] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mitotic inhibitors: Drugs that kill cancer cells by interfering with cell division (mitostis). [NIH]
Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Mitral Valve Prolapse: Abnormal protrusion of one or both of the leaflets of the mitral valve into the left atrium during systole. This may be accompanied by mitral regurgitation, systolic murmur, nonejection click, or cardiac arrhythmia. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH]
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Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] 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] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Morbillivirus: A genus of the family Paramyxoviridae (subfamily Paramyxovirinae) where all the virions have hemagglutinin but not neuraminidase activity. All members produce both cytoplasmic and intranuclear inclusion bodies. MEASLES VIRUS is the type species. [NIH]
Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motivations: The most compelling inner determinants of human behavior; also called drives, urges, impulses, needs, wants, tensions, and willful cravings. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Motor Cortex: Area of the frontal lobe concerned with primary motor control. It lies anterior to the central sulcus. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]
Motor Neurons: Neurons which activate muscle cells. [NIH] Motor Skills: Performance of complex motor acts. [NIH] Mucolytic: Destroying or dissolving mucin; an agent that so acts : a mucopolysaccharide or glycoprotein, the chief constituent of mucus. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH]
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Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Muscle Fatigue: A state arrived at through prolonged and strong contraction of a muscle. Studies in athletes during prolonged submaximal exercise have shown that muscle fatigue increases in almost direct proportion to the rate of muscle glycogen depletion. Muscle fatigue in short-term maximal exercise is associated with oxygen lack and an increased level of blood and muscle lactic acid, and an accompanying increase in hydrogen-ion concentration in the exercised muscle. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscle Hypertonia: Abnormal increase in skeletal or smooth muscle tone. Skeletal muscle hypertonicity may be associated with pyramidal tract lesions or basal ganglia diseases. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (Curare and related compounds). [EU] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Musculoskeletal Diseases: Diseases of the muscles and their associated ligaments and other connective tissue and of the bones and cartilage viewed collectively. [NIH] Musculoskeletal System: Themuscles, bones, and cartilage of the body. [NIH] Myalgia: Pain in a muscle or muscles. [EU] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Mycobacterium: A genus of gram-positive, aerobic bacteria. Most species are free-living in soil and water, but the major habitat for some is the diseased tissue of warm-blooded hosts. [NIH]
Mycobacterium avium: A bacterium causing tuberculosis in domestic fowl and other birds. In pigs, it may cause localized and sometimes disseminated disease. The organism occurs occasionally in sheep and cattle. It should be distinguished from the M. avium complex, which infects primarily humans. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopathy: Any disease of a muscle. [EU] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from
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front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myositis: Inflammation of a voluntary muscle. [EU] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Natural selection: A part of the evolutionary process resulting in the survival and reproduction of the best adapted individuals. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Nearsightedness: The common term for myopia. [NIH] Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle Sharing: Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis,
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as the neutral arch. [EU] Neurasthenia: A mental disorder characterized by chronic fatigue and concomitant physiologic symptoms. [NIH] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]
Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroendocrinology: The study of the anatomical and functional relationships between the nervous system and the endocrine system. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Diseases: A general term encompassing lower motor neuron disease; peripheral nervous system diseases; and certain muscular diseases. Manifestations include muscle weakness; fasciculation; muscle atrophy; spasm; myokymia; muscle hypertonia, myalgias, and musclehypotonia. [NIH] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropharmacology: The branch of pharmacology dealing especially with the action of drugs upon various parts of the nervous system. [NIH] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neuropsychological Tests: Tests designed to assess neurological function associated with certain behaviors. They are used in diagnosing brain dysfunction or damage and central nervous system disorders or injury. [NIH] Neurotoxin: A substance that is poisonous to nerve tissue. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Nickel: A trace element with the atomic symbol Ni, atomic number 28, and atomic weight 58.69. It is a cofactor of the enzyme urease. [NIH] Nimodipine: A calcium channel blockader with preferential cerebrovascular activity. It has marked cerebrovascular dilating effects and lowers blood pressure. [NIH]
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Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nociceptors: Peripheral receptors for pain. Nociceptors include receptors which are sensitive to painful mechanical stimuli, extreme heat or cold, and chemical stimuli. All nociceptors are free nerve endings. [NIH] Non-small cell lung cancer: A group of lung cancers that includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] NSAIDs: Nonsteroidal anti-inflammatory drugs. A group of drugs that decrease fever, swelling, pain, and redness. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Omega-3 fatty acid: A type of fat obtained in the diet and involved in immunity. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Operating Rooms: Facilities equipped for performing surgery. [NIH] Ophthalmology: A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each
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half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Organ Culture: The growth in aseptic culture of plant organs such as roots or shoots, beginning with organ primordia or segments and maintaining the characteristics of the organ. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orthopaedic: Pertaining to the correction of deformities of the musculoskeletal system; pertaining to orthopaedics. [EU] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH] Osteocytes: Mature osteoblasts that have become embedded in the bone matrix. They occupy a small cavity, called lacuna, in the matrix and are connected to adjacent osteocytes via protoplasmic projections called canaliculi. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Overwork: Work strain that exceeds a person's natural physical or mental capabilities. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] 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]
Oxidative Phosphorylation: Electron transfer through the cytochrome system liberating free
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energy which is transformed into high-energy phosphate bonds. [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxides: Binary compounds of oxygen containing the anion O(2-). The anion combines with metals to form alkaline oxides and non-metals to form acidic oxides. [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Palladium: A chemical element having an atomic weight of 106.4, atomic number of 46, and the symbol Pd. It is a white, ductile metal resembling platinum, and following it in abundance and importance of applications. It is used in dentistry in the form of gold, silver, and copper alloys. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pallor: A clinical manifestation consisting of an unnatural paleness of the skin. [NIH] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Parallax: The apparent change in direction or lateral displacement of a viewed object when the eye is moved from one position to another, or when the object is viewed first with one eye and then with the other. [NIH] Paramedic: An emergency medical technician (EMT) who received further training for the delivery of some aspects of advanced life support (ALS) care. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH]
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Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Parvovirus: A genus of the family Parvoviridae, subfamily Parvovirinae, infecting a variety of vertebrates including humans. Parvoviruses are responsible for a number of important diseases but also can be non-pathogenic in certain hosts. The type species is mice minute virus. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]
Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pergolide: A long-acting dopamine agonist which is effective in the treatment of Parkinson's disease and hyperprolactinemia. It has also been observed to have antihypertensive effects. [NIH]
Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]
Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous
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system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peripheral Vascular Disease: Disease in the large blood vessels of the arms, legs, and feet. People who have had diabetes for a long time may get this because major blood vessels in their arms, legs, and feet are blocked and these limbs do not receive enough blood. The signs of PVD are aching pains in the arms, legs, and feet (especially when walking) and foot sores that heal slowly. Although people with diabetes cannot always avoid PVD, doctors say they have a better chance of avoiding it if they take good care of their feet, do not smoke, and keep both their blood pressure and diabetes under good control. [NIH] Peripheral vision: Side vision; ability to see objects and movement outside of the direct line of vision. [NIH] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH] Peroneal Nerve: The lateral of the two terminal branches of the sciatic nerve. The peroneal (or fibular) nerve provides motor and sensory innervation to parts of the leg and foot. [NIH] Pertussis: An acute, highly contagious infection of the respiratory tract, most frequently affecting young children, usually caused by Bordetella pertussis; a similar illness has been associated with infection by B. parapertussis and B. bronchiseptica. It is characterized by a catarrhal stage, beginning after an incubation period of about two weeks, with slight fever, sneezing, running at the nose, and a dry cough. In a week or two the paroxysmal stage begins, with the characteristic paroxysmal cough, consisting of a deep inspiration, followed by a series of quick, short coughs, continuing until the air is expelled from the lungs; the close of the paroxysm is marked by a long-drawn, shrill, whooping inspiration, due to spasmodic closure of the glottis. This stage lasts three to four weeks, after which the convalescent stage begins, in which paroxysms grow less frequent and less violent, and finally cease. Called also whooping cough. [EU] Pesticides: Chemicals used to destroy pests of any sort. The concept includes fungicides (industrial fungicides), insecticides, rodenticides, etc. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Phallic: Pertaining to the phallus, or penis. [EU] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmacist: A person trained to prepare and distribute medicines and to give information
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about them. [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] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phonation: The process of producing vocal sounds by means of vocal cords vibrating in an expiratory blast of air. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photoreceptor: Receptor capable of being activated by light stimuli, as a rod or cone cell of the eye. [NIH] Phototherapy: Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]
Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH]
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Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [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]
Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Plethysmography: Recording of change in the size of a part as modified by the circulation in it. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Podiatrist: A doctor who treats and takes care of people's feet. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Port: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port-a-cath. [NIH] Port-a-cath: An implanted device through which blood may be withdrawn and drugs may be infused without repeated needle sticks. Also called a port. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of
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the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Post-traumatic stress disorder: A psychological disorder that develops in some individuals after a major traumatic experience such as war, rape, domestic violence, or accident. [NIH] Postural: Pertaining to posture or position. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [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] Precipitation: The act or process of precipitating. [EU] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Pre-Eclampsia: Development of hypertension with proteinuria, edema, or both, due to pregnancy or the influence of a recent pregnancy. It occurs after the 20th week of gestation, but it may develop before this time in the presence of trophoblastic disease. [NIH] Prefrontal Cortex: The rostral part of the frontal lobe, bounded by the inferior precentral fissure in humans, which receives projection fibers from the mediodorsal nucleus of the thalamus. The prefrontal cortex receives afferent fibers from numerous structures of the diencephalon, mesencephalon, and limbic system as well as cortical afferents of visual, auditory, and somatic origin. [NIH] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and
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painful breasts. [NIH] Preoptic Area: Region of hypothalamus between the anterior commissure and optic chiasm. [NIH]
Pressoreceptors: Receptors in the vascular system, particularly the aorta and carotid sinus, which are sensitive to stretch of the vessel walls. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [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] Primary Biliary Cirrhosis: A chronic liver disease. Slowly destroys the bile ducts in the liver. This prevents release of bile. Long-term irritation of the liver may cause scarring and cirrhosis in later stages of the disease. [NIH] Primary endpoint: The main result that is measured at the end of a study to see if a given treatment worked (e.g., the number of deaths or the difference in survival between the treatment group and the control group). What the primary endpoint will be is decided before the study begins. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Procarbazine: An antineoplastic agent used primarily in combination with mechlorethamine, vincristine, and prednisone (the MOPP protocol) in the treatment of Hodgkin's disease. [NIH] Proestrus: Phase of the estrous cycle preceding estrus during which the Graafian follicle undergoes maturation. Applies to animals. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (Coming back). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Prone: Having the front portion of the body downwards. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward
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opposite poles. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol is used in the treatment or prevention of many disorders including acute myocardial infarction, arrhythmias, angina pectoris, hypertension, hypertensive emergencies, hyperthyroidism, migraine, pheochromocytoma, menopause, and anxiety. [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] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prosthesis: An artificial replacement of a part of the body. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] 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] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and
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treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychoneuroimmunology: The field concerned with the interrelationship between the brain, behavior and the immune system. Neuropsychologic, neuroanatomic and psychosocial studies have demonstrated their role in accentuating or diminishing immune/allergic responses. [NIH] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotomimetic: Psychosis miming. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Punishment: The application of an unpleasant stimulus or penalty for the purpose of eliminating or correcting undesirable behavior. [NIH] Pyrazoloacridine: An anticancer drug that belongs to the family of drugs called acridines. [NIH]
Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quiescent: Marked by a state of inactivity or repose. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the
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waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radicular: Having the character of or relating to a radicle or root. [NIH] Radiculopathy: Disease involving a spinal nerve root (see spinal nerve roots) which may result from compression related to intervertebral disk displacement; spinal cord injuries; spinal diseases; and other conditions. Clinical manifestations include radicular pain, weakness, and sensory loss referable to structures innervated by the involved nerve root. [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] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [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] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Rape: Unlawful sexual intercourse without consent of the victim. [NIH]
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Reaction Time: The time from the onset of a stimulus until the organism responds. [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] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recur: To occur again. Recurrence is the return of cancer, at the same site as the original (primary) tumor or in another location, after the tumor had disappeared. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflective: Capable of throwing back light, images, sound waves : reflecting. [EU] 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] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractive Power: The ability of an object, such as the eye, to bend light as light passes through it. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression (see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [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] Rehabilitative: Instruction of incapacitated individuals or of those affected with some mental disorder, so that some or all of their lost ability may be regained. [NIH]
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Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Resolving: The ability of the eye or of a lens to make small objects that are close together, separately visible; thus revealing the structure of an object. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Respiratory Muscles: These include the muscles of the diaphragm and the intercostal muscles. [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Response rate: The percentage of patients whose cancer shrinks or disappears after treatment. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU]
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Retinitis: Inflammation of the retina. It is rarely limited to the retina, but is commonly associated with diseases of the choroid (Chorioretinitis) and of the optic nerve (neuroretinitis). The disease may be confined to one eye, but since it is generally dependent on a constitutional factor, it is almost always bilateral. It may be acute in course, but as a rule it lasts many weeks or even several months. [NIH] Retinoids: Derivatives of vitamin A. Used clinically in the treatment of severe cystic acne, psoriasis, and other disorders of keratinization. Their possible use in the prophylaxis and treatment of cancer is being actively explored. [NIH] Retinol: Vitamin A. It is essential for proper vision and healthy skin and mucous membranes. Retinol is being studied for cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Retrograde: 1. Moving backward or against the usual direction of flow. 2. Degenerating, deteriorating, or catabolic. [EU] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribavirin: 1-beta-D-Ribofuranosyl-1H-1,2,4-triazole-3-carboxamide. A nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both RNA and DNA viruses. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk-Taking: Undertaking a task involving a challenge for achievement or a desirable goal in which there is a lack of certainty or a fear of failure. It may also include the exhibiting of certain behaviors whose outcomes may present a risk to the individual or to those associated with him or her. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rodenticides: Substances used to destroy or inhibit the action of rats, mice, or other rodents. [NIH]
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Rotator: A muscle by which a part can be turned circularly. [NIH] Rotator Cuff: The musculotendinous sheath formed by the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. These help stabilize the head of the humerus in the glenoid fossa and allow for rotation of the shoulder joint about its longitudinal axis. [NIH] Rubber: A high-molecular-weight polymeric elastomer derived from the milk juice (latex) of Hevea brasiliensis and other trees. It is a substance that can be stretched at room temperature to atleast twice its original length and after releasing the stress, retractrapidly, and recover its original dimensions fully. Synthetic rubber is made from many different chemicals, including styrene, acrylonitrile, ethylene, propylene, and isoprene. [NIH] Ryanodine: Insecticidal alkaloid isolated from Ryania speciosa; proposed as a myocardial depressant. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Sarcoplasmic Reticulum: A network of tubules and sacs in the cytoplasm of skeletal muscles that assist with muscle contraction and relaxation by releasing and storing calcium ions. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sciatic Nerve: A nerve which originates in the lumbar and sacral spinal cord (L4 to S3) and supplies motor and sensory innervation to the lower extremity. The sciatic nerve, which is
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the main continuation of the sacral plexus, is the largest nerve in the body. It has two major branches, the tibial nerve and the peroneal nerve. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Seasonal Affective Disorder: A syndrome characterized by depressions that recur annually at the same time each year, usually during the winter months. Other symptoms include anxiety, irritability, decreased energy, increased appetite (Carbohydrate cravings), increased duration of sleep, and weight gain. SAD (seasonal affective disorder) can be treated by daily exposure to bright artificial lights (phototherapy), during the season of recurrence. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [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] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [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] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Sella: A deep depression in the shape of a Turkish saddle in the upper surface of the body of the sphenoid bone in the deepest part of which is lodged the hypophysis cerebri. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senescence: The bodily and mental state associated with advancing age. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming;
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immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] 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] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sexual Partners: Married or single individuals who share sexual relations. [NIH] Ships: Large vessels propelled by power or sail used for transportation on rivers, seas, oceans, or other navigable waters. Boats are smaller vessels propelled by oars, paddles, sail, or power; they may or may not have a deck. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [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] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet
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activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Silicon: A trace element that constitutes about 27.6% of the earth's crust in the form of silicon dioxide. It does not occur free in nature. Silicon has the atomic symbol Si, atomic number 14, and atomic weight 28.09. [NIH] Silicon Dioxide: Silica. Transparent, tasteless crystals found in nature as agate, amethyst, chalcedony, cristobalite, flint, sand, quartz, and tridymite. The compound is insoluble in water or acids except hydrofluoric acid. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Sleep Deprivation: The state of being deprived of sleep under experimental conditions, due to life events, or from a wide variety of pathophysiologic causes such as medication effect, chronic illness, psychiatric illness, or sleep disorder. [NIH] Small cell lung cancer: A type of lung cancer in which the cells appear small and round when viewed under the microscope. Also called oat cell lung cancer. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [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] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall
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in contrast to the viscera. [EU] Somnolence: Sleepiness; also unnatural drowsiness. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., wounds, gunshot; whiplash injuries; etc.). [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Spinal tap: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a lumbar puncture. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Spondylitis: Inflammation of the vertebrae. [EU]
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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] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]
Staphylococcus: A genus of gram-positive, facultatively anaerobic, coccoid bacteria. Its organisms occur singly, in pairs, and in tetrads and characteristically divide in more than one plane to form irregular clusters. Natural populations of Staphylococcus are membranes of warm-blooded animals. Some species are opportunistic pathogens of humans and animals. [NIH] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Steatosis: Fatty degeneration. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stem cell transplantation: A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Stereoscopic: Accurate depth perception in the presence of binocular single vision, due to the slight disparity in the two retinal images of the same object. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Sternum: Breast bone. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Steroid therapy: Treatment with corticosteroid drugs to reduce swelling, pain, and other symptoms of inflammation. [NIH] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other
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excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strained: A stretched condition of a ligament. [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] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [NIH] Stria: 1. A streak, or line. 2. A narrow bandlike structure; a general term for such longitudinal collections of nerve fibres in the brain. [EU] Striatum: A higher brain's domain thus called because of its stripes. [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] Stroke Volume: The amount of blood pumped out of the heart per beat not to be confused with cardiac output (volume/time). [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal Cells: Connective tissue cells of an organ found in the loose connective tissue. These are most often associated with the uterine mucosa and the ovary as well as the hematopoietic system and elsewhere. [NIH] Strontium: An element of the alkaline earth family of metals. It has the atomic symbol Sr, atomic number 38, and atomic weight 87.62. [NIH] Styrene: A colorless, toxic liquid with a strong aromatic odor. It is used to make rubbers, polymers and copolymers, and polystyrene plastics. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] 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]
Substrate: A substance upon which an enzyme acts. [EU] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH]
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Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Supine: Having the front portion of the body upwards. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suprachiasmatic Nucleus: An ovoid densely packed collection of small cells of the anterior hypothalamus lying close to the midline in a shallow impression of the optic chiasm. [NIH] Supratentorial: Located in the upper part of the brain. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Vesicles: Membrane-bound compartments which contain transmitter molecules. Synaptic vesicles are concentrated at presynaptic terminals. They actively sequester transmitter molecules from the cytoplasm. In at least some synapses, transmitter release occurs by fusion of these vesicles with the presynaptic membrane, followed by exocytosis of their contents. [NIH] Synaptophysin: A 38-kDa integral membrane glycoprotein of the presynaptic vesicles in neuron and neuroendocrine cells. It is expressed by a variety of normal and neoplastic neuroendocrine cells and is therefore used as an immunocytochemical marker for
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neuroendocrine differentiation in various tumors. In Alzheimer disease and other dementing disorders there is an important synapse loss due in part to a decrease of synaptophysin in the presynaptic vesicles. [NIH] Syncytium: A living nucleated tissue without apparent cellular structure; a tissue composed of a mass of nucleated protoplasm without cell boundaries. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Syringomyelia: The presence in the spinal cord of elongated central fluid containing cavities surrounded by gliosis. [NIH] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systole: Period of contraction of the heart, especially of the ventricles. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tachypnea: Rapid breathing. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [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] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Tendon Injuries: Injuries to the fibrous cords of connective tissue which attach muscles to bones or other structures. [NIH] Terminalis: A groove on the lateral surface of the right atrium. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]
Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH]
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Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thoracic: Having to do with the chest. [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] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thromboxanes: Physiologically active compounds found in many organs of the body. They are formed in vivo from the prostaglandin endoperoxides and cause platelet aggregation, contraction of arteries, and other biological effects. Thromboxanes are important mediators of the actions of polyunsaturated fatty acids transformed by cyclooxygenase. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroiditis: Inflammation of the thyroid gland. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Time Management: Planning and control of time to improve efficiency and effectiveness. [NIH]
Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Preservation: The process by which a tissue or aggregate of cells is kept alive outside of the organism from which it was derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism). [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] Tome: A zone produced by a number of irregular spaces contained in the outermost layer of denture of the root of a tooth. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU]
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Tonicity: The normal state of muscular tension. [NIH] Tooth Preparation: Procedures carried out with regard to the teeth or tooth structures preparatory to specified dental therapeutic and surgical measures. [NIH] Toothache: Pain in the adjacent areas of the teeth. [NIH] Topical: On the surface of the body. [NIH] Topoisomerase inhibitors: A family of anticancer drugs. The topoisomerase enzymes are responsible for the arrangement and rearrangement of DNA in the cell and for cell growth and replication. Inhibiting these enzymes may kill cancer cells or stop their growth. [NIH] Tourniquet: A device, band or elastic tube applied temporarily to press upon an artery to stop bleeding; a device to compress a blood vessel in order to stop bleeding. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]
Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual,
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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] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [NIH] Triad: Trivalent. [NIH] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tungsten: A metallic element with the atomic symbol W, atomic number 74, and atomic weight 183.85. It is used in many manufacturing applications, including increasing the hardness, toughness, and tensile strength of steel; manufacture of filaments for incandescent light bulbs; and in contact points for automotive and electrical apparatus. [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] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Unconditioned: An inborn reflex common to all members of a species. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Universal Precautions: Prudent standard preventive measures to be taken by professional and other health personnel in contact with persons afflicted with a communicable disease, to avoid contracting the disease by contagion or infection. Precautions are especially applicable in the diagnosis and care of AIDS patients. [NIH]
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Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Ursodeoxycholic Acid: An epimer of chenodeoxycholic acid. It is a mammalian bile acid found first in the bear and is apparently either a precursor or a product of chenodeoxycholate. Its administration changes the composition of bile and may dissolve gallstones. It is used as a cholagogue and choleretic. [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] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vagotomy: The interruption or removal of any part of the vagus (10th cranial) nerve. Vagotomy may be performed for research or for therapeutic purposes. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic 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] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Vanadium: Vanadium. A metallic element with the atomic symbol V, atomic number 23, and atomic weight 50.94. It is used in the manufacture of vanadium steel. Prolonged exposure can lead to chronic intoxication caused by absorption usually via the lungs. [NIH] Varicose: The common ulcer in the lower third of the leg or near the ankle. [NIH] Varicose vein: An abnormal swelling and tortuosity especially of the superficial veins of the legs. [EU] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is
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used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Venous Pressure: The blood pressure in a vein. It is usually measured to assess the filling pressure to the ventricle. [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] Ventilator: A breathing machine that is used to treat respiratory failure by promoting ventilation; also called a respirator. [NIH] 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] Ventral Tegmental Area: A region in the mesencephalon which is dorsomedial to the substantia nigra and ventral to the red nucleus. The mesocortical and mesolimbic dopaminergic systems originate here, including an important projection to the nucleus accumbens. Overactivity of the cells in this area has been suspected to contribute to the positive symptoms of schizophrenia. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]
Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs
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including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Visual field: The entire area that can be seen when the eye is forward, including peripheral vision. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Vocal cord: The vocal folds of the larynx. [NIH] Void: To urinate, empty the bladder. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] War: Hostile conflict between organized groups of people. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Wheelchairs: Chairs mounted on wheels and designed to be propelled by the occupant. [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]
Whooping Cough: A respiratory infection caused by Bordetella pertussis and characterized by paroxysmal coughing ending in a prolonged crowing intake of breath. [NIH] Whooping Cough: A respiratory infection caused by Bordetella pertussis and characterized by paroxysmal coughing ending in a prolonged crowing intake of breath. [NIH]
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Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Yttrium: An element of the rare earth family of metals. It has the atomic symbol Y, atomic number 39, and atomic weight 88.91. In conjunction with other rare earths, yttrium is used as a phosphor in television receivers and is a component of the yttrium-aluminum garnet (YAG) lasers. [NIH] Zoonoses: Diseases of non-human animals that may be transmitted to man or may be transmitted from man to non-human animals. [NIH]
381
INDEX 3 3-dimensional, 83, 295 A Abdomen, 56, 180, 295, 304, 305, 310, 337, 340, 364, 369, 371, 374, 377, 379 Abdominal, 15, 199, 249, 281, 295, 296, 319, 328, 338, 352, 357, 364 Abdominal Pain, 281, 295, 328, 338 Aberrant, 9, 295, 312 Ablation, 295 Abrasion, 295 Absenteeism, 191, 295 Acceptor, 295, 340, 351 Acclimation, 21, 295 Accommodation, 295, 348 Acetone, 295, 338 Acetylcarnitine, 75, 116, 120, 295 Acetylcholine, 295, 310 Acetylcysteine, 98, 295 Acetylgalactosamine, 295, 330 Acetylglucosamine, 295, 330 Acoustic, 295 Acrylonitrile, 295, 365 Actin, 295, 347, 348 Activities of Daily Living, 6, 32, 296 Activity Cycles, 27, 296 Acuity, 101, 296 Acute Disease, 180, 246, 296 Adaptation, 53, 60, 62, 112, 190, 239, 295, 296, 356 Adenine, 296 Adenocarcinoma, 296, 350 Adenosine, 62, 254, 296, 355 Adenosine Triphosphate, 254, 296, 355 Adipocytes, 296, 314, 339 Adjustment, 18, 103, 171, 198, 295, 296 Adjuvant, 30, 71, 130, 296, 328 Adrenal Cortex, 296, 315, 324, 333, 358 Adrenal Glands, 185, 296 Adrenal Medulla, 296, 308, 323, 350 Adrenergic, 63, 296, 320, 323, 345, 359, 372 Adverse Effect, 58, 296, 300, 321, 367 Aerobic, 13, 71, 160, 164, 296, 324, 345, 347 Aerobic Exercise, 13, 160, 296 Afferent, 34, 44, 296, 339, 357, 369 Affinity, 297, 301, 368 Age of Onset, 297, 376 Agonist, 297, 300, 306, 320, 345, 353, 373
Airway, 222, 297, 368 Airway Obstruction, 222, 297 Alertness, 25, 54, 297 Algorithms, 7, 297, 304 Alkaline, 205, 297, 298, 302, 306, 352, 371 Alkaloid, 297, 306, 307, 311, 346, 365 Allergen, 297, 318, 367 Allergic Rhinitis, 133, 297 Alopecia, 297, 316 Alpha Particles, 297, 361 Alternative medicine, 253, 297 Alternative nutrition, 268, 297 Alveolar Process, 297, 363 Alveoli, 298, 378 Ameliorating, 36, 219, 298 Amenorrhea, 298, 306 Amino Acid Sequence, 298, 299 Amino Acids, 150, 151, 298, 301, 307, 353, 356, 359, 364, 372, 375, 377 Ammonia, 160, 298, 377 Amnestic, 298, 344 Amphetamine, 22, 25, 298, 318 Amplification, 45, 55, 298 Amygdala, 42, 298, 340 Anaerobic, 60, 160, 161, 298, 370 Anaesthesia, 298, 335 Anal, 298, 326, 341 Analog, 46, 298, 327 Analysis of Variance, 25, 49, 61, 298 Anaplasia, 298 Anaplastic, 45, 298 Anatomical, 224, 298, 301, 314, 319, 335, 349, 366 Androgens, 60, 296, 298, 315 Anesthesia, 101, 131, 297, 299, 316, 338 Aneurysm, 299, 377 Angina, 299, 359 Angina Pectoris, 299, 359 Angiogenesis, 299, 342 Animal model, 14, 15, 17, 299 Anions, 205, 299, 338, 367 Ankle, 60, 299, 377 Annealing, 299 Anode, 299 Anomalies, 12, 299 Anorexia, 33, 184, 268, 269, 270, 299, 328 Antibacterial, 299, 369 Antibiotic, 299, 317, 320, 369
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Antibodies, 229, 299, 302, 334, 342, 356, 361 Antibody, 297, 299, 312, 332, 333, 335, 343, 346, 361, 367, 369 Antidepressant, 183, 299, 311, 327, 378 Antifungal, 299, 327 Antigen, 297, 299, 312, 329, 332, 333, 334, 335, 343, 366 Antihypertensive, 300, 353 Anti-inflammatory, 155, 276, 300, 315, 318, 327, 329, 350, 357 Antimetabolite, 300, 364 Antimony, 192, 300 Antineoplastic, 300, 307, 315, 316, 320, 343, 358, 379 Antioxidant, 53, 100, 136, 162, 300, 352 Antipruritic, 300, 310 Antiseptic, 225, 295, 300 Antiviral, 246, 295, 300, 337, 364 Anuria, 300, 338 Anus, 298, 300, 305, 362 Anxiety, 9, 16, 42, 44, 78, 111, 140, 170, 183, 199, 233, 248, 252, 256, 278, 291, 300, 352, 359, 366 Anxiety Disorders, 278, 300 Aorta, 300, 331, 358, 378 Aortic Valve, 24, 29, 300 Apathy, 11, 300 Aperture, 213, 300 Apnea, 300 Apnoea, 99, 300 Apomorphine, 226, 227, 300 Apoptosis, 40, 60, 300 Approximate, 55, 300 Aqueous, 169, 205, 206, 301, 303, 317, 322, 339 Arachidonic Acid, 30, 301, 339, 359 Arginine, 116, 120, 301 Aromatic, 301, 307, 313, 371 Arrhythmia, 301, 345 Arterial, 15, 17, 43, 301, 315, 333, 359, 373 Arteries, 300, 301, 305, 315, 331, 341, 344, 347, 360, 374 Arteriolar, 17, 301 Arterioles, 301, 305, 377 Articulation, 301, 321 Aseptic, 301, 351, 370 Aspartate, 3, 132, 301, 338 Aspartic, 206, 301 Aspartic Acid, 301 Asthenia, 190, 301 Astrocytes, 301, 329, 346
Astrocytoma, 45, 301, 329 Asymptomatic, 32, 65, 239, 244, 301 Atmospheric Pressure, 301 Atopic, 91, 301 Atrial, 301, 315, 376 Atrioventricular, 301, 315 Atrium, 301, 315, 345, 373, 376, 378 Atrophy, 180, 301, 349 Attenuated, 3, 302, 319 Attenuation, 164, 302 Atypical, 185, 302, 335 Auditory, 22, 41, 136, 161, 238, 239, 302, 357, 377 Auditory Fatigue, 136, 161, 239, 302 Aural, 302 Autoantibodies, 65, 74, 302 Autoantigens, 302 Autoimmune disease, 65, 302, 347 Autonomic, 4, 17, 42, 63, 90, 91, 295, 302, 350, 353, 354, 369 Axonal, 52, 302 B Back Pain, 20, 144, 165, 169, 302 Bacteremia, 119, 302 Bacteria, 198, 245, 299, 300, 302, 303, 323, 326, 330, 345, 347, 369, 370, 375, 377 Bacterial Physiology, 296, 302 Bactericidal, 302, 324 Bacterium, 302, 347 Barbiturate, 302, 314 Barium, 302 Baroreflex, 17, 302 Basal Ganglia, 103, 302, 329, 340, 347, 350 Base, 35, 161, 164, 173, 207, 296, 297, 303, 317, 318, 338, 339, 373 Basement Membrane, 303, 325 Behavior Therapy, 81, 303 Benign, 303, 331, 348, 361 Benzene, 303 Benzodiazepines, 276, 303 Beta Rays, 303, 322 Bewilderment, 303, 314 Bilateral, 25, 303, 364 Bile, 65, 151, 239, 303, 309, 310, 328, 333, 338, 340, 358, 370, 377 Bile Acids, 303, 370 Bile Acids and Salts, 303 Bile Ducts, 303, 328, 358 Bile Pigments, 303, 338 Biliary, 65, 239, 303, 310 Binding Sites, 44, 303
Index 383
Biochemical, 74, 254, 296, 300, 303, 304, 338, 367 Biodegradation, 138, 303 Biogenesis, 58, 304 Biological response modifier, 304, 336 Biological therapy, 304, 330 Biological Transport, 304, 319 Biomarkers, 30, 304 Biomechanics, 14, 20, 24, 27, 65, 304 Biomedical Engineering, 13, 29, 34, 304 Biopsy, 77, 241, 255, 304 Biosynthesis, 301, 304 Biotechnology, 67, 69, 82, 238, 253, 265, 304 Bismuth, 304 Bladder, 276, 304, 327, 347, 359, 363, 377, 379 Blister, 67, 304 Blister pack, 67, 304 Bloating, 199, 200, 304, 338 Blood Cell Count, 279, 304, 331, 354 Blood Coagulation, 304, 305, 306 Blood Coagulation Factors, 304, 305 Blood Flow Velocity, 17, 304 Blood Glucose, 5, 247, 304, 332, 336 Blood Platelets, 305, 367 Blood Proteins, 244, 305 Blood transfusion, 243, 247, 248, 277, 305 Body Composition, 40, 268, 305 Body Fluids, 173, 247, 254, 304, 305, 321, 368, 376 Body Mass Index, 305, 351 Bone Density, 13, 305 Bone Marrow, 140, 255, 277, 303, 305, 316, 324, 334, 341, 342, 343, 346, 368, 370, 371 Bone Remodeling, 39, 305 Bone Resorption, 13, 305 Bone scan, 305, 365 Boron, 192, 305 Boron Neutron Capture Therapy, 305 Bottle Feeding, 18, 305 Bowel, 9, 200, 276, 298, 305, 319, 336, 337, 371 Bowel Movement, 305, 319, 371 Brachytherapy, 306, 337, 361 Brain metastases, 179, 306 Brain Stem, 306, 314 Branch, 268, 289, 306, 322, 342, 349, 353, 360, 369, 372, 373 Breakdown, 306, 319, 328, 343 Breast Feeding, 198, 306 Bromocriptine, 226, 227, 306
Bronchi, 306, 323, 325, 375 Bronchial, 73, 306 Bronchitis, 140, 306, 310 Buccal, 306, 341 Buffers, 206, 302, 306 C Calcification, 14, 24, 306 Calcium, 54, 56, 60, 63, 131, 254, 276, 305, 306, 312, 339, 342, 345, 349, 365, 367 Calcium Channels, 54, 306 Camptothecin, 306, 338 Candidiasis, 141, 236, 306, 327 Capsaicin, 47, 116, 120, 307 Capsules, 307, 326, 328 Carbohydrate, 38, 164, 307, 315, 329, 366 Carbon Dioxide, 307, 326, 328, 355, 363, 378 Carboplatin, 46, 307 Carboxy, 63, 307 Carboxylic Acids, 63, 307 Carcinogenic, 303, 307, 336, 370 Carcinogens, 307, 310 Carcinoma, 105, 307, 350, 370 Cardiac, 12, 15, 17, 24, 29, 58, 89, 151, 302, 307, 315, 321, 323, 324, 345, 347, 352, 370, 371 Cardiac Output, 15, 17, 302, 307, 371 Cardiopulmonary, 267, 307 Cardiorespiratory, 296, 307 Cardioselective, 307, 359 Cardiovascular, 56, 59, 140, 298, 306, 307, 324, 339, 367 Cardiovascular disease, 56, 59, 307 Carnitine, 95, 125, 126, 177, 190, 266, 295, 307 Carotene, 151, 307, 363 Carpal Tunnel Syndrome, 17, 307 Case report, 307, 308, 311 Case series, 77, 308, 311 Catecholamine, 308, 320 Cathode, 204, 299, 303, 308, 322 Cations, 205, 308, 338 Caudal, 308, 319, 334, 350, 357 Caudate Nucleus, 308, 350 Causal, 308, 337 Cause of Death, 56, 185, 247, 308 Cell Count, 32, 308 Cell Cycle, 308, 311, 316 Cell Death, 300, 308, 329, 348 Cell Differentiation, 308, 367 Cell Division, 302, 308, 330, 337, 343, 345, 356, 358
384 Fatigue
Cell membrane, 304, 306, 308, 318, 328, 355 Cell proliferation, 308, 367 Cell Respiration, 308, 345, 363 Cell Survival, 308, 330 Cell Transplantation, 181, 308 Cellulose, 309, 327, 356 Central Nervous System Infections, 309, 331 Centrifugation, 309, 331 Cerebral hemispheres, 303, 306, 309, 329, 373 Cerebral Palsy, 87, 309, 369 Cerebrospinal, 180, 309, 341, 367, 369 Cerebrospinal fluid, 180, 309, 341, 367, 369 Cerebrovascular, 196, 307, 309, 349 Cerebrum, 309, 373 Cervical, 11, 33, 97, 175, 309, 343, 348 Cervix, 309, 327 Character, 24, 299, 309, 317, 361 Chelating Agents, 63, 309 Chenodeoxycholic Acid, 309, 377 Chest Pain, 5, 310 Chest wall, 56, 310 Chickenpox, 140, 146, 274, 310 Child Care, 244, 310 Chlorophyll, 309, 310, 327 Cholangitis, 65, 310 Cholecystokinin, 43, 310 Choleretic, 309, 310, 377 Cholesterol, 247, 303, 310, 315, 321, 328, 333, 340, 341, 370, 373 Cholestyramine, 222, 310 Cholinergic, 54, 74, 310 Chromatin, 300, 310 Chromium, 125, 310 Chromosomal, 298, 310 Chronic Disease, 5, 108, 199, 246, 310, 312 Chronic Obstructive Pulmonary Disease, 79, 141, 310 Chronic renal, 310, 356 Circadian, 27, 44, 54, 56, 160, 162, 310 Circadian Rhythm, 27, 44, 54, 56, 162, 310 Cisplatin, 46, 125, 310 Citalopram, 109, 311 Clamp, 54, 311 Clear cell carcinoma, 311, 318 Clinical Medicine, 311, 357 Clinical study, 311, 314 Clinical trial, 8, 14, 36, 47, 65, 177, 186, 265, 269, 311, 314, 316, 359, 361 Clonic, 311, 314
Cloning, 304, 311 Coal, 303, 311, 327 Cobalt, 311 Coca, 311 Cocaine, 44, 247, 311 Cochlea, 136, 311 Cofactor, 311, 349, 359 Cognition, 10, 32, 44, 52, 199, 311, 312 Cognitive behavior therapy, 135, 311 Cognitive restructuring, 312, 371 Cognitive Therapy, 10, 51, 312 Colitis, 146, 312, 336, 338 Collagen, 14, 303, 312, 325, 328, 333, 342, 358 Collagen disease, 312, 333 Collapse, 306, 312, 368 Colorectal, 40, 141, 178, 312 Colorectal Cancer, 40, 141, 312 Combination chemotherapy, 183, 312 Communicable disease, 312, 376 Comorbidity, 3, 9, 312 Complement, 78, 312, 313, 367 Complementary and alternative medicine, 36, 48, 129, 157, 313 Complementary medicine, 129, 313 Compress, 313, 375 Computational Biology, 265, 313 Computed tomography, 63, 305, 313, 365 Computer Simulation, 47, 55, 313 Computerized axial tomography, 313, 365 Computerized tomography, 313 Concomitant, 4, 12, 63, 239, 240, 313, 349 Condiments, 209, 210, 313 Condoms, 248, 313 Conduction, 86, 313 Cone, 313, 355, 372 Confusion, 41, 222, 269, 314, 320, 377 Congestion, 199, 314 Conjugated, 303, 309, 314, 317 Conjunctiva, 314, 336 Connective Tissue, 227, 305, 312, 314, 326, 328, 341, 347, 364, 365, 371, 373 Connective Tissue Cells, 314 Consciousness, 314, 318 Consolidation, 18, 314 Constipation, 199, 254, 270, 314, 338 Constitutional, 314, 347, 364 Constriction, 314, 338, 377 Constriction, Pathologic, 314, 377 Consumption, 202, 314, 328, 350, 352 Contamination, 243, 314 Contractility, 131, 314
Index 385
Contraindications, ii, 314 Contralateral, 34, 43, 109, 314, 351, 362 Contrast Sensitivity, 222, 314 Control group, 36, 40, 52, 183, 314, 358, 361 Controlled clinical trial, 40, 48, 314 Controlled study, 90, 314 Convulsants, 46, 314 Convulsions, 302, 314 Coordination, 19, 173, 216, 269, 309, 315, 347 Cor, 4, 315 Coronary, 30, 299, 307, 315, 344, 347 Coronary heart disease, 307, 315 Coronary Thrombosis, 315, 344, 347 Corrosion, 20, 162, 163, 206, 207, 221, 231, 237, 315 Cortex, 34, 135, 315, 323, 324, 326, 357 Cortical, 7, 34, 63, 99, 315, 324, 357, 366 Corticosteroid, 315, 370 Cortisol, 73, 185, 315 Cortisone, 315, 318, 357 Cranial, 315, 316, 331, 333, 354, 377 Craniocerebral Trauma, 316, 331 Creatine, 53, 60, 116, 117, 118, 120, 122, 125, 126, 132, 135, 254, 316 Creatine Kinase, 53, 60, 316 Creatinine, 254, 316, 338 Criterion, 57, 316 Crowns, 39, 316 Cryptococcosis, 316 Cryptococcus, 269, 316 Cryptococcus neoformans, 269, 316 Crystallization, 316 Cues, 66, 316 Curare, 316, 347 Curative, 316, 373 Cutaneous, 306, 316, 341 Cyclic, 9, 24, 34, 39, 47, 64, 84, 117, 120, 121, 129, 166, 169, 194, 316, 366 Cyclins, 226, 316, 343 Cyclophosphamide, 46, 152, 255, 316 Cyclosporine, 255, 316 Cysteine, 295, 317, 372 Cytochrome, 317, 351 Cytokine, 4, 21, 32, 62, 63, 99, 184, 185, 317 Cytomegalovirus, 229, 246, 317 Cytomegalovirus Retinitis, 246, 317 Cytoplasm, 300, 308, 317, 330, 346, 364, 365, 372 Cytosine, 317, 327 Cytoskeleton, 53, 317
Cytotoxic, 307, 317, 361, 367 Cytotoxicity, 20, 311, 317 D Dairy Products, 266, 317 Databases, Bibliographic, 265, 317 Daunorubicin, 317, 320 Deamination, 317, 377 Degenerative, 9, 206, 317, 329, 332, 364 Dehydration, 5, 174, 317 Deletion, 58, 300, 317 Delivery of Health Care, 318, 331 Dementia, 6, 31, 196, 197, 246, 318, 344 Denaturation, 14, 318 Dendrites, 318, 349 Density, 14, 54, 63, 185, 198, 204, 305, 309, 318, 321, 340, 350, 369 Dental Alloys, 59, 318 Dental Care, 65, 318 Dentate Gyrus, 318, 332 Depolarization, 318, 367 Depressive Disorder, 178, 184, 185, 318 Depth Perception, 318, 370 Dermatitis, 214, 318, 321 DES, 318 Desensitization, 55, 318 Detoxification, 147, 244, 318 Deuterium, 318, 333 DEXA, 14, 70, 318 Dexamethasone, 46, 184, 318 Dextroamphetamine, 298, 318, 344 DHEA, 152, 319 Diabetes Mellitus, 28, 141, 167, 319, 329, 332 Diagnostic procedure, 189, 253, 319 Diaphragm, 15, 53, 56, 80, 94, 131, 166, 319, 363 Diarrhea, 199, 222, 254, 267, 268, 270, 310, 319, 338 Diarrhoea, 319, 328 Diastolic, 319, 333 Diencephalon, 319, 334, 357, 373, 374 Dietitian, 245, 319 Diffusion, 204, 217, 304, 319 Digestion, 246, 303, 305, 319, 337, 340, 371 Digestive system, 186, 296, 319 Dilatation, 299, 319, 358, 377 Dilatation, Pathologic, 319, 377 Dilation, 319, 377 Dilution, 17, 319 Direct, iii, 8, 13, 33, 38, 43, 54, 65, 88, 222, 257, 311, 312, 319, 320, 347, 354, 362, 372 Discrimination, 41, 196, 319
386 Fatigue
Disease Progression, 12, 31, 319, 379 Disease Susceptibility, 42, 319 Disinfectant, 320, 324 Disorientation, 54, 314, 320 Disparity, 320, 370 Dispenser, 209, 210, 320 Distal, 47, 66, 302, 320, 321, 354, 359 Diuretic, 225, 320 Dizziness, 199, 237, 320, 378 Docetaxel, 152, 184, 320 Dopamine, 44, 67, 298, 300, 306, 311, 319, 320, 346, 353 Doping, 320 Dorsal, 44, 320, 356, 369 Dorsum, 320 Dose-dependent, 52, 320 Dosimeter, 55, 320 Doxorubicin, 46, 320 Drive, ii, vi, 43, 115, 211, 217, 223, 224, 230, 245, 256, 320, 340 Drug Interactions, 258, 320 Drug Tolerance, 320, 374 Drug Toxicity, 6, 321 Duct, 65, 310, 321, 324, 352, 365 Duodenum, 303, 321, 371 Dura mater, 321, 344, 352 Dysarthria, 12, 321 Dyskinesia, 311, 321 Dyslipidemia, 28, 321 Dysphoric, 10, 54, 318, 321 Dyspnea, 15, 81, 321 Dystonia, 34, 109, 321 E Eating Disorders, 77, 199, 200, 321 Eczema, 9, 199, 321 Edema, 17, 52, 254, 317, 321, 357 Effector, 295, 312, 321, 349 Effector cell, 321, 349 Efficacy, 10, 11, 15, 16, 19, 26, 31, 35, 36, 46, 48, 49, 58, 104, 182, 321 Elastin, 312, 321, 325 Elastomers, 162, 321 Electrocardiogram, 180, 321 Electrode, 48, 208, 211, 216, 299, 308, 321 Electrolysis, 299, 308, 321 Electrolyte, 174, 315, 321, 339, 345, 357, 368 Electromyography, 23, 73, 75, 84, 93, 96, 175, 255, 281, 321 Electron microscope, 31, 322 Electrons, 300, 303, 308, 322, 337, 342, 351, 361
Electrophysiological, 22, 34, 73, 84, 93, 322, 378 Elementary Particles, 322, 342, 349, 359 Embryo, 308, 322, 335 Emesis, 139, 322 Emetic, 300, 322 Emphysema, 56, 310, 322 Empirical, 10, 11, 27, 237, 322 Emulsion, 322, 326 Encapsulated, 202, 322 Encephalitis, 322, 344 Encephalomyelitis, 68, 85, 94, 231, 235, 322 Endemic, 269, 322 Endocrine System, 322, 349 Endocrinologist, 247, 322 Endometrial, 323 Endometriosis, 91, 323 Endometrium, 323, 344 Endothelial cell, 60, 323 Endotoxic, 323, 340 Endotoxin, 323, 376 End-stage renal, 310, 323, 356 Energetic, 190, 323 Energy balance, 323, 339 Entorhinal Cortex, 323, 332 Environmental Health, 91, 130, 264, 266, 323 Enzymatic, 306, 307, 313, 316, 323, 363 Enzyme, 206, 306, 321, 323, 338, 346, 349, 359, 367, 371, 379 Epidemic, 229, 230, 232, 236, 244, 269, 323 Epidemiological, 5, 10, 58, 65, 72, 248, 323 Epidermis, 304, 323 Epinephrine, 296, 320, 323, 350, 376 Epoetin alfa, 178, 181, 184, 323 Ergonomics, 23, 43, 85, 102, 111, 323 Ergot, 306, 323 Erythrocyte Indices, 304, 323 Erythrocytes, 299, 304, 305, 324, 362, 367 Erythropoietin, 255, 266, 267, 324 Esophagus, 319, 324, 355, 362, 371 Estradiol, 32, 324 Estrogen, 33, 324, 358, 366, 373 Ethanol, 14, 311, 324 Ethanolamine, 324, 345 Euphoria, 44, 324 Evacuation, 314, 324 Evoke, 324, 370 Excitability, 79, 135, 324 Excitation, 38, 58, 85, 194, 324 Excitatory, 43, 324 Excrete, 300, 324, 338
Index 387
Exercise Test, 107, 164, 255, 324 Exhaustion, 142, 255, 324, 339 Exocrine, 310, 324, 352 Exogenous, 321, 324, 376 Expectorant, 225, 324 Expiration, 325, 363 Expiratory, 15, 325, 355 Extensor, 60, 90, 93, 94, 135, 175, 325 External-beam radiation, 325, 361 Extracellular, 9, 14, 24, 60, 206, 301, 314, 325, 342, 351, 368 Extracellular Matrix, 9, 14, 24, 314, 325, 342, 351 Extracellular Matrix Proteins, 325, 342 Extracellular Space, 325 Extraction, 38, 325 Extrapyramidal, 320, 325 Extremity, 7, 48, 164, 325, 343, 365 Exudate, 325 Eye Movements, 25, 325 Eye socket, 193, 325 F Facial, 110, 193, 325, 352 Family Characteristics, 50, 325 Family Planning, 265, 325 Fasciculation, 325, 349 Fathers, 61, 325 Fatty acids, 295, 307, 326, 359, 374 Fatty Liver, 28, 326 Febrile, 32, 326 Feces, 314, 326, 371 Feeding Behavior, 33, 326 Femoral, 15, 47, 81, 89, 326 Femoral Nerve, 47, 326 Femur, 326 Fetus, 324, 326, 355, 370, 377 Fibrosis, 28, 141, 326, 365, 366 Fibrositis, 227, 326 Filler, 57, 326 Filtration, 17, 254, 326, 338 Fissure, 318, 326, 357 Fixation, 138, 326, 367 Flatus, 326, 328 Flexion, 15, 22, 47, 166, 167, 168, 327 Flexor, 43, 90, 109, 169, 171, 172, 325, 327 Fluconazole, 269, 327 Flucytosine, 269, 327 Fludrocortisone, 78, 90, 327 Fluorescence, 53, 327 Fluoxetine, 126, 183, 327 Flush, 217, 327 Fold, 55, 65, 326, 327
Follow-Up Studies, 21, 327 Forearm, 15, 167, 168, 169, 171, 172, 174, 224, 255, 305, 327, 343 Fossa, 11, 137, 327, 365 Fossil Fuels, 207, 327 Fovea, 326, 327 Free Radical Scavengers, 30, 327 Friction, 327 Frontal Lobe, 327, 346, 357 Fundus, 327 Fungi, 299, 327, 345, 380 Fungus, 269, 306, 316, 323, 327 G Gallbladder, 295, 303, 310, 319, 327, 328 Gallstones, 303, 309, 328, 377 Gamma Rays, 328, 361 Ganglia, 295, 328, 348, 354, 369 Gap Junctions, 328, 372 Gas exchange, 328, 363, 378 Gastric, 307, 328, 337 Gastrin, 328, 332 Gastroenteritis, 274, 328 Gastrointestinal, 54, 310, 323, 324, 328, 339, 343, 367, 371, 376 Gastrointestinal tract, 324, 328, 340, 367, 376 Gelatin, 202, 328, 372 Gels, 328 Gene, 42, 45, 46, 54, 58, 62, 68, 112, 238, 304, 328, 356 Gene Expression, 45, 112, 328 Generator, 208, 223, 328 Genetic testing, 18, 328 Genotype, 328, 355 Gestation, 329, 355, 357 Gestational, 247, 329 Giant Cells, 329, 365 Ginseng, 150, 153, 155, 156, 329 Gland, 185, 296, 315, 329, 341, 352, 355, 359, 366, 370, 374 Glare, 204, 329 Glioblastoma, 45, 329 Glioblastoma multiforme, 45, 329 Glioma, 45, 329 Gliosarcoma, 45, 329 Gliosis, 329, 373 Glomerular, 329, 338, 363 Glucocorticoid, 60, 184, 318, 329, 333, 345, 357 Glucose, 99, 164, 247, 304, 309, 310, 319, 329, 330, 332, 336, 365 Glucose Intolerance, 319, 329
388 Fatigue
Glucose tolerance, 247, 329 Glucose Tolerance Test, 247, 329 Glycogen, 38, 69, 83, 254, 330, 347 Glycolysis, 60, 160, 254, 330 Glycoprotein, 324, 329, 330, 337, 346, 372, 376 Glycosaminoglycans, 14, 325, 330 Goats, 317, 330 Gold Alloys, 64, 330 Gonad, 330 Gonadal, 32, 330, 370 Governing Board, 330, 357 Grade, 45, 52, 329, 330 Grading, 45, 90, 172, 330 Graft, 330, 333, 335 Grafting, 330, 335 Gram-positive, 330, 347, 370 Granulocytes, 330, 367, 379 Gravis, 54, 88, 169, 330 Growth factors, 226, 330 H Habitat, 330, 347 Habitual, 309, 330 Haematemesis, 322, 331 Hair follicles, 331, 379 Headache, 6, 9, 146, 214, 222, 256, 269, 270, 331, 336, 357 Headache Disorders, 331 Health Behavior, 50, 331 Health Care Costs, 191, 331 Health Education, 244, 331 Health Expenditures, 331 Health Promotion, 40, 50, 182, 331 Health Status, 32, 119, 122, 183, 331 Heart attack, 247, 251, 307, 331 Heart failure, 15, 29, 85, 254, 331 Heart Valves, 24, 29, 331 Hematocrit, 255, 304, 324, 331 Hemodialysis, 331, 338, 339 Hemodynamics, 76, 91, 331 Hemoglobin, 32, 109, 255, 299, 304, 309, 323, 324, 331, 332 Hemoglobin A, 309, 332 Hemorrhage, 316, 317, 331, 332, 371 Hemostasis, 332, 367 Hepatic, 28, 329, 332 Hepatitis, 4, 8, 88, 95, 118, 121, 142, 240, 243, 244, 245, 246, 258, 332, 335, 379 Hepatocytes, 332 Hepatologist, 244, 332 Hepatomegaly, 332, 335 Hepatotoxicity, 225, 332
Hereditary, 281, 332 Heredity, 328, 332 Herpes, 97, 142, 147, 229, 230, 332 Herpes virus, 97, 332 Herpes Zoster, 142, 147, 332 Hippocampus, 44, 185, 318, 332, 340, 371 Homeostasis, 28, 58, 108, 305, 332 Homologous, 332, 367, 372 Hormonal, 60, 277, 296, 302, 315, 332 Hormone therapy, 184, 332 Host, 297, 333, 334, 335, 339, 379 Human Activities, 202, 333 Humoral, 62, 333 Humour, 333 Hydration, 82, 83, 333 Hydrocortisone, 78, 333 Hydrogen, 174, 295, 303, 306, 307, 318, 325, 333, 340, 346, 347, 349, 351, 354, 359 Hydrolysis, 301, 310, 333, 355, 356, 359 Hydroxylysine, 312, 333 Hydroxyproline, 312, 333 Hyperalgesia, 3, 46, 197, 333 Hyperbilirubinemia, 333, 338 Hypercholesterolemia, 321, 333 Hyperlipidemia, 321, 333 Hyperphagia, 44, 333 Hypersensitivity, 64, 140, 199, 297, 318, 333, 339, 364, 367 Hypersensitivity, Immediate, 333 Hypertension, 28, 143, 239, 254, 307, 331, 333, 357, 359 Hyperthyroidism, 333, 359 Hypertriglyceridemia, 321, 333 Hypertrophy, 315, 333, 376 Hypoglossal Nerve, 25, 333 Hypoglycemia, 127, 143, 164, 247, 334 Hypotension, 6, 17, 314, 334, 345 Hypothalamic, 4, 42, 44, 63, 92, 334 Hypothalamus, 319, 334, 340, 355, 358, 372, 374 Hypothyroidism, 5, 6, 143, 334 Hypovolemia, 17, 334 Hypoxemia, 18, 334 Hypoxia, 15, 53, 334 Hysterectomy, 136, 334 I Id, 123, 139, 199, 279, 282, 288, 290, 334 Idiopathic, 103, 109, 254, 334, 365 Illusion, 109, 334, 378 Immersion, 172, 334 Immune function, 30, 32, 334
Index 389
Immune response, 32, 42, 113, 296, 299, 302, 315, 334, 335, 366, 371, 379 Immune Sera, 334 Immunity, 30, 113, 196, 230, 334, 335, 350, 375 Immunization, 244, 334, 335, 367 Immunocompromised, 267, 334 Immunodeficiency, 245, 248, 267, 268, 269, 270, 277, 278, 334, 335 Immunodeficiency syndrome, 248, 267, 269, 335 Immunogenic, 335, 340 Immunoglobulin, 107, 299, 335, 346 Immunologic, 4, 65, 334, 335, 361 Immunology, 78, 91, 99, 106, 296, 297, 335 Immunosuppressive, 65, 316, 329, 335 Immunotherapy, 304, 318, 335 Impairment, 4, 6, 11, 24, 25, 31, 53, 66, 222, 244, 270, 303, 321, 335, 344 Implant radiation, 335, 337, 361 Implantation, 14, 335 In situ, 40, 335 In vitro, 13, 14, 29, 38, 55, 60, 63, 64, 93, 119, 123, 335 In vivo, 17, 24, 38, 40, 44, 47, 51, 60, 335, 374 Incision, 335, 337 Indicative, 231, 335, 353, 377 Induction, 44, 169, 298, 335, 338, 358 Infancy, 335 Infantile, 199, 200, 335 Infarction, 174, 335 Infectious Mononucleosis, 102, 335 Infertility, 306, 336 Inflammatory bowel disease, 91, 336 Influenza, 42, 143, 206, 336 Infusion, 98, 336, 375 Ingestion, 22, 327, 329, 333, 336, 344, 356 Inhalation, 222, 336, 356 Initiation, 17, 39, 64, 160, 165, 168, 171, 195, 336 Inlays, 88, 336 Innervation, 44, 45, 326, 334, 336, 343, 354, 365 Inorganic, 171, 174, 310, 336, 346 Inotropic, 320, 336 Insecticides, 336, 354 Insight, 17, 38, 45, 63, 336 Insomnia, 16, 35, 54, 56, 78, 143, 185, 197, 227, 292, 336, 357 Insulator, 336, 347 Insulin, 28, 247, 329, 336, 338, 376
Insulin-dependent diabetes mellitus, 336 Intercostal, 336, 363 Interferon, 45, 95, 182, 244, 245, 278, 336, 337 Interferon-alpha, 95, 336, 337 Interleukin-1, 62, 337 Interleukin-2, 337 Intermittent, 8, 45, 47, 60, 61, 92, 143, 160, 166, 337 Internal radiation, 337, 361 Interphase, 57, 337 Interstitial, 13, 306, 325, 337, 363 Intervention Studies, 19, 28, 337 Intervertebral, 20, 160, 337, 361 Intestinal, 307, 309, 310, 329, 337 Intestine, 303, 305, 312, 337, 339 Intoxication, 44, 196, 337, 377, 380 Intracellular, 60, 99, 206, 335, 337, 343, 357, 362, 366, 367 Intravascular, 100, 337 Intravenous, 107, 247, 269, 336, 337 Intrinsic, 9, 29, 57, 59, 297, 303, 337 Intrinsic Factor, 57, 337 Invasive, 27, 36, 334, 337, 342 Involuntary, 337, 347, 362, 369 Ion Channels, 301, 337, 349 Ionizing, 297, 320, 337, 361 Ions, 63, 174, 196, 303, 306, 309, 310, 321, 333, 337, 346, 365 Irinotecan, 45, 338 Irritable Bowel Syndrome, 3, 4, 7, 9, 143, 178, 199, 237, 338 Ischemia, 116, 120, 136, 299, 301, 338 Isoenzyme, 316, 338 Isometric Contraction, 43, 61, 162, 338 J Jaundice, 239, 244, 268, 281, 333, 338 Job Satisfaction, 191, 338 K Kb, 264, 338 Ketamine, 3, 338 Ketone Bodies, 28, 295, 338 Kidney Disease, 186, 253, 254, 255, 264, 281, 338 Kidney Failure, 254, 266, 267, 323, 338 Kidney Failure, Acute, 338 Kidney Failure, Chronic, 254, 338 Kidney stone, 254, 339 Kidney Transplantation, 339 Kinetic, 22, 161, 337, 339 Knee Injuries, 7, 339
390 Fatigue
L Labyrinth, 311, 339, 378 Lag, 54, 143, 339 Lanthanum, 339 Large Intestine, 312, 319, 337, 339, 362, 368 Larynx, 55, 339, 375, 377, 379 Lassitude, 12, 339 Latent, 339, 357 Least-Squares Analysis, 339, 362 Lens, 339, 363 Leptin, 88, 339 Lesion, 329, 339, 341, 373, 376 Lethargy, 292, 334, 339 Leukemia, 46, 141, 143, 183, 268, 320, 339 Leukocytes, 304, 305, 330, 337, 339, 346, 376 Leukotrienes, 301, 339 Libido, 70, 298, 340 Library Services, 288, 340 Life cycle, 327, 340 Ligament, 340, 359, 371 Ligands, 45, 340 Ligation, 30, 340 Likelihood Functions, 340, 362 Limbic, 42, 298, 340, 357 Limbic System, 298, 340, 357 Linear Models, 340, 362 Linkages, 330, 332, 340 Lipid, 30, 336, 340, 347, 352 Lipid A, 30, 340 Lipid Peroxidation, 340, 352 Lipopolysaccharides, 340 Lipoprotein, 321, 340, 341 Liver cancer, 246, 340 Liver scan, 341, 365 Liver Transplantation, 65, 244, 341 Localization, 45, 63, 341 Locomotion, 341, 356 Locomotor, 15, 45, 341 Logistic Models, 341, 362 Longitudinal study, 32, 50, 61, 341 Loop, 155, 341 Low-density lipoprotein, 321, 340, 341 Lumbar, 69, 86, 105, 138, 165, 180, 302, 326, 341, 365, 369 Lumbar puncture, 180, 341, 369 Lung volume, 56, 341 Lupus, 144, 146, 237, 256, 274, 277, 278, 341, 373 Lymph, 4, 101, 197, 227, 254, 309, 323, 333, 335, 341, 342, 365
Lymph node, 4, 197, 227, 254, 309, 341, 342, 365 Lymphadenopathy, 101, 335, 341 Lymphatic, 335, 341, 342, 356, 368, 369, 374 Lymphatic system, 341, 342, 368, 369, 374 Lymphocyte, 300, 342, 343 Lymphoid, 299, 342 Lymphoma, 46, 100, 268, 270, 342 M Macrophage, 337, 342 Magnetic Resonance Imaging, 52, 342, 365 Magnetic Resonance Spectroscopy, 60, 103, 342 Maintenance therapy, 269, 342 Malaise, 4, 32, 70, 197, 227, 235, 270, 292, 342 Malformation, 11, 342 Malignancy, 254, 293, 342 Malignant, 296, 300, 329, 340, 342, 348, 361, 365 Malnutrition, 6, 169, 301, 342 Mammary, 342, 373 Mammogram, 306, 342, 345 Mandible, 297, 342, 363 Manifest, 302, 342 Mannans, 327, 342 Matrix metalloproteinase, 14, 342 Maturation-Promoting Factor, 316, 342 Measles Virus, 46, 343 Meat, 200, 266, 343 Mechanical ventilation, 15, 80, 343 Mechlorethamine, 343, 358 Median Nerve, 307, 343 Mediate, 38, 42, 92, 320, 343 Mediator, 42, 66, 110, 310, 337, 343, 367 Medical Records, 9, 343, 364 Medicament, 227, 343, 372 MEDLINE, 265, 343 Meiosis, 342, 343, 372 Melanocytes, 343 Melanoma, 182, 305, 343 Membrane Glycoproteins, 46, 343 Membrane Proteins, 343, 359 Memory Disorders, 130, 344 Meninges, 269, 309, 316, 321, 344 Meningitis, 144, 269, 327, 344 Menopause, 198, 199, 344, 357, 359 Menstrual Cycle, 199, 344, 357, 358 Menstruation, 199, 298, 344, 357 Mental Disorders, 187, 344, 360 Mental Fatigue, 6, 110, 215, 344
Index 391
Mental Health, iv, 7, 66, 163, 185, 187, 248, 264, 271, 344, 360 Mental Processes, 66, 344, 360 Mentors, 51, 344 Mesolimbic, 344, 378 Meta-Analysis, 30, 344 Metastasis, 342, 344 Metastatic, 179, 344 Methanol, 198, 199, 344 Methionine, 344, 372 Methylphenidate, 179, 182, 344 MI, 100, 108, 116, 119, 123, 136, 202, 226, 293, 344 Mice Minute Virus, 345, 353 Microbe, 345, 375 Microbiology, 91, 296, 302, 345 Microcalcifications, 306, 345 Microorganism, 311, 345, 379 Microscopy, 31, 40, 64, 162, 303, 345 Midodrine, 18, 107, 345 Migration, 345 Milliliter, 305, 345 Millimeter, 204, 345 Mineralocorticoid, 327, 345 Mitochondria, 295, 345, 351 Mitosis, 300, 343, 345 Mitotic, 320, 342, 345 Mitotic inhibitors, 320, 345 Mitral Valve, 5, 14, 144, 345 Mitral Valve Prolapse, 5, 144, 345 Modeling, 17, 20, 58, 96, 160, 345 Modification, 39, 96, 166, 210, 221, 345, 360 Molecular Structure, 346, 376 Molecule, 300, 303, 313, 321, 324, 333, 346, 351, 361, 362, 367 Monitor, 204, 316, 346, 350 Monoamine, 298, 319, 346 Monoclonal, 346, 361 Monocytes, 32, 337, 339, 346 Mononuclear, 69, 99, 106, 119, 123, 335, 346, 376 Mood Disorders, 5, 185, 346 Morbillivirus, 343, 346 Morphine, 300, 346 Morphological, 24, 33, 322, 327, 343, 346 Morphology, 13, 24, 33, 168, 346 Motility, 85, 346, 367 Motion Sickness, 144, 346, 348 Motivations, 50, 346 Motor Activity, 206, 314, 346 Motor Cortex, 34, 346, 362
Motor nerve, 325, 346, 347, 354 Motor Neurons, 43, 346 Motor Skills, 199, 200, 346 Mucolytic, 295, 346 Mucosa, 310, 341, 346, 358, 371 Mucus, 324, 346 Muscle Contraction, 92, 208, 333, 347, 365 Muscle Fibers, 347, 348 Muscle Hypertonia, 347, 349 Muscle relaxant, 276, 347 Muscle tension, 56, 109, 347 Musculature, 65, 347 Musculoskeletal Diseases, 230, 347 Musculoskeletal System, 347, 351 Myalgia, 336, 347 Myasthenia, 54, 88, 169, 347 Mycobacterium, 246, 347, 376 Mycobacterium avium, 246, 347 Myelin, 347, 367 Myocardial infarction, 106, 315, 344, 347, 359 Myocardium, 299, 344, 347 Myopathy, 84, 96, 252, 254, 270, 347 Myopia, 66, 347, 348, 362 Myosin, 25, 347, 348 Myositis, 254, 348 N Narcolepsy, 25, 180, 256, 319, 344, 348 Nasal Mucosa, 336, 348 Natural selection, 304, 348 Nausea, 104, 199, 244, 248, 254, 256, 268, 269, 270, 292, 328, 348, 357, 377 NCI, 1, 177, 179, 181, 182, 183, 184, 186, 263, 348 Nearsightedness, 348 Neck Pain, 97, 348 Necrosis, 300, 317, 329, 335, 344, 347, 348, 365 Needle Sharing, 248, 348 Neoplasm, 348, 365 Neoplastic, 298, 333, 342, 348, 372 Nephropathy, 247, 338, 348 Nerve Endings, 348, 350 Nervous System, 22, 34, 45, 47, 48, 229, 276, 278, 295, 297, 298, 302, 303, 306, 309, 310, 311, 318, 328, 329, 339, 343, 344, 346, 347, 348, 349, 353, 367, 372 Networks, 58, 348 Neural, 4, 42, 43, 44, 46, 62, 68, 73, 93, 129, 296, 333, 348 Neurasthenia, 95, 349 Neuroanatomy, 41, 340, 349
392 Fatigue
Neuroendocrine, 42, 230, 240, 276, 349, 372 Neuroendocrinology, 110, 230, 349 Neurologic, 4, 19, 183, 235, 329, 349 Neuromuscular Diseases, 106, 349 Neuromuscular Junction, 25, 54, 232, 295, 349 Neuronal, 67, 306, 311, 349 Neurons, 34, 43, 44, 311, 318, 324, 328, 346, 347, 348, 349, 369, 372 Neuropathy, 247, 349, 354 Neuropharmacology, 41, 349 Neurophysiology, 41, 89, 92, 97, 135, 232, 318, 349 Neuropsychological Tests, 21, 41, 349 Neurotoxin, 222, 349 Neurotransmitters, 240, 349 Neutrons, 297, 305, 349, 361 Nickel, 117, 120, 161, 173, 217, 349 Nimodipine, 56, 349 Nitrogen, 45, 174, 254, 297, 298, 316, 325, 326, 338, 350, 376 Nociceptors, 46, 350 Non-small cell lung cancer, 183, 184, 350 Norepinephrine, 67, 197, 296, 320, 350 NSAIDs, 155, 350 Nuclear, 302, 306, 311, 320, 322, 328, 329, 340, 343, 348, 350, 373 Nuclei, 45, 297, 298, 322, 340, 342, 345, 349, 350, 356, 359 Nucleic acid, 317, 350, 364 Nucleus Accumbens, 44, 350, 378 Nutritional Status, 32, 268, 350 O Ocular, 25, 350 Odour, 301, 350 Oliguria, 338, 350 Omega-3 fatty acid, 119, 123, 138, 350 Opacity, 318, 350 Operating Rooms, 8, 350 Ophthalmology, 326, 350 Opportunistic Infections, 245, 269, 350 Optic Chiasm, 334, 350, 358, 372 Oral Health, 268, 351 Orbit, 325, 351 Organ Culture, 9, 351 Organelles, 309, 317, 343, 346, 351 Orthopaedic, 9, 26, 95, 351 Orthostatic, 17, 70, 351 Osmosis, 351 Osmotic, 53, 351, 367 Osteoblasts, 351
Osteocytes, 40, 60, 351 Osteoporosis, 60, 144, 185, 305, 351 Outpatient, 6, 8, 49, 351 Ovary, 324, 330, 351, 371 Overdose, 314, 351 Overweight, 123, 245, 247, 351 Overwork, 278, 351 Ovum, 329, 340, 351, 358 Oxidation, 30, 295, 300, 317, 340, 351, 352 Oxidative Phosphorylation, 60, 351 Oxidative Stress, 105, 131, 160, 352 Oxides, 352 Oxygen Consumption, 169, 324, 352, 363 Oxygenation, 334, 352 P Pacemaker, 44, 162, 352 Pachymeningitis, 344, 352 Palladium, 64, 352 Palliative, 270, 352, 373 Pallor, 81, 352 Palpation, 197, 352 Palsy, 11, 352 Pancreas, 295, 304, 319, 336, 352, 376 Pancreatic, 307, 310, 327, 352 Panic, 199, 200, 352 Parallax, 201, 352 Paramedic, 173, 352 Parasite, 297, 352 Parkinsonism, 300, 352 Parotid, 352, 365 Paroxysmal, 15, 299, 331, 353, 354, 379 Particle, 59, 353, 369, 375 Parvovirus, 107, 345, 353 Pathogenesis, 4, 9, 30, 63, 206, 239, 240, 353 Pathologic, 7, 14, 42, 100, 300, 304, 315, 333, 353, 363 Pathologic Processes, 300, 353 Pathologies, 62, 66, 353 Pathophysiology, 11, 24, 28, 41, 88, 353 Patient Care Team, 267, 278, 353 Patient Education, 52, 69, 245, 256, 275, 286, 288, 293, 353 Patient Satisfaction, 16, 353 Pelvic, 17, 137, 323, 353, 359 Penis, 313, 353, 354 Peptide, 310, 339, 353, 356, 359, 374 Perception, 46, 55, 100, 101, 103, 108, 164, 172, 173, 197, 313, 318, 353, 365 Perforation, 300, 353 Perfusion, 60, 327, 334, 353 Pergolide, 100, 226, 227, 353
Index 393
Pericardium, 353, 373 Peripheral blood, 106, 119, 123, 337, 353 Peripheral Nervous System, 321, 349, 352, 353, 354, 371 Peripheral Nervous System Diseases, 349, 354 Peripheral Neuropathy, 183, 354 Peripheral Vascular Disease, 145, 247, 354 Peripheral vision, 354, 379 Pernicious, 337, 354 Pernicious anemia, 337, 354 Peroneal Nerve, 15, 354, 366 Pertussis, 354, 379 Pesticides, 76, 303, 336, 354 Petroleum, 327, 354 PH, 233, 305, 354 Phallic, 326, 354 Pharmaceutical Preparations, 309, 324, 328, 354 Pharmacist, 245, 354 Pharmacologic, 6, 62, 299, 355, 375 Pharynx, 336, 355, 377 Phenotype, 44, 54, 58, 355 Phonation, 55, 355 Phospholipases, 355, 367 Phospholipids, 325, 340, 355 Phosphorus, 156, 306, 355 Photoreceptor, 355 Phototherapy, 355, 366 Physical Examination, 4, 12, 48, 278, 355 Physical Fitness, 278, 355 Physical Therapy, 104, 276, 355 Physiologic, 12, 19, 26, 41, 56, 297, 304, 344, 349, 355, 362, 363 Pigment, 343, 355 Pigmentation, 98, 355 Pilot study, 8, 41, 52, 85, 102, 107, 108, 116, 119, 130, 355 Pitch, 193, 355 Pituitary Gland, 185, 315, 355 Placenta, 324, 355, 358 Plants, 225, 295, 297, 301, 307, 309, 311, 329, 346, 350, 356, 365, 375, 376 Plasma, 32, 58, 68, 164, 247, 299, 308, 328, 329, 332, 338, 345, 356, 366, 367, 379 Plasma cells, 299, 356 Plasticity, 34, 42, 55, 57, 356 Platelet Activation, 356, 368 Platelets, 269, 356, 374 Platinum, 310, 341, 352, 356 Pleomorphic, 350, 356 Plethysmography, 17, 356
Plexus, 326, 343, 356, 366 Podiatrist, 245, 356 Poisoning, 130, 142, 268, 300, 309, 321, 323, 328, 337, 348, 356 Polycystic, 255, 356 Polymers, 164, 356, 359, 371 Polypeptide, 298, 312, 356, 358 Polyposis, 312, 356 Port, 214, 356 Port-a-cath, 356 Posterior, 11, 39, 42, 160, 298, 302, 320, 348, 352, 356 Postmenopausal, 351, 357 Postnatal, 111, 357, 370 Postoperative, 101, 136, 357 Postsynaptic, 54, 357, 367, 372 Post-traumatic, 42, 102, 183, 331, 357 Post-traumatic stress disorder, 42, 102, 183, 357 Postural, 17, 22, 83, 102, 168, 357 Potassium, 126, 254, 269, 345, 357 Potentiates, 337, 357 Potentiation, 93, 357, 367 Practice Guidelines, 130, 271, 279, 357 Precipitation, 221, 357 Preclinical, 46, 357 Precursor, 33, 301, 316, 320, 321, 323, 350, 357, 376, 377 Predisposition, 247, 357 Prednisone, 357, 358 Pre-Eclampsia, 62, 357 Prefrontal Cortex, 11, 41, 42, 357 Premenstrual, 145, 198, 199, 237, 357 Premenstrual Syndrome, 145, 198, 199, 237, 357 Preoptic Area, 62, 358 Pressoreceptors, 302, 358 Presynaptic, 54, 348, 358, 372 Prevalence, 3, 9, 12, 28, 40, 41, 49, 50, 60, 67, 76, 91, 103, 111, 183, 358 Primary Biliary Cirrhosis, 80, 100, 136, 239, 358 Primary endpoint, 42, 358 Probe, 223, 358 Procarbazine, 45, 358 Proestrus, 33, 358 Progesterone, 358, 370 Prognostic factor, 16, 358 Progression, 17, 19, 28, 32, 46, 194, 299, 358 Projection, 350, 357, 358, 362, 378 Prolactin, 306, 358
394 Fatigue
Proline, 312, 333, 358 Prone, 358 Prophase, 358, 372 Proportional, 13, 15, 359 Propranolol, 64, 359 Prospective study, 341, 359 Prostaglandins, 62, 301, 359 Prostate, 16, 36, 37, 40, 145, 182, 184, 304, 359, 376 Prosthesis, 20, 359 Protease, 206, 359 Protein C, 298, 340, 359, 377 Protein S, 238, 304, 359, 364 Proteinuria, 100, 357, 359 Protocol, 14, 15, 17, 27, 61, 80, 177, 179, 181, 182, 183, 358, 359 Proton Pump, 206, 359 Protons, 206, 297, 333, 337, 342, 359, 361 Proximal, 47, 89, 254, 320, 358, 359 Pruritic, 321, 359 Pruritus, 65, 359 Psychiatric, 4, 11, 41, 45, 51, 90, 103, 105, 185, 230, 240, 278, 344, 359, 368 Psychiatry, 6, 15, 16, 21, 27, 31, 51, 79, 80, 81, 84, 99, 109, 111, 131, 135, 137, 326, 359, 378 Psychic, 340, 360, 366 Psychology, 10, 30, 32, 37, 42, 53, 86, 92, 110, 119, 122, 130, 360 Psychomotor, 185, 360 Psychoneuroimmunology, 37, 360 Psychopathology, 230, 237, 360 Psychosomatic, 79, 81, 92, 95, 103, 104, 108, 133, 134, 249, 360 Psychotherapy, 311, 312, 360 Psychotomimetic, 298, 319, 360 Public Health, 185, 229, 238, 247, 249, 250, 269, 271, 360 Public Policy, 265, 360 Publishing, 5, 68, 240, 268, 360 Pulmonary, 305, 314, 315, 324, 327, 331, 338, 339, 360, 378 Pulmonary Artery, 305, 360, 378 Pulmonary Edema, 338, 360 Pulmonary hypertension, 315, 360 Pulse, 208, 346, 360 Punishment, 53, 360 Pyrazoloacridine, 46, 360 Q Quiescent, 91, 360 R Race, 28, 320, 345, 360
Radiation therapy, 37, 40, 109, 179, 295, 325, 337, 361 Radicular, 361 Radiculopathy, 86, 361 Radioactive, 305, 333, 335, 337, 341, 350, 361, 365 Radioimmunotherapy, 361 Radiolabeled, 361 Radiopharmaceutical, 328, 361 Radiotherapy, 31, 40, 52, 137, 306, 320, 361 Random Allocation, 361 Randomization, 37, 361 Randomized clinical trial, 50, 178, 179, 181, 182, 361 Rape, 357, 361 Reaction Time, 6, 7, 27, 362 Receptor, 44, 45, 54, 58, 62, 64, 74, 296, 300, 313, 320, 355, 362, 367 Receptors, Serotonin, 362, 367 Recombinant, 42, 45, 258, 362 Rectal, 36, 146, 362 Rectum, 300, 305, 312, 319, 326, 328, 336, 339, 359, 362, 372 Recur, 362, 366 Recurrence, 16, 51, 310, 362, 366 Red blood cells, 254, 255, 277, 323, 324, 362, 365 Red Nucleus, 362, 378 Refer, 1, 211, 266, 267, 306, 312, 320, 326, 327, 332, 341, 349, 361, 362, 378 Reflective, 203, 204, 362 Reflex, 17, 109, 116, 120, 149, 325, 362, 376 Reflux, 142, 200, 362 Refraction, 347, 362, 369 Refractive Power, 348, 362 Refractory, 184, 362 Regimen, 36, 45, 137, 321, 362 Regression Analysis, 36, 362 Regurgitation, 331, 345, 362 Rehabilitative, 11, 362 Relapse, 269, 363 Relaxant, 363 Reliability, 31, 33, 59, 72, 74, 97, 217, 223, 232, 363 Remission, 342, 362, 363 Renal failure, 255, 363 Renal pelvis, 339, 363 Research Design, 11, 21, 36, 363 Resolving, 256, 363 Resorption, 13, 40, 305, 363 Respiration, 117, 121, 180, 300, 307, 314, 316, 346, 363
Index 395
Respirator, 25, 343, 363, 378 Respiratory failure, 56, 363, 378 Respiratory Muscles, 15, 55, 174, 363 Respiratory Physiology, 19, 97, 363, 378 Response rate, 46, 363 Restoration, 316, 355, 363, 380 Retina, 317, 339, 347, 350, 363, 364 Retinal, 313, 317, 320, 350, 363, 370, 379 Retinitis, 317, 364 Retinoids, 364, 379 Retinol, 127, 363, 364 Retinopathy, 247, 364 Retrograde, 58, 364 Retroperitoneal, 296, 364 Retrospective, 51, 76, 100, 364 Retrospective study, 76, 100, 364 Rheumatic Diseases, 99, 254, 277, 364 Rheumatism, 90, 91, 364 Rheumatoid, 62, 63, 146, 237, 312, 364 Rheumatoid arthritis, 62, 312, 364 Ribavirin, 244, 247, 364 Ribose, 296, 364 Ribosome, 364, 375 Rigidity, 24, 352, 356, 364 Risk factor, 8, 32, 50, 86, 245, 247, 341, 359, 364 Risk-Taking, 50, 364 Rod, 216, 217, 302, 311, 355, 364 Rodenticides, 354, 364 Rotator, 65, 365 Rotator Cuff, 65, 365 Rubber, 74, 190, 191, 295, 321, 365 Ryanodine, 58, 365 S Salivary, 317, 319, 365 Salivary glands, 317, 319, 365 Saponins, 365, 370 Sarcoidosis, 117, 121, 146, 253, 254, 365 Sarcoma, 230, 267, 365 Sarcoplasmic Reticulum, 38, 58, 96, 365 Scans, 14, 41, 53, 365 Schizoid, 365, 380 Schizophrenia, 45, 196, 344, 365, 378, 380 Schizotypal Personality Disorder, 365, 380 Sciatic Nerve, 354, 365 Scleroderma, 65, 366 Sclerosis, 10, 11, 12, 62, 71, 79, 80, 82, 83, 88, 95, 101, 104, 108, 110, 116, 119, 133, 138, 144, 180, 185, 249, 252, 256, 274, 312, 347, 366 Screening, 4, 18, 33, 66, 181, 196, 311, 366 Seasonal Affective Disorder, 5, 146, 366
Sebaceous, 366, 379 Second Messenger Systems, 349, 366 Secretion, 44, 54, 306, 310, 315, 333, 334, 336, 345, 346, 366 Secretory, 222, 366, 372 Sedentary, 25, 41, 50, 105, 247, 366 Seizures, 199, 200, 329, 353, 366 Selective estrogen receptor modulator, 366, 373 Self Care, 26, 50, 296, 366 Sella, 320, 355, 366 Semen, 359, 366 Semisynthetic, 306, 366 Senescence, 25, 206, 366 Senile, 196, 351, 366 Sensibility, 298, 333, 366 Sensitization, 48, 366 Sensor, 25, 58, 205, 208, 367 Sensory loss, 361, 367 Serotonin, 44, 67, 197, 276, 311, 327, 362, 367, 376 Serum, 118, 121, 174, 254, 305, 312, 316, 334, 338, 341, 345, 367, 376 Serum Albumin, 305, 367 Sex Characteristics, 298, 367 Sexual Partners, 244, 367 Ships, 367 Shock, 164, 203, 237, 333, 334, 367, 376 Shunt, 69, 367 Signal Transduction, 60, 367 Signs and Symptoms, 97, 363, 368 Silicon, 167, 218, 368 Silicon Dioxide, 368 Skeleton, 295, 305, 326, 338, 368 Skull, 316, 325, 351, 368, 373 Sleep apnea, 62, 101, 117, 121, 368 Sleep Deprivation, 62, 250, 368 Small cell lung cancer, 368 Small intestine, 303, 309, 321, 332, 337, 368 Social Environment, 360, 368 Social Support, 174, 368, 371 Sodium, 119, 216, 276, 345, 368 Soft tissue, 305, 368 Solid tumor, 177, 178, 179, 181, 182, 183, 299, 320, 368 Solvent, 295, 303, 324, 344, 351, 368 Soma, 368 Somatic, 3, 10, 45, 48, 64, 86, 237, 333, 340, 343, 345, 353, 354, 357, 368, 377 Somnolence, 46, 369 Sound wave, 313, 362, 369 Spasm, 349, 369
396 Fatigue
Spastic, 338, 369 Spatial disorientation, 320, 369 Specialist, 111, 244, 283, 319, 369 Specificity, 41, 43, 52, 61, 111, 297, 306, 369 Spectrum, 10, 103, 168, 369 Sperm, 298, 369 Sphincter, 339, 369 Spinal Cord Injuries, 361, 369 Spinal Nerve Roots, 361, 369 Spinal tap, 180, 341, 369 Spleen, 254, 317, 341, 342, 365, 369 Splenomegaly, 335, 369 Spondylitis, 99, 369 Squamous, 350, 370 Squamous cell carcinoma, 350, 370 Staging, 365, 370 Staphylococcus, 119, 328, 370 Statistically significant, 45, 370 Steatosis, 326, 370 Stem cell transplantation, 181, 370 Stem Cells, 324, 370 Stereoscopic, 201, 370 Sterility, 316, 336, 370 Sternum, 89, 370 Steroid, 60, 184, 274, 277, 303, 315, 365, 370 Steroid therapy, 184, 277, 370 Stillbirth, 247, 370 Stimulant, 22, 45, 157, 298, 318, 344, 370 Stimulus, 41, 45, 302, 314, 320, 321, 324, 336, 337, 339, 360, 362, 370, 374 Stomach, 225, 245, 295, 319, 324, 327, 328, 329, 332, 348, 355, 362, 368, 369, 371 Stool, 216, 338, 339, 371 Strained, 209, 220, 371 Stress management, 78, 371 Stria, 42, 371 Striatum, 350, 371 Stroke, 15, 34, 180, 187, 225, 247, 264, 307, 371 Stroke Volume, 15, 307, 371 Stromal, 60, 323, 371 Stromal Cells, 60, 371 Strontium, 166, 371 Styrene, 365, 371 Subacute, 335, 371 Subarachnoid, 331, 371 Subclinical, 335, 366, 371 Subcutaneous, 199, 296, 321, 371 Subiculum, 332, 371 Subspecies, 369, 371 Substance P, 366, 371 Substrate, 33, 218, 219, 223, 371
Suction, 326, 371 Sulfur, 127, 325, 344, 372 Supine, 17, 372 Support group, 6, 244, 246, 279, 372 Supportive care, 18, 372 Suppositories, 328, 372 Suppression, 30, 32, 315, 372 Suprachiasmatic Nucleus, 44, 372 Supratentorial, 52, 372 Sympathomimetic, 298, 319, 320, 323, 350, 372 Symphysis, 359, 372 Symptomatic, 11, 32, 37, 50, 372 Symptomatology, 42, 51, 199, 372 Synapses, 55, 349, 372 Synapsis, 372 Synaptic, 54, 367, 372 Synaptic Vesicles, 372 Synaptophysin, 58, 372 Syncytium, 60, 329, 373 Synergistic, 32, 47, 225, 358, 373 Syringomyelia, 11, 373 Systemic lupus erythematosus, 88, 133, 278, 312, 373 Systole, 345, 373 Systolic, 333, 345, 373 T Tachycardia, 17, 302, 373 Tachypnea, 302, 373 Tamoxifen, 67, 366, 373 Tardive, 311, 373 Telencephalon, 302, 373 Temporal, 3, 40, 298, 331, 332, 373 Temporal Lobe, 298, 373 Tendon Injuries, 9, 373 Terminalis, 42, 373, 374 Testis, 324, 373 Thalamus, 42, 319, 340, 357, 373 Therapeutics, 62, 100, 135, 136, 258, 373 Thigh, 326, 373 Third Ventricle, 334, 373, 374 Thoracic, 15, 17, 55, 302, 319, 343, 374, 380 Thorax, 295, 341, 374, 377 Threshold, 9, 15, 59, 84, 169, 173, 302, 324, 333, 374 Thrombocytes, 356, 374 Thrombosis, 359, 371, 374 Thromboxanes, 301, 374 Thymus, 334, 341, 342, 374 Thyroid, 237, 256, 292, 333, 334, 374, 376 Thyroid Gland, 333, 374 Thyroiditis, 65, 374
Index 397
Thyrotropin, 334, 374 Time Management, 49, 371, 374 Tin, 118, 122, 162, 192, 245, 281, 307, 354, 356, 374 Tissue Preservation, 29, 374 Tolerance, 19, 27, 59, 329, 374 Tome, 151, 157, 374 Tomography, 63, 342, 374 Tonic, 314, 374 Tonicity, 321, 375 Tooth Preparation, 39, 296, 375 Toothache, 225, 375 Topical, 324, 375 Topoisomerase inhibitors, 338, 375 Tourniquet, 63, 375 Toxic, iv, 25, 45, 47, 203, 233, 254, 300, 303, 316, 317, 322, 324, 334, 344, 349, 371, 375 Toxicity, 67, 254, 320, 375 Toxicology, 44, 266, 375 Toxins, 254, 300, 306, 322, 335, 361, 375 Toxoplasmosis, 246, 375 Trace element, 305, 310, 311, 349, 368, 374, 375 Trachea, 306, 325, 339, 355, 374, 375 Traction, 311, 375 Transduction, 367, 375 Transfection, 304, 375 Transfer Factor, 334, 375 Transfusion, 375 Translation, 7, 375 Translational, 38, 47, 194, 375 Transmitter, 295, 301, 320, 337, 343, 350, 372, 375 Transplantation, 310, 334, 375 Trauma, 17, 35, 95, 191, 254, 348, 376 Trees, 365, 376 Triad, 58, 376 Tricuspid Atresia, 315, 376 Tricyclic, 197, 276, 311, 376 Tryptophan, 312, 367, 376 Tubercle, 350, 376 Tuberculosis, 146, 230, 267, 314, 341, 347, 376 Tumor marker, 304, 376 Tumor Necrosis Factor, 62, 117, 121, 376 Tungsten, 308, 376 Type 2 diabetes, 247, 376 Tyrosine, 157, 320, 376 U Ulcer, 376, 377 Ultrasonography, 17, 376 Unconditioned, 41, 376
Unconscious, 111, 334, 376 Universal Precautions, 244, 376 Urea, 254, 338, 377 Uremia, 338, 363, 377 Ureters, 339, 377 Urethra, 353, 359, 377 Urinary, 146, 225, 350, 377 Urinate, 377, 379 Urine, 180, 254, 300, 304, 316, 320, 338, 339, 350, 359, 363, 377 Ursodeoxycholic Acid, 65, 240, 377 Uterus, 309, 323, 327, 334, 344, 358, 377 V Vaccine, 240, 243, 244, 258, 296, 359, 377 Vagal, 18, 377 Vagina, 306, 309, 318, 344, 377 Vagotomy, 62, 377 Vagus Nerve, 377 Valves, 14, 29, 377 Vanadium, 164, 165, 170, 377 Varicose, 191, 377 Varicose vein, 191, 377 Vascular, 15, 17, 302, 304, 331, 333, 335, 355, 358, 374, 377 Vascular Resistance, 15, 302, 377 Vasoconstriction, 17, 323, 377 Vasodilation, 15, 377 Vasodilator, 320, 378 VE, 70, 71, 92, 102, 183, 378 Vein, 299, 337, 350, 352, 378 Venlafaxine, 67, 378 Venous, 17, 304, 359, 376, 378 Venous blood, 304, 378 Venous Pressure, 17, 378 Ventilation, 55, 174, 378 Ventilator, 343, 363, 378 Ventral, 44, 334, 350, 369, 378 Ventral Tegmental Area, 44, 378 Ventricle, 298, 300, 301, 308, 315, 332, 345, 350, 360, 373, 374, 376, 378 Ventricular, 71, 116, 119, 315, 376, 378 Ventricular Function, 71, 116, 119, 378 Venules, 305, 378 Vertebrae, 337, 369, 378 Vertigo, 147, 222, 378 Vestibular, 278, 378 Vestibule, 311, 378 Veterinary Medicine, 265, 378 Vinca Alkaloids, 378, 379 Vincristine, 45, 358, 379 Viral Hepatitis, 147, 246, 379 Viral Load, 32, 379
398 Fatigue
Virulence, 302, 375, 379 Viscera, 369, 379 Viscosity, 295, 379 Visual Acuity, 173, 314, 379 Visual field, 196, 351, 379 Vitamin A, 230, 268, 364, 379 Vitro, 13, 29, 60, 379 Vivo, 14, 40, 45, 51, 379 Vocal cord, 355, 379 Void, 20, 379 Vulgaris, 150, 379 W Wakefulness, 25, 180, 296, 379 War, 68, 71, 92, 102, 159, 163, 183, 237, 343, 357, 379 Weight Gain, 366, 379
Wheelchairs, 35, 379 White blood cell, 185, 269, 299, 335, 339, 342, 346, 356, 379 Whooping Cough, 225, 354, 379 Windpipe, 355, 374, 380 Withdrawal, 18, 44, 380 Wound Healing, 342, 380 X Xenograft, 299, 380 X-ray, 64, 305, 308, 313, 318, 327, 328, 342, 350, 361, 365, 380 Y Yeasts, 327, 355, 380 Yttrium, 380 Z Zoonoses, 380
Index 399
400 Fatigue
