FINASTERIDE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Finasteride: 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: 0-597-84422-4 1. Finasteride-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 finasteride. 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 FINASTERIDE ............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Finasteride..................................................................................... 5 E-Journals: PubMed Central ....................................................................................................... 30 The National Library of Medicine: PubMed ................................................................................ 31 CHAPTER 2. NUTRITION AND FINASTERIDE ................................................................................... 79 Overview...................................................................................................................................... 79 Finding Nutrition Studies on Finasteride ................................................................................... 79 Federal Resources on Nutrition ................................................................................................... 81 Additional Web Resources ........................................................................................................... 82 CHAPTER 3. ALTERNATIVE MEDICINE AND FINASTERIDE ............................................................. 83 Overview...................................................................................................................................... 83 The Combined Health Information Database............................................................................... 83 National Center for Complementary and Alternative Medicine.................................................. 84 Additional Web Resources ........................................................................................................... 88 General References ....................................................................................................................... 90 CHAPTER 4. PATENTS ON FINASTERIDE .......................................................................................... 91 Overview...................................................................................................................................... 91 Patents on Finasteride.................................................................................................................. 91 Patent Applications on Finasteride.............................................................................................. 98 Keeping Current ........................................................................................................................ 100 CHAPTER 5. BOOKS ON FINASTERIDE ........................................................................................... 101 Overview.................................................................................................................................... 101 Book Summaries: Online Booksellers......................................................................................... 101 Chapters on Finasteride ............................................................................................................. 102 CHAPTER 6. MULTIMEDIA ON FINASTERIDE................................................................................. 105 Overview.................................................................................................................................... 105 Video Recordings ....................................................................................................................... 105 CHAPTER 7. PERIODICALS AND NEWS ON FINASTERIDE.............................................................. 107 Overview.................................................................................................................................... 107 News Services and Press Releases.............................................................................................. 107 Newsletter Articles .................................................................................................................... 110 Academic Periodicals covering Finasteride................................................................................ 112 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................. 113 Overview.................................................................................................................................... 113 U.S. Pharmacopeia..................................................................................................................... 113 Commercial Databases ............................................................................................................... 114 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 117 Overview.................................................................................................................................... 117 NIH Guidelines.......................................................................................................................... 117 NIH Databases........................................................................................................................... 119 Other Commercial Databases..................................................................................................... 121 APPENDIX B. PATIENT RESOURCES ............................................................................................... 123 Overview.................................................................................................................................... 123 Patient Guideline Sources.......................................................................................................... 123 Finding Associations.................................................................................................................. 131 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 133 Overview.................................................................................................................................... 133 Preparation................................................................................................................................. 133
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Finding a Local Medical Library................................................................................................ 133 Medical Libraries in the U.S. and Canada ................................................................................. 133 ONLINE GLOSSARIES................................................................................................................ 139 Online Dictionary Directories ................................................................................................... 139 FINASTERIDE DICTIONARY.................................................................................................... 141 INDEX .............................................................................................................................................. 191
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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 finasteride is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about finasteride, 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 finasteride, 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 finasteride. 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 finasteride, 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 finasteride. 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 FINASTERIDE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on finasteride.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and finasteride, 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 “finasteride” (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: •
Finasteride: A 5Alpha-Reductase Inhibitor Source: Clinical Pharmacy. Volume 12: 15-23. January 1993. Summary: Finasteride is a member of a new class of medications, the azasteroids, that have anti-androgenic activity limited to certain tissues, including the prostate gland. In this article, the pharmacology and pharmocokinetics of finasteride are reviewed. The author describes finasteride's clinical efficacy, adverse effects, and dosage in patients with benign prostatic hyperplasia (BPH). The author notes that in clinical studies, finasteride has been effective in decreasing prostatic volume, increasing urinary flow rate, and decreasing the obstructive and irritative symptoms of BPH. Adverse effects of this drug include decreased libido, ejaculatory disorders, and effects on prostate-specific antigen.
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Long-Term Effects of Finasteride on Invasive Urodynamics and Symptoms in the Treatment of Patients With Bladder Outflow Obstruction Due to Benign Prostatic Hyperplasia Source: Journal of Urology. 154(4): 1466-1469. October 1995. Contact: Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (800) 638-6423; in Maryland (800) 638-4007. Summary: In this article, the authors report on a study in which they assessed the long term effects of finasteride on bladder outlet obstruction and symptoms in the treatment of patients with benign prostatic hyperplasia. Of the original 36 patients assigned to treatment with 5 mg finasteride daily (group 1) or placebo (group 2) for 6 months, 27 completed an open extension study of 5 mg finasteride for 4 more years. The possible relief of bladder outlet obstruction was monitored with repeated pressure-flow studies at baseline, 6 months, and 4.5 years. Results showed that the treatment resulted in a further slight decrease in detrusor pressure at maximum flow rate in group 1 and a significant decrease in group 2 during the 4-year period, whereas improvement in maximum flow rate did not achieve statistical significance. Concomitantly, there was a significant improvement in obstructive and irritative symptoms. The authors conclude that finasteride decreases bladder outlet obstruction moderately and only occasionally relieves it completely. However, the decrease in obstruction achieved in many patients is sufficient to improve the symptoms significantly. The beneficial effect is long lasting. 2 figures. 2 tables. 24 references. (AA-M).
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Efficacy of Terazosin, Finasteride, or Both in Benign Prostatic Hyperplasia Source: New England Journal of Medicine. 335(8): 533-539. August 22, 1996. Summary: Men with benign prostatic hyperplasia (BPH) can be treated with alpha1adrenergic antagonist drugs that relax prostatic smooth muscle or with drugs that inhibit 5alpha-reductase and therefore reduce tissue androgen concentrations. This article reports on a study in which the authors compared the safety and efficacy of placebo, finasteride (5 mg daily), terazosin (10 mg daily), and the combination of both drugs in 1,229 men with BPH. American Urological Association symptom scores and peak urinary flow rates were determined at baseline and periodically for 1 year. The mean changes from baseline in the symptoms scores in the placebo, finasteride, terazosin, and combination-therapy groups were decreases of 2.6, 3.2, 6.1, and 6.2 points, respectively. The mean changes at 1 year in the peak urinary flow rates were increases of 1.4, 1.6, 2.7, and 3.2 ml per second, respectively. Finasteride had no more effect on either measure than placebo. In the placebo group, 1.6 percent of the men discontinued the study because of adverse effects, as did 4.8 to 7.8 percent of the men in the other three groups. The authors conclude that, in men with BPH, terazosin was effective therapy, whereas finasteride was not, and the combination of terazosin and finasteride was no more effective than terazosin alone. 2 figures. 3 table. 24 references. (AA-M).
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Comparison of the Efficacy and Safety of Finasteride in Older Versus Younger Men with Benign Prostatic Hyperplasia Source: Urology. 57(6): 1073-1077. June 2001. Contact: Available from Urology. P.O. Box 2126, Marion, OH 43306-8226. (800) 215-4692. Fax (740) 382-5866. Summary: This article reports on a study undertaken to compare the efficacy and safety of finasteride (5 milligrams) in older (65 years old or older) versus younger (45 to
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younger than 65 years old) men with benign prostatic hyperplasia (BPH). The Proscar Long Term Efficacy and Safety Study (PLESS) was a 4 year, randomized, double blind, placebo controlled trial assessing the safety and efficacy of finasteride 5 milligrams in 3,040 men aged 45 to 78 years old with symptomatic BPH, enlarged prostates, and no evidence of prostate cancer. The endpoints included urinary symptoms, prostate volume, occurrence of acute urinary retention, or BPH related surgery, and safety. In both age groups, finasteride treatment led to a 51 percent reduction in the relative risk for acute urinary retention (inability to urinate because of blockage) or BPH related surgery, a significant and durable improvement in symptoms score, and a significant and sustained reduction in prostate volume. Within each age cohort, no significant differences were found between the placebo and finasteride treated patients in the incidence of cardiovascular adverse events. Significant differences were evident between the placebo and finasteride groups in the incidence of the typical, known, drug related adverse events, but no specific differences were associated with age. No drug interactions of clinical importance were observed in the finasteride treated patients. The results demonstrate that finasteride is highly effective in improving symptoms and reducing prostate volume in many men and in reducing the risk of acute urinary retention and BPH related surgery. 2 figures. 3 tables. 16 references. •
Finasteride Under FDA Review for Male Baldness Source: Skin and Allergy News. 28(3):6; March 1997. Summary: This journal article for health professionals reports on the findings from a phase II study of finasteride. A 5 milligram (mg) per day formulation of the drug is used for treating benign prostatic hyperplasia. During phase II, 74 men received this dosage of the drug and 80 men received a placebo. Those who were treated with finasteride had a significant increase in vertex hair during the 1-year treatment program. The drug inhibits an enzyme that converts testosterone to dihydrotestosterone, which is responsible for male-pattern hair loss. The manufacturer of finasteride has filed data from phase III trials with the Food and Drug Administration for treating baldness with a 1 mg per day formulation of the drug.
Federally Funded Research on Finasteride The U.S. Government supports a variety of research studies relating to finasteride. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to finasteride. 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 2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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animals or simulated models to explore finasteride. The following is typical of the type of information found when searching the CRISP database for finasteride: •
Project Title: CALGB Principal Investigator & Institution: Bloomfield, Clara D.; Director; Internal Medicine; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2002; Project Start 16-APR-1998; Project End 31-MAR-2003 Summary: (adapted from the applicant's abstract): This is a multi-disciplinary collaborative research project for the development of more effective methods of prevention, detection, and treatment of human cancer in all its forms. This research focuses the efforts of medical oncologists, surgeons, radiotherapists, psychiatrists, pathologists, basic scientists, statisticians, epidemiologists, nurses, pharmacists, and clinical research associates on well designed and conducted studies asking interrelated clinical and basic science questions whose answers contribute significantly to patient care and to reduction of cancer within populations at increased risk for its development. Included in this project are the following: (1) the exploration of new therapeutic agents, and their associated toxicities, through a wide range of neoplastic diseases in Phase I, II, and III studies; (2) the evaluation of the efficacy and toxicity of new regimens including combinations of new and old agents in an effort to exploit synergistic combinations more effectively; (3) the development of multi-modal approaches to specific tumor problems using surgical, immunological, and radiotherapeutic measures in optimal combinations; (4) the involvement of pertinent basic science disciplines such as biochemistry, pharmacology, cellular biology, and mathematics in the formulation and execution of specific treatment protocols; (5) the improvement of cancer care in the community by using these programs in the educational effort directed at pre- and postdoctoral students, nurses, allied medical personnel and physicians; (6) the evaluation of biologic studies in correlation with clinical endpoints so as to build toward more rationally, based cancer management; (7) the evaluation of cancer control efforts such as early detection; and (8) the study of the psycho-social aspects of cancer. This application for permanent membership in the Cancer and Leukemia Group B represents a turning point in the cooperative group clinical research activities of The Ohio State University as it leaves its long-standing affiliation with the Southwest Oncology Group. Motivating this change is the recruitment of Drs. Clara D. Bloomfield, Michael A. Caligiuri, and Albert de la Chapelle. The research attributes of these outstanding investigators are synergistic with existing capabilities at Ohio State. Combining these separate strengths will enhance development of innovative clinical trials especially those with basic science correlates and strengthen Ohio State's cancer cooperative group participation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CANCER AND ACUTE LEUKEMIA GROUP B (CALGB) INST GRANT Principal Investigator & Institution: Gelmann, Edward P.; Professor of Medicine & Cell Biology; None; Georgetown University Washington, Dc 20057 Timing: Fiscal Year 2002; Project Start 30-APR-1998; Project End 31-MAR-2003 Summary: (adapted from applicant's abstract): The overall objective of this project is to provide support for performance of clinical studies of the Cancer and Leukemia Group B at the Lombardi Cancer Center at Georgetown University Medical School. The LCC/GUMC is an NCI-designated Comprehensive Cancer Center. In 1988, Marc Lippman, M.D., assumed Directorship of the Lombardi Cancer Center. Under his
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direction, the Cancer Center was designated as a Federally Funded Cancer Center in 1989. The Cancer Center became a Federal designated "Comprehensive Cancer Center" in 1992, and the Cancer Center Support Grant was renewed in 1996 with an overall rating of "excellent to outstanding." During the previous funding period, LCC/GUMC has participated in CALGB studies as an unfunded affiliate institution of the University of Maryland Cancer Center. In March, 1997, the CALGB Board of Directors approved LCC/GUMC as a Main Member Institution. At that time, Dr. Daniel F. Hayes was named as Institutional Principal Investigator. LCC/GUMC will participate in the entire range of multimodatity clinical studies, including both therapeutic studies, correlative science studies. and companion studies of quality of life, survivorship, and cost effectiveness analyses. LCC faculty have been active in all three areas of CALGB activities: accrual, scientific leadership, and administrative tasks. As of May 1, 1997, 41 CALGB protocols were active at LCC/GUMC. A total of 129 patients have entered CALGB studies since LCC entered CALGB in 1990, with 78 of these during this funding period (1993-1996). Accrual has increased over the last three years: 1994, 10 patients; 1995, 26 patients, and 1996, 31 patients. 17 percent of these patients were from minority populations, and 69 percent of patients entered onto CALGB trials were women. A recent audit by CALGB rated LCC as "Acceptable." Several initiative are being used to increase accrual at LCC, including recruitment of onsite clinical faculty committed to clinical trials, organization of a highly coordinated Clinical Research Management Office, development of a clinical Research Consortium of off-site affiliates. and development of a Patient Accession Core Project. Lombardi has a major program to increase accrual of minorities and women to clinical trials, coordinated by the Associate Director of the Cancer Center, Dr. John Kemer. It is estimated that LCC will accrue 95 patients/year to CALCB therapeutic and companion studies. LCC faculty are already leaders in CALGB, with 12 cadre committee members, two of whom are Committee Chairs (Dr. Hayes, Solid Tumor Correlative Science; Dr. Raymond Weiss, Audit). Five faculty members are Study Chairs for 11 active CALGB trials or companion studies. Two faculty have two concepts under review that are likely to open in the next twelve months. Because of the depth of scientific accomplishments of the LCC faculty, it is anticipated that many more will assume leadership roles within CALGB now that LCC/GUMC has Main Member Status. Three faculty have had administrative roles, including Dr. Raymond Weiss who started and has been the only Chair of the Audit Committee. The LCC research infrastructure for clinical and translational science is substantial, and LCC faculty are expected to provide leadership in developing clinical and correlative science studies during the next funding cycle. In summary, with Main Membership status and maturation of the Cancer Center, the LCC is expected to become one of the leading institutions within the CALGB during the next five years. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CANCER AND LEUKEMIA GROUP B Principal Investigator & Institution: Schilsky, Richard L.; Associate Dean for Clinical Research; None; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2002; Project Start 30-SEP-1983; Project End 31-MAR-2003 Summary: The CALGB is comprised of 31 academic medical centers and over 185 affiliated community hospitals joined in the pursuit of improved cancer treatment and better understanding of tumor biology via the conduct of controlled clinical trials. Over 3000 members of the Group including oncology physicians, statisticians, clinical research associates, oncology nurses, pharmacists, epidemiologists, and basic scientists participate in these studies. From 25-35 phase III protocols are active at any one time,
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along with Phase II, Phase I and pilot studies required for the appropriate design of large scale randomized trials. In 1996 the CALGB accrued nearly 4700 entries to its protocols. Multidisciplinary disease committees of the Group design and implement protocols for the treatment of patients with leukemia, lymphoma, breast, respiratory, GI, and prostate cancer. Modality Committees, including Clinical Economics, Correlative Sciences, Pharmacology and Experimental Therapeutics, Psycho-Oncology, Surgery, Pathology, Radiation Oncology, Transplantation, Oncology Nursing, and Clinical Research Associates serve as the sites for planning and implementing new approaches for these disciplines and most committees develop these concepts jointly with the appropriate Disease Committees. Major area of emphasis in CALGB include development of innovative treatments for patients with cancer; studies of molecular predictors of prognosis and response to therapy; studies of pharmacokinetics and pharmacodynamics of new and established anticancer drugs; evaluation of minimally invasive surgical techniques; determining the cost and cost-effectiveness of new cancer therapies; evaluating the impact of cancer and its treatment on the quality of life of cancer patients and their caregivers; developing new strategies for cancer prevention; and addressing the needs of special populations, particularly minorities and the elderly. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CANCER AND LEUKEMIA GROUP B Principal Investigator & Institution: Sugarbaker, David J.; Vice Chairman/Chief; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 26-APR-1993; Project End 31-MAR-2003 Summary: application intended to support surgical activities within CALGB including the recruitment of patients to adjuvant trials, development and performance of surgical trials, and surgical quality control. Historically, surgical participation within CALGB had been limited, in part due to the early focus of CALGB investigations of leukemia and late-stage solid malignancies. Increasing emphasis on adjuvant trials has required greater surgical participation, both for recruitment of perioperative patients, but as well for surgical quality control. The application describes five specific aims of the Surgery Modality Committee: (1) to develop a quality control program that will seek to standardize the surgical component of CALGB protocols; (2) to provide a platform to support the intellectual activity of CALGB surgeons; (3) to provide a mechanism for the practical support of surgical activity within the group; (4) to assure regular review and monitoring of individual surgical productivity; and (5) to permit CALGB surgeons to assume leadership roles in protocol development. The Surgery Modality Committee consists of a consortium of 29 surgeon members, each representing a CALGB institution. The group is organized and run by a central committee for which Dr. Sugarbaker is chair and Dr. Leslie Kohman is vice-chair, as well as three disease site subcommittees, including Thoracic, Breast, Gastrointestinal, and an Institutional Coordinators Committee. Protocol concepts are developed in the disease committees. Three stages of group development are described: (1) surgeon recruitment phase; (2) patient recruitment phase (educational activities about adjuvant therapy trials. etc.); and (3) protocol development phase (intellectual activities). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CANCER AND LEUKEMIA GROUP B Principal Investigator & Institution: Crawford, Jeffrey; Medicine; Duke University Durham, Nc 27706
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Timing: Fiscal Year 2002; Project Start 01-APR-1988; Project End 31-MAR-2003 Summary: (adapted from the applicant's abstract): Duke Medical Center is currently completing its second five year grant cycle as a member of Cancer and Leukemia Group B (CALGB). Throughout Duke's involvement with CALGB, this institution has consistently been one of the top institutions in overall patient accrual and specifically has been one of the leading institutions in patient accrual from a main member institution. Over the period of the last grant cycle, Duke has developed an affiliate program through the Duke Oncology Consortia (DOC) which involves cancer centers and hospitals throughout the Southeast United States. This affiliate membership is still growing in number of sites and level of participation in clinical trials. In addition, the Duke Oncology OutReach Services (DOORS) network provides onsite cancer care at small hospitals and clinics in neighboring counties. Both intramural and extramural clinical trial participation are coordinated through centralized clinical trials offices at Duke. This includes personnel support for core administrative functions, clinical trial coordination provided by disease and modality specific clinical research nurses, and data management and follow-up by dedicated CALGB data managers. This organizational structure is further strengthened by close interaction with the CALGB biostatistics and data management center under the direction of Dr. Stephen George who is also director of biostatistics for the Duke Cancer Center, Scientifically, Duke has active cadre members in all the disease and modality related CALGB committees. Duke investigators serve as study chairs on Phase III trials in AML, stage IV breast cancer, the national high priority trial of bone marrow transplant in the adjuvant treatment of breast cancer patients (9082), as well as numerous Phase II studies. Duke is also a center for Phase I studies for pharmacology/experimental therapeutics. This has been further strengthened by the recruitment of Dr. Michael Colvin to become Director of the Cancer Center. Furthermore, Dr. Harvey J. Cohen, Director of the Aging Center has become an active member of CALGB and was instrumental in the formation and leadership of a working group evaluating cancer and aging. The recruitment of Dr. David Harpole in Thoracic Surgery, led to Duke becoming a major site for participation in CALGB surgical trials. Multimodality support has also been provided by active participation from other members of surgical oncology as well as radiation oncology, pathology, and correlative sciences. Areas of expansion by Duke investigators within CALGB over the next grant cycle will be particularly targeted to multimodality trials, Phase I studies, bone marrow transplant trials, and the continued participation in ongoing phase II and III trials. In addition, our participation in community trials addressing minority issues, gero-oncology, and cancer control will expand with the participation of Dr. Barbara Rimer and Dr. Colleen McBride. As a leading institution in CALGB activities over the last decade, Duke is looking forward to funding support appropriate to our current and anticipated level of patient accrual and scientific involvement in CALGB trials during the next grant cycle. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CANCER AND LEUKEMIA GROUP B Principal Investigator & Institution: Edelman, Martin J.; Director; Medicine; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2002; Project Start 01-APR-1982; Project End 31-MAR-2003 Summary: The GCC continues to grow and develop a scientific and clinical relationship with CALGB. A number of the faculty at GCC participate in CALGB scientific and administrative committees. GCC faculty design, conduct and chair many group studies and enter large numbers of patients onto CALGB studies. The GCC faculty are on five
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core committees and chair the Leukemia Committee and the Subcommittee on Thoracic Surgery. The funding to continue these activities will allow further growth in the scientific and administrative participation of GCC and its affiliates. GCC is one of the largest accruing institutions for leukemia and one of the largest accruing institutions overall. The basic science laboratories studying acute leukemia, cellular, animal and clinical pharmacology and cellular and molecular biology form an important correlative science resource for the group. The grant will allow GCC to continue its highly effective scientific and administrative participation in the group and will continue to allow them to develop a scientific base in the greater Baltimore area and across the state and region. The grant will also allow for continuation of meritorious pilot protocols and will allow GCC to monitor and collect data which will produce mutual benefit to the GCC and CALGB. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CANCER AND LEUKEMIA GROUP B (CALGB) Principal Investigator & Institution: Ernstoff, Marc S.; Medicine; Dartmouth College 11 Rope Ferry Rd. #6210 Hanover, Nh 03755 Timing: Fiscal Year 2002; Project Start 01-APR-1979; Project End 31-MAR-2004 Summary: (adapted from the applicant's abstract): Patients with breast cancer, lung cancer, gastrointestinal malignancies, prostate carcinoma, leukemia and lymphoma and other malignancies will be entered into therapeutic, cancer control and correlative science trials developed by the Cancer and Leukemia Group B (CALGB). A broader base for recruitment of patients to CALGB has been established in much of New Hampshire, eastern Vermont and northern Massachusetts through the eight member Cooperative Group Oncology Program, and with this network it is planned to increase the numbers of patients accrued to CALGB studies. Dartmouth will continue to make significant contributions to the scientific and administrative activities of CALGB. Within the Norris Cotton Cancer Center (NCCC) strategies to refocus the scientific directions will allow more translational programs to be piloted for future testing in the CALGB setting. The six areas of development are immunotherapy, retinoid development, clinical pharmacology, genetics and gene modulation, drug development and interactions with radiation, tumor markers, pain and psychosocial initiatives. It is anticipated that phase I, II and pilot clinical trials currently underway at the Norris Cotton Cancer Center will soon be ready for expanded trials in CALGB. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CANCER AND LEUKEMIA GROUP B--MINNESOTA ONCOLOGY GROUP Principal Investigator & Institution: Peterson, Bruce A.; Medicine; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 01-APR-1979; Project End 31-MAR-2003 Summary: (adapted from the applicant's abstract): The University of Minnesota has been a participating member of the Cancer and Leukemia Cooperative Group B (CALGB) for the clinical studies of hematologic malignancies and solid tumors since August 1973. The Minnesota Oncology Group consists of established investigators from the Department of Medicine, the Department of Therapeutic Radiology, the Department of Laboratory Medicine and Pathology, the Department of Surgery, and the Department of Pediatrics/School of Public Health with extensive expertise in clinical cancer research, including clinical trials, bone marrow transplantation, immunology, cytogenetics,
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pathology and epidemiology. The Minnesota Oncology Group participates in the CALGB in order to pool its intellectual, technical and clinical resources with other academic institutions to expedite progress in clinical cancer research. The specific aims of this proposal include: (1) to contribute to and participate in the scientific endeavors of CALGB; (2) to reach our accrual potential and then to maintain patient accrual at that increased level; (3) to assist in the administrative and organizational matters of CALGB. The methods of study are through the clinical research protocols established by the CALGB. The clinical material provided by the Minnesota Oncology Group is composed primarily of patients with leukemia, lymphoma, breast cancer, gastrointestinal cancer and lung cancer, and participation is in the entire range of trials, including bone marrow transplantation and phase I drug testing. Major scientific positions held by Minnesota participants are the Chair of the Lymphoma Committee and Vice-Chair of the Pathology Committee for Hematologic Malignancies. In addition, 10 participants are members of various scientific core committees and a major group service in leukemic research is centered at Minnesota. The Minnesota Oncology Group is active in administrative activities with the Chair of the Constitution Committee and membership on the Institutional Performance Evaluation Committee (Standards, Ethics and Peer Review Committee), Membership Committee, Data Audit Committee and the Board of Directors. The objective of this research program is to participate in inter-institutional clinical research to resolve unanswered and important questions in the therapy and biology of malignant diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CANCER AND LEUKEMIA GROUP B--MOUNT SINAI Principal Investigator & Institution: Silverman, Lewis R.; Chairman; Medicine; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 01-APR-1979; Project End 31-MAR-2003 Summary: (adapted from the applicant's abstract): Mount Sinai intends to continue its vigorous participation in activities of the Cancer and Leukemia Group B. We will commit intellectual and patient resources to research in leukemia, lymphomas, breast cancer, respiratory cancers, gastrointestinal cancer, prostate cancer, transplantation and companion studies. These clinical undertakings involve psycho-oncology, pathology, cytogenetics, immunology and epidemiology. Various members of the Mount Sinai faculty serve as Study Chairs, and bring some of their pilot observations to Group consideration. Our efforts are particularly focused on breast cancer, myelodysplastic syndrome and innovations in chemotherapy. The objectives of the Group are to discover and validate effective treatments for the cure and long term palliation of cancer. Mount Sinai is wholeheartedly committed to these objectives and will devote energy to make the most effective studies available to the Group for research purposes. We will participate in single and multi-disciplinary trials, Phase I, II, III and will contribute specimens to the Group's correlative science studies. We will conduct scientific inquiries on Group specimens. Mount Sinai will coordinate the studies of Cooperative Group Outreach Program (CGOP) participants, and serve as a research base for Community Clinical Oncology Program (CCOP) institutions. With these associated investigators in 12 affiliated institutions, Mount Sinai plans to participate in all Group activities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CANCER AND LEUKEMIA GROUP B--PET COMMITTEE Principal Investigator & Institution: Ratain, Mark J.; Professor of Medicine and Chairman; Medicine; University of Chicago 5801 S Ellis Ave Chicago, Il 60637
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Finasteride
Timing: Fiscal Year 2002; Project Start 01-APR-1986; Project End 31-MAR-2003 Summary: (Adapted from the applicant's abstract): The overall objectives for the Pharmacology and Experimental Therapeutics (PET) Committee of the CALGB are to study population pharmacokinetics and pharmacodynamics of new and established anticancer agents in a multi-institutional setting; to introduce new drugs and combinations, including immunomodulatory and cytostatic agents into the CALGB for eventual phase II and III testing; to initiate and conduct a program of mucositis prevention in the CALGB; and to organize educational symposia for the Group on topics in cancer pharmacology and experimental therapeutics. The committee meets twice annually in addition to sponsoring an educational session at each of the full Group meetings. Population pharmacology are ongoing of suramin, carboplatin, paclitaxel, 9aminocamptothecin, 5-fluorouracil and etoposide. Studies are planned of irinotecan and docetaxel, in addition to two additional studies of paclitaxel with regard to the effects of age and body surface on toxicity and pharmacokinetics, Other special populations to be studied include race (docetaxel and irinotecan) and end-organ dysfunction (gemcitabine, irinotecan). Two novel therapeutic studies involving biologics are planned, including IL-2 in combination with an anti-HER-2 monoclonal antibody and interferon alpha in combination with tamoxifen. Another new initiative is a program to prevent mucositis. The initial study will evaluate the effect of IL-11 on mucositis secondary to cisplatin, 5-FU and leucovorin. Since many of the studies include analysis of pharmacological specimens, the Committee utilizes three core laboratories--at the University of Chicago, the University of Maryland and the University of Tennessee. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CANCER AND LEUKEMIA GROUP B--RPCI/SUNYAB Principal Investigator & Institution: Levine, Ellis G.; Roswell Park Cancer Institute Corp Buffalo, Ny 14263 Timing: Fiscal Year 2002; Project Start 15-APR-1993; Project End 31-MAR-2003 Summary: (Adapted from applicant's abstract): Roswell Park Cancer Institute (RPCI) is requesting support to continue its participation in the Cancer and Leukemia Group B (CALGB). The goals of our participation in CALGB include the following: (1) to continue our strong contribution to the scientific agenda of the group, (2) to continue our performance of pilot activity at the local level that can be considered for group adaption, (3) to continue our administrative support for the efficient functioning of the group, (4) to sustain accrual in order to allow the rapid accumulation of clinical data and experience through the cooperative group process, and (5) to continue to provide data of high quality in a timely manner. Over the last 3-plus years during which we have had funding, we have contributed substantially to the scientific, administrative, core, and publication activities of the CALGB. More specifically, five RPCI members serve or have served as chairs or vice chairs of scientific committee; 22 serve or have served as members on 33 scientific committees; 14 serve or have served as study chairs on 21 protocols; 7 provide or have provided core services to the Group; and 5 have performed pilot studies that have led to the development of CALGB protocols, 3 have protocols pending activation, and 3 have submitted concepts for development. Moreover, RPCI members have contributed to 111 publications and given over 70 educational sessions. Furthermore, several members have administrative roles in the Group. Accrual is customarily between 150-200 credits/year. Data quality and timeliness of submission is regularly cited by the Group's quality assurance committee as among the best in the Group. Continued funding should allow us to sustain the vigor of our activities and therefore meet our specific aims. Founded in 1898, RPCI was one of the first institutions
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dedicated exclusively to the research and treatment of cancer and allied diseases. The campus spans 25 acres in downtown Buffalo and consists of 15 research and clinical buildings with approximately one million square feet of space. Projected statistics for fiscal year 1996-1997 include 2381 new cancer cases, 5300 hospital admissions, and 104,000 outpatient visits from patients in 42 states and 22 foreign countries. The Institute is currently undergoing a $241 million modernization of its facilities. When completed in 1998, Roswell Park will have a new 133 bed hospital, a diagnostic and treatment center, outpatient clinics, and medical research laboratories, as well as renovated education, research, and support space. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CANCER CENTER CALGB PARTICIPATION Principal Investigator & Institution: Muss, Hyman B.; Professor of Medicine; Vermont Regional Cancer Center; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2002; Project Start 20-APR-1998; Project End 31-MAR-2003 Summary: (adapted from the applicant's abstract): The Vermont Cancer Center (VCC), an NCI designated Comprehensive Cancer Center, joined the CALGB in 1995. In that short time the VCC has made significant headway in becoming a major participant in CALGB activities. Eight VCC members have made major commitments to supporting CALGB efforts. Dr. Hyman Muss continues to be extremely active in CALGB and serves as the Co-Chair of the Working Group for the Elderly and the Vice Chair of the Breast Cancer Committee, in addition to chairing two CALGB protocols (8869 and 9670). Dr. Steven Grunberg, a member of the Clinical Economics Committee, is currently developing a clinical protocol that will compare cost with symptom control for antiemetics. Dr. David Krag is an active member of the Breast Core Committee and is helping CALBG develop a protocol for sentinel node staging for women with early stage breast cancer. Dr. Seth Harlow will assume Dr. Krag's role as member of the Surgery Committee. Dr. Donald Weaver participates extensively in pathology group activities and has a major interest in breast cancer. Drs. Michael Cooper, Barbara Grant, and Richard Branda have major interest in urologic cancer, leukemia and lymphoma, and nutrition and cancer, respectively, and have developed concepts for CALGB clinical investigations. The development of multidisciplinary, disease-site oriented, affinity groups within our Center has established major liaisons between laboratory and clinical scientists. This will strengthen our institutional commitment to the group and allow VCC members to develop innovative companion trials for the CALGB. Recently, Drs. Grant and Branda presented two concepts-one related to assessing the importance of folate status on chemotherapy toxicity in women with early breast cancer, and a second that utilizes a novel reporter gene (hprt) to monitor and possibly define women with early stage breast cancer who might be at high risk for developing secondary acute nonlymphocytic leukemia. Drs. Weaver and other VCC scientists are drafting a concept that will explore the role of erbB-2 associated signaling proteins as mediators of apoptosis for women with early stage breast cancer treated with anthracyclines (CALGB 8541). We anticipate a major increase in accrual in the next year. The Green Mountain Oncology Group (CCOP) selected the VCC as its research base beginning in April, 1997. In one month they have entered 10 patients on CALGB protocols. Two new faculty will join the VCC this summer who have major interests in genetics and high-dose therapy; it is anticipated they will be active in CALGB activities. Also, we are developing a major outreach program and expect to add several affiliates with interest in clinical trials. In addition, we have developed a high-dose chemotherapy autologous stem cell support
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program and expect to become a CALGB Transplant Center by the start of the next funding period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FINASTERIDE
CHEMOPREVENTION
OF
PROSTATE
CANCER
WITH
Principal Investigator & Institution: Szatrowski, Ted P.; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CHEMOPREVENTION FINASTERIDE, PHASE III INTERGROUP
OF
PROSTATE
CANCER
WITH
Principal Investigator & Institution: Long, John S.; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CLINICAL TRIAL OF MEDICAL THERAPY IN BENIGN PROSTATIC HYPERPLASIA Principal Investigator & Institution: Ramsdell, Joe W.; University of California San Diego 9500 Gilman Dr, Dept. 0934 La Jolla, Ca 920930934 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CLINICAL TRIAL OF MEDICAL THERAPY IN BPH Principal Investigator & Institution: Foster, Harris E.; Associate Professor; Surgery; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 27-APR-1995; Project End 31-MAR-2004 Summary: Benign prostatic hyperplasia (BPH) is the most common non-malignant neoplasm in the aging male. Primarily treated surgically in the past, the costs, complications and outcome of this treatment has spurned interest in medical management. The primary objective of this study is to critically evaluate pharmacological strategies for the treatment of symptomatic BPH. In particular, to determine the efficacy of alpha blockade (terazosin), androgen suppression (finasteride), and the combination of alpha blockade and androgen suppression for the treatment of men with symptomatic bladder outlet obstruction secondary to BPH. Other areas to be investigated include the ability of the above agents to delay or prevent progression of the disease, the relationship between prostate size and regression of symptoms, the ability of objective diagnostic and pathologic studies to determine which patients are better candidates for pharmacologic therapy, and determining at which stage of prostatic growth or symptoms it is best to intervene pharmacologically. The primary goal of this application is to demonstrate the ability of Yale University School of Medicine and the Yale-New Haven Hospital to successfully implement this protocol
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such that quality data is obtained to achieve the goals of the above stated proposal. The advantages of this site include: 1) investigators with recent experience in successfully implementing a similar protocol; 2) an institution with the necessary infrastructure and experience in participating in large multicenter protocols; 3) the presence of the university in an ethnically and socioeconomically diverse community, which will allow utilization of peripheral sites in these communities so that their inclusion is maximized; and 4) an established basic science laboratory skilled in many techniques which could be utilized for future studies of BPH, specifically immunohistochemical localization of various antigens. Recruitment strategies will include; 1) utilization of local media outlets such as newspapers, radio and television stations, specifically those targeting minority populations; 2) utilizing the peripheral sites, their staff and physicians to maximize enrollment by the population served; 3) soliciting participation from primary care physicians and urologists in the area who are not affiliated with any of the peripheral sites; and 4) speaking to various community organizations (i.e. churches and clubs) to increase public awareness. Subject follow-up will be encouraged by providing each with wallet sized information cards detailing return appointments, the presence of a daily central on-site nurse to maximize convenience, following subjects at two peripheral sites, travel and parking reimbursement, and a small financial incentive provided for each year of follow-up. The above characteristics and strategies make the Yale University School of Medicine and the Yale-New Haven Hospital an excellent candidate for a Clinical Center. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COHORT HYPERPLASIA
STUDY
OF
RISKS
FOR
BENIGN
PROSTATIC
Principal Investigator & Institution: Kristal, Alan R.; Member; Fred Hutchinson Cancer Research Center Box 19024, 1100 Fairview Ave N Seattle, Wa 98109 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2006 Summary: (provided by applicant): The overall goal of this application is to understand relationships among hormonal, genetic and behavioral risk factors for symptomatic benign prostatic hyperplasia (BPH). BPH symptoms affect well over half of American men over age 50, with substantial effects on quality of life and medical care cost of over 4 billion dollars annually. This study will assess whether the risk of symptomatic BPH is associated with (1) serum concentrations of steroid hormones and insulin-like growth factors known to affect prostate growth; (2) polymorphisms in genes that affect hormone and growth factor metabolism or activity; and (3) diet and other lifestyle factors that affect steroid hormones and insulin-like growth factor concentration or activity. Data are from the Prostate Cancer Prevention Trial (PCPT), a double blinded, placebo-controlled, randomized trial of the drug finasteride (Proscar) for the primary prevention of prostate cancer. Analyses will be restricted to the approximate 5,000 men in the placebo control group with no medical history or symptoms of BPH at baseline. The primary endpoint, incidence of symptomatic BPH, is based on careful and standardized assessments of lower urinary tract symptoms and treatment for prostate-related disease collected at baseline and annually for 7 years. Steroid hormones, insulin-like growth factor 1 and insulin-like growth factor binding protein 3 will be measured from plasma banked at baseline, and genetic characteristics will be assessed using banked lymphocytes. Diet and other behavioral risk factors were assessed by both interviewer- and selfadministered questionnaires. A nested case-control design, with 700 cases and 700 controls, will be used to address hypotheses related to serum measures and genetic polymorphisms. A cohort study using all 5,000 men will be used to examine hypotheses
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related to diet and other behavioral risk factors. The nested case-control studies are powered to detect odds ratios of 1.5 and the cohort studies are powered to detect hazard ratios of 1.35, comparing highest to lowest quartiles of exposures, with type I error = 0.05 and type II error = 0.20. This study is highly cost-effective, as all data and samples have been collected, and funds are requested for laboratory analyses of serum and genetic polymorphisms, data preparation, statistical analyses and manuscript preparation. Results from this study will enhance our understanding of the etiology of symptomatic BPH and could potentially be used to develop new strategies for prevention and control of this very common disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EFFECTS OF FINASTERIDE ON MALE PATTERN BALDNESS Principal Investigator & Institution: Imperato, Julianne; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ETHANOL WITHDRAWAL AND NEUROACTIVE STEROIDS Principal Investigator & Institution: Finn, Deborah A.; Associate Professor; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002 Summary: The neuroactive steroid 3alpha-hydroxy-5alpha-pregnan-20 one (3alpha, 5alpha-P or allopregnanolone) is a potent positive modulator of GABA receptors. Recent results from years 01-04 of the previous Center application suggest that genotypic differences in the modulatory effect of 3alpha,5alpha-P on EtOH withdrawal severity may reflect a balance between the change in sensitivity of the GABAa receptors to 3alpha, 5alpha-P that are occurring concomitantly during EtOH withdrawal. These studies were conducted in two different animal models of ethanol (EtOH) withdrawal severity [i.e., DBA/2 (D2) and C57BL/6(B6) inbred strains and the selectively bred Withdrawal Seizure-Prone and-Resistant lines]. In addition, gene mapping studies in BXD Recombinant Inbred strains found a significant genetic correlation between chronic EtOH withdrawal severity and a region of chromosome 13 (combined p=0.00008) in which the murine gene for the enzyme 5alpha-reductase-1 (Srd5alpha1). Since 5alphareductase is the rate-limiting enzyme in the biosynthesis of 3alpha, 5alpha-P, we hypothesize that Srd5a1 represents a candidate gene for differences in EtOH withdrawal severity in mice derived form the B6 and D2 inbred strains. Because male and female mice differ in endogenous levels of 3alpha, 5alpha-P (i.e., female > male) and in EtOH withdrawal severity ( female <male), studies related to Specific Aims 1 and 2 will determine whether male and female B6 and D2 mice differ in Srd5a1 sequence and whether the genotypes differ in enzyme activity and/or gene expression of Srd5a1 following exposure to chronic EtOH. The physiological consequence of 5alpha-reductase inhibition or deletion on EtOH withdrawal severity will be examined in Specific Aims 3 and 4. Therefore, the combined use of behavioral, biochemical, genetic and molecular strategies will determine the importance of 3alpha, 5alpha-P as a neuromodulator of EtOH withdrawal severity by assessing Srd5a1 as a candidate gene for genetic differences in EtOH withdrawal severity. These goals are consistent with the two main themes of the Center, which are to identify genes and to explore mechanisms underlying EtOH neuroadaptation. A longer-term goal of this research is to gain information that
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would help in the development of new strategies for the treatment of alcohol dependence. As recent findings emphasize the therapeutic potential of neurosteroid treatment during alcohol withdrawal, the studies proposed in Component #5 will determine whether neurosteroid biosynthesis represents a target for therapeutic intervention in the treatment of alcohol dependence and withdrawal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ETIOLOGY AND TREATMENT OF ALCOHOL DEPENDENCE Principal Investigator & Institution: Hesselbrock, Victor M.; Professor; Psychiatry; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 Timing: Fiscal Year 2003; Project Start 01-MAR-1978; Project End 30-NOV-2007 Summary: (provided by applicant): Since 1978, the Center on the Etiology and Treatment of alcohol Dependence (UConn ARC) has been devoted to a systematic exploration of the etiology and the treatment of alcohol dependence. This application requests five years of continued funding for the Center's research programs on vulnerability to alcohol dependence and promising biological and psychosocial treatment interventions. The Administrative/Scientific Cores describe the UConn ARC's organizational framework, quality control mechanisms related to research and publications, and core research facilities. Project 0027 describes the continuation of a prospective longitudinal study of Deviance Proneness as a model for predicting alcohol use behaviors, including pathological alcohol involvement, among older adolescents and young adults. Personality traits, cognitive factors, and conduct problems are examined as predictors of pathological alcohol involvement. Project 0032, a second study of vulnerability, will focus on several motivational pathways that may increase the susceptibility for developing heavy drinking and alcohol-related problems among college students. Using a multi-wave, cohort-sequential design, daily process information will be collected via web-based data methods at three different sites. Continuing our Center's emphasis on novel treatments for alcohol dependence, we have proposed two research components in this area. Project 0033 will evaluate the efficacy of contingency management (CM) procedures versus standard case management for reducing chronic alcoholic recidivism. A variety of alcohol use and behavioral outcomes will be examined, and an economic analysis of CM for reducing recidivism will be conducted. Project 0034 is a placebo-controlled trial of targeted vs. daily administration of naltrexone treatment for early problem drinkers. In addition to drinking behavior, mood, desire to drink and self-efficacy will be measured daily to examine possible mechanisms of naltrexone's effects. A pilot studies component will support five studies that relate directly to the Center's themes of vulnerability and novel treatments for alcohol dependence. Three studies will use animal models to examine neurobiological substrates of vulnerability, while two studies will provide an examination of the effects of two pharmacologic agents (finasteride, naltrexone). Finally, this application describes educational activities, information dissemination, a visiting scholars program, and consulting and mentoring activities that strengthen the role of the UConn ARC as a regional and national resource. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GENETIC MARKERS OF TRANSITION ZONE HYPERPLASIA Principal Investigator & Institution: Shappell, Scott B.; Assistant Professor; Pathology; Vanderbilt University 3319 West End Ave. Nashville, Tn 372036917 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2005
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Finasteride
Summary: (provided by applicant): BPH is characterized pathologically by glandular and stromal hyperplasia leading to nodular expansion of the transition zone (TZ). As many as 50 % of males will require some form of treatment in their lifetime. Screening tests to assess risk for developing symptomatic BPH and tissue or blood based tests to stratify disease severity and to predict treatment response do not exist. BPH is extremely common in the TZ of radical prostatectomies performed for prostate carcinoma. Therefore to screen for candidate biomarkers we will utilize a large bank of snap frozen TZ tissues (> 2000 from > than 500 patients, including MTOPS trial patients) procured intraoperatively during RPs over the last several years. Three parallel screening strategies will be adopted: 1) cDNA microarrays will be used to detect genes that have altered expression correlating with disease severity; 2) TZ tissues implanted in the renal capsule of SCID mice will be used to identify genes regulated by androgens and the nuclear receptor peroxisome proliferator activated receptor gamma (PPAR() in human prostate in vivo by comparing gene expression in tissues from intact or castrated mice with or without treatment with agents such as testosterone, finasteride and ligands for PPARgamma; 3) data base mining will be used to identify candidate genes which can then be studied for altered expression in progressively severe BPH and for allelic variation in blood drawn from BPH patients. The combination of these strategies will allow identification of genes, or groups of genes by more than one approach. Correlation of expression of these genes in samples with progressively severe BPH will be confirmed by real time RT-PCR and epithelial and/or stromal localization of candidate genes will be determined by immunohistochemistry and in situ hybridization. Hormonally modulated genes and those that are involved in regulating epithelialstromal interactions are likely to be useful markers for disease and/or targets for novel therapeutics. Analysis of the results from these different strategies will indicate candidate genes to investigate for their role in regulating epithelial-stromal interactions in a tissue recombination system allowing for selectively manipulating gene expression in either prostate epithelium or stroma. This integrated interdisciplinary approach involving prostate investigators in Pathology, Urology, and Medical Genetics and key Core facilities at Vanderbilt will facilitate the success for this program. Large volumes of available cases and novel detection strategies will allow for the discovery and characterization of biomarkers useful in managing BPH patients. Models employed will be useful for characterizing the role of novel gene targets identified within the MTOPS Consortium as well as for testing new therapeutic strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMPACT OF PUBERTY ON THE KIDNEY IN DIABETES Principal Investigator & Institution: Lane, Pascale H.; Associate Professor; Pediatrics; University of Nebraska Medical Center Omaha, Ne 681987835 Timing: Fiscal Year 2002; Project Start 01-AUG-2001; Project End 31-JUL-2006 Summary: (provided by applicant): The prepubertal years of type 1 diabetes (DM) appear to be protected from expression of nephropathy and other microvascular complications. Only post-pubertal male rats given the diabetogenic agent streptozocin (STZ) develop renal and glomerular hypertrophy associated with increased expression and activity of transforming growth factor b (TGFb). Prepubertal rats do not develop hypertrophy or upregulation of the TGF system. Given clinical differences in the prevalence and rate of progression between the sexes, gonadal steroids seem likely to be involved in these processes. Overall hypothesis: Androgen synthesis that accompanies puberty contributes to the development of diabetic nephropathy via changes in the renal transforming growth factor (TGF(3) system. Specific Aims: I) What are the roles of
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androgens in diabetic kidney disease? 1)Examine sex differences in the renal reponse to STZ DM; 2)Examine the effects of gonadectomy on the post-pubertal renal response to STZ DM; 3)Determine the effect of testosterone treatment on the renal response to STZ DM; 4)Determine the role of the androgen receptor in the renal response to DM; and 5)Determine whether conversion to dihydrotestosterone is necessary for the postpubertal renal response to STZ DM. II) What is the mechanism through which puberty promotes TGFfi expression/activation? 1 )Examine the renin-angiotensin system in response to pre- and post-pubertal states and hormonal manipulation; 2)Examine the protein kinase C system in response to pre- and post-pubertal states and hormonal manipulation; 3)Examine the oxidative stress system in response to pre- and postpubertal states and hormonal manipulation; 4)Define the direct effects of sex steroids in vitro on the oxidative stress pathway; and 5)Define the direct effects of sex steroids in vitro on the PKC pathway. Methods: Rats will be given STZ DM pre- or post-puberty for 6 weeks, a duration of DM which increases TGFI3 expression and renal weight in adults. Groups will include males and females with and without earlier gonadectomy. Some groups will also receive treatment with testosterone, flutamide, an androgen receptor blocker, or finasteride, which blocks conversion of testosterone to dihydrotestosterone. in vitro studies will involve kidney slice cultures from 10 week old castrated male rats, with or without prior induction of OM. Media will include normal or high glucose conditions, as well as variable amounts of testosterone or estrogen. Measurements will include TGFJ3 proteins by ELISA and nitric oxide synthase isoforms, angiotensin II receptor, and protein kinase C isoforms by immunoblotting; superoxide generation; nitric oxide synthase activity; protein kinase C activity; mRNA for TGFb, nitric oxide synthases, and TGFb inducible gene-H3 by RT-PCR; plasma and renal levels of angiotensin II; and blood levels of sex steroids by RIA. Health implications: New treatments to prevent diabetic kidney disease, the most important cause of kidney failure in the US, may emerge from a better understanding of a naturally protected state such as the prepubertal animal. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MEDICAL THERAPY AND BENIGN PROSTATE HYPERPLASIA Principal Investigator & Institution: See, William A.; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002 Summary: The goal of the study is to ascertain if medical therapy with finasteride and/or doxazosin delays or prevents the progression of benign prostatic hyperplasia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MEDICAL THERAPY FOR BPH--DATA COORDINATING CENTER Principal Investigator & Institution: Noble, William; Associate Professor; Statistics; George Washington University 2121 I St Nw Washington, Dc 20052 Timing: Fiscal Year 2001; Project Start 30-SEP-1992; Project End 31-MAR-2004 Summary: The Biostatistics Center of The George Washington University proposes to work in cooperative agreement with the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK-NIH) to serve as the Data Coordinating Center (DCC) for a proposed multi-center clinical trial of the medical therapy of benign prostatic hyperplasia (BPH). the purpose of the NIH-BPH Clinical Trial is to determine the safety and efficacy of the pharmacotherapies finasteride (an inhibitor of 5-alpha-reductase) and doxazosin (a blocker of alpha-1 adrenoreceptors) on the clinical progression of BPH.
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The objective of the transition phase is to finalize the protocol, operations manual and data collection forms to be implemented in a 6 year full-scale clinical trial. The trial will require randomization of 2,800 participants with a diagnosis of BPH over a 2 year period in 17 clinical centers. Eligible participants will be randomly assigned, double-masked, to one of four treatment groups: (1) active finasteride (5 mg., once per day) and active doxazosin (4 mg or 8 mg, once per day); (2) active finasteride and doxazosin placebo; (3) finasteride placebo and active doxazosin; or (4) finasteride placebo and doxazosin placebo. Randomized participants will be followed for a minimum of 4 years (maximum of 6 years) with quarterly follow-up visits. Clinical progression of BPH is defined by the incidence of acute urinary retention, renal insufficiency, recurrent urinary tract infections, incontinence, or a pre-specified increase in the American Urological Association (AUA) symptom score. Secondary outcomes include differences over time among the four treatment groups with respect to AUA symptom score Quality of Life and maximal uroflow. Tissue biopsies will be obtained in 20 percent of the participants to provide information on the histopathobiology of BPH and to test existing biomarkers for their prognostic ability regarding response to medical therapy. The specific aims of the DCC are to provide centralized support and biostatistical consultation in the transition of the pilot study's patient management protocols, operations manual, data collection forms and randomization procedures to the full-scale clinical trial; implementation of a data processing system including data quality assessment; interim analysis of protocol performance, patient safety and treatment efficacy; ad final analysis for publication of the NIH-BPH Clinical Trial results in collaboration with the clinical investigators. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MEDICAL THERAPY OF BENIGN PROSTATIC HYPERPLASIA Principal Investigator & Institution: Mcconnell, John D.; Executive Vice President; Surgery; University of Texas Sw Med Ctr/Dallas Dallas, Tx 753909105 Timing: Fiscal Year 2001; Project Start 30-SEP-1992; Project End 31-MAR-2004 Summary: The primary goal of this proposal is to initiate a collaborative full- scale trial to test whether medical therapy (finasteride and/or doxazosin) delays or prevents the progression of symptoms of BPH or if it relieves these symptoms, and the duration of these effects. The primary outcome will be the time-to-progression of BPH. Clinical progression is defined as the occurrence of one or more of the following: acute urinary retention, renal insufficiency due to BPH, recurrent urinary tract infection, incontinence or an increase in AUA Symptom Score of 4 or more points. Approximately 2,800 study participants will be required for the full-scale trial, with 200 study participants randomized at UT Southwestern. A variety of secondary research questions will be addressed, including the value of diagnostic tests in predicting the progression of BPH and response to therapy, as well as a variety of tissue-based analyses yet to be defined. The Division of Urology at UT Southwestern served as one of the pilot Centers in the NIH/BPH Study, recruiting the requested number of patients and meeting all protocol and data entry requirements. We have an extensive experience with BPH clinical trial design and conduct. Our recruitment strategies to randomize 200 patients over two years are outlined. In addition, our group has an active basic prostate research program and hope to actively participate in the design of biochemical/molecular studies to be performed on the prostate tissue biopsies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MEDICAL THERAPY OF BENIGN PROSTATIC HYPERTROPHY Principal Investigator & Institution: Lepor, Herbert; New York University School of Medicine 550 1St Ave New York, Ny 10016 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MEDICAL THERAPY OF PROSTATIC SYMPTONS (MTOPS) Principal Investigator & Institution: Foley, John P.; Henry M. Jackson Fdn for the Adv Mil/Med Rockville, Md 20852 Timing: Fiscal Year 2002; Project Start 27-APR-1995; Project End 31-MAR-2003 Summary: The objective of this two-by-two, prospective, blinded trial is to determine if finasteride and/or doxazosin will delay or alter the development of benign prostatic hyperplasia (BPH) in a population of at- risk men with mild to moderate symptoms of BPH. Progression of BPH will be defined as development of urinary retention, renal insufficiency, urinary tract infections, or incontinence as well as an increase in the AUA symptom score of greater than or equal to 4 points. The trial includes a two-year accrual phase followed by four years of follow-up and a one-year study closeout period. From a large population of retired military health care beneficiaries in the San Antonio metropolitan area, including a large proportion of African American and Hispanic men, the Urology Service, BAMC proposes to identify eligible men for the trial, conduct regular screening clinics and randomize 200 men during a two year period. Particular emphasis will be placed on recruitment of minority populations. Compliance to the dosing schedule of study drugs will be assured through a schedule of regular telephone contacts with participants and will be monitored through regular pill counts. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MEMORIAL HOSPITAL AND CANCER AND ACUTE LEUKEMIA GROUP B Principal Investigator & Institution: Hudis, Clifford A.; Chief; Sloan-Kettering Institute for Cancer Res New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 30-JUL-1998; Project End 31-MAR-2003 Summary: (adapted from the applicant's abstract): This is the first application for support of Cancer and Leukemia Group B (CALGB) research activities by Memorial Sloan-Kettering Cancer Center (MSKCC) as a Main Member institution. MSKCC's mission is devoted to clinical and laboratory research related to cancer treatment and biology. Previously an affiliate of the New York Hospital, MSKCC became a Main Member in February 1996. This change from affiliate to Main Member represents our commitment to participate in a broad-based cooperative group in order to participate in national group and intergroup randomized trials and to interdigitate the national agenda into our extensive clinical trials program. Strong research interactions already exist between CALGB and MSKCC. Larry Norton, M.D., Chair, Breast Committee, and Jimmie Holland, M.D. first and only Chair, Psycho-Oncology Committee, both play dominant roles in shaping group and national clinical trials. In addition, Nancy Kemeny, M.D., is a member of the GI Committee and Medical Oncology Chair of CALGB 9481, studying intrahepatic chemotherapy in colorectal cancer patients with hepatic metastases. We plan to augment participation in these areas, and Clifford Hudis, M.D., and Andrew Seidman, M.D., are already actively presenting to the Breast
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Committee. Alice Kornblith, Ph.D., leads several psycho-oncology efforts, and Russell Porenoy, M.D., and Raymond Wesson, Ph.D., will join palliative care and minority issue efforts. Committee participation has expanded, with 19 MSKCC faculty appointed to 12 committees. Protocol accrual has increased, with 69 credits between 3/1/96 and 5/1/97, and 47 credits since 12/96 alone. Increased clinical trial accrual will result from newly activated CALGB therapeutic and nontherapeutic studies from additional disease and modality committees and, by introducing new drugs and biologics under development at MSKCC, into Group studies. This integration is under way. R.S.K. Chaganti, Ph.D., will participate in Leukemia/Lymphoma Correlative Sciences studies by providing the introduction of comparative genomic hybridization into the study of malignant lymphomas. Accrual from affiliation with McGill University will augment MSKCC activities in CALGB. MSKCC looks forward to participation in CALGB's excellent group science. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MINIMALLY INVASIVE SURGICAL THERAPIES CONSORTIUM FOR BP* Principal Investigator & Institution: Hirst, Kathryn; Associate Research Professor; Statistics; George Washington University 2121 I St Nw Washington, Dc 20052 Timing: Fiscal Year 2002; Project Start 30-SEP-2001; Project End 30-JUN-2006 Summary: (provided by applicant): The George Washington University Biostatistics Center proposes to work in cooperative agreement with the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) to serve as the Biostatistical Coordinating Center (BCC) for the Minimally Invasive Surgical Therapies (MIST) Consortium for Benign Prostatic Hyperplasia (BPH). The prostate surgeries labeled minimally invasive offer exciting treatment alternatives to the gold standard, transurethral resection of the prostate (TURP). The proposed consortium?s objective is to design and conduct up to four randomized, controlled, multi-center clinical trials to determine the long-term efficacy and safety of minimally invasive therapies for symptomatic benign prostatic hyperplasia (BPH). Researchers and investigators from 15 prostate evaluation and treatment centers (PETC), the NIDDK Division of Kidney, Urologic, and Hematologic Diseases, and the BCC will comprise the consortium and collaborate under a cooperative agreement mechanism. The Steering and Planning Committee, composed of the principal investigators from the BCC and each PETC and the NIDDK project officer, will design and develop each of the clinical trials. The BCC will provide centralized support and biostatistical consultation in: the development of protocols, manuals of procedures, data collection forms, and randomization procedures; implementation of a data management system including data quality assessment; interim analysis of protocol performance, patient safety, and treatment efficacy; and final analysis for publication of results in collaboration with the clinical investigators. The BCC will establish a secure encrypted and password protected web site for study staff to enhance development, distribution, and use of study documents. The application includes a proposed protocol for a 3-arm, placebo/sham controlled, randomized, double-blind clinical trial to address whether the apoptotic effect of neoadjuvant and adjuvant finasteride in combination with the thermal effect of high-energy transurethral microwave thermotherapy (TUMT) act synergistically to destroy more BPH mass and improve outcome than either finasteride alone or TUMT alone. Success is defined as at least 30 percent improvement in AUA symptom score. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MPSA PATHOLOGY COORDINATING CENTER Principal Investigator & Institution: Lucia, M S.; Pathology; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2005 Summary: (provided by applicant): Benign prostatic hyperplasia (BPH) is the most common proliferative disease of the prostate in men in the United States. More than two thirds of men over age 50 have some degree of BPH. Treatment for BPH approaches $5 billion annually. Prostate enlargement may lead to urinary retention and, in some cases, renal impairment. The NIDDK has sponsored a large clinical trial entitled "Medical Therapy of Prostate Symptoms (MTOPS)" that tested the ability of two medications, the 5 a-reductase inhibitor finasteride and the alpha-1 adrenergic receptor blocker doxazosin, alone or in combination, to treat this disorder. As part of this study, over 3000 men had annual serum samples drawn and approximately 1000 men had prostate biopsies at 0, 1 and 5 years of the study. These now comprise a large archival collection of clinical specimens currently being housed at our institution. The availability of these specimens presents a valuable opportunity for research to identify genetic and biologic markers that will further our understanding of the causes and progression of prostatic diseases and responses to therapy. The overall aim of this application is to establish a Pathology Coordinating Center (PCC) in support of the MTOPS Prostate Samples Analysis (MPSA) Consortium as described in RFA-DK-02-017. In response to the RFA, the Pathology Coordinating Center will provide expertise and resources in the areas of: 1) Archival Repository Management and Distribution, acting as a repository for all the serum and tissue specimens generated by the MTOPS project; 2) Histopathology, including diagnostic interpretation, paraffin processing and microtomy, cryomicrotomy, conventional light microscopy, laser capture microdissection, tissue arrays, immunohistochemistry, and imaging; and 3) Specialized Sample Preparation including high-quality DNA purifications, protein extractions for protein arrays and other proteomic applications, and SMARTa cDNA amplification of RNA. Our intent is to provide the highest quality non-biased patient samples prepared to meet the needs of individual research teams whether their studies focus on genetics, gene expression, or proteomics. It is our belief that the quality, reliability and applicability of biomarker research in prostatic diseases can only be guaranteed through the use of high quality non-biased patient specimens that have been handled, processed and interpreted in a uniform manner that can be directly linked to clinical information and outcome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MTOPS BIOMARKER UNIT AT THE UNIVERSITY OF PITTSBURGH Principal Investigator & Institution: Getzenberg, Robert H.; Director of Urological Research and Asso; Pathology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2005 Summary: (provided by applicant): Benign Prostatic Hyperplasia (BPH) is a disease of unknown etiology that significantly affects the quality of life in aging men. Histologic BPH may present itself either as symptomatic or asymptomatic in nature. To elucidate the molecular differences underlying BPH, gene expression profiles from the prostate transition zone tissue have been analyzed using microarrays. A set of 511 differentially expressed genes distinguished symptomatic and asymptomatic BPH. This genetic signature separates BPH from normal tissue but does not appear to change with age. This analysis resulted in the identification of several targets, which appear to
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differentiate BPH from individuals with symptoms from those with histologic BPH. As a Biomarker Unit of the MTOPS Prostate Sample Analysis Consortium we propose to both utilize these markers in a cooperative nature to analyze the tissue and serum samples collected as part of the Medical Therapy of Prostatic Symptoms clinical trial. Our Biomarker Unit will work closely together with the existing MTOPS Data Coordinating Center, the Pathology Coordinating Center as well as the other awarded Biomarker Units. We hypothesize that the genetic markers that we have identified may correlate with the occurrence of BPH as well as the severity of the BPH, responses to pharmacological agents as well as with clinical parameters obtained as part of the study. This hypothesis will be addressed by conducting the following specific aims: 1) to analyze the expression of JM-27, BMP-5 (list other markers) as well as other markers in biopsy samples obtained from the MTOPS trial as well as normal and BPH (symptomatic and asymptomatic) tissues in our bank and to correlate the abovedescribed markers with both response to therapy and symptom progression; 2) to develop serum-based methodologies for testing the expression of the above-described markers in patient samples obtained from the MTOPS trial as well as from normal and BPH (symptomatic and asymptomatic) individuals from our Institution; and 3) to further develop a system by which other markers developed and prioritized by the MTOPS Consortium can be analyzed. As a component of the MTOPS Consortium, these studies should provide the development of novel biomarkers with utility in diagnosing and characterizing BPH. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OVARIAN HORMONE METABOLITES & NEURAL CIRCULATORY CONTROL Principal Investigator & Institution: Heesch, Cheryl M.; Associate Professor; Veterinary Biomedical Sciences; University of Missouri Columbia 310 Jesse Hall Columbia, Mo 65211 Timing: Fiscal Year 2002; Project Start 01-SEP-1985; Project End 31-DEC-2003 Summary: (Adapted from the application) Normal pregnancy is associated with a 40% increase in blood volume and cardiac output, slight tachycardia, and a decrease in arterial blood pressure. Enhanced baroreflex sympathoinhibition and attenuated sympathoexcitation have been reported in pregnant animals, although the mechanisms have not been well defined. The primary metabolite of progesterone, 3-alpha-hydroxydihydroprogesterone (3-alpha-OH-DHP), which is elevated in pregnancy, is a potent positive modulator of central nervous system (CNS) inhibitory GABA-A receptors. Exogenous administration of 3-alpha-OH-DHP to virgin animals mimics the effects of pregnancy: sympathoinhibition is enhanced and sympathoexcitation is attenuated, most likely through a CNS mechanism. Importantly, blocking the formation of endogenous 3alpha-OH-DHP in pregnant reverses the attenuated sympathoinhibition. Previous studies focused mainly on enhanced arterial baroreflex sympathoinhibition. In the current proposal, experiments are designed to evaluate mechanisms for the attenuation of sympathoexcitatory responses (likely not arterial baroreflex mediated). The general hypothesis is to be tested that attenuated sympathoexcitation during pregnancy is associated with GABAergic mechanisms in central nervous system sites involved in regulation of cardiovascular function. Three possibilities will be evaluated: Increased inhibitory influences from peripheral receptors other than arterial baroreceptors, increased inhibitory influences from the CNS, and decreased excitatory effects in the rostral ventrolateral medulla (RVLM, brainstem site of cardiovascular sympathetic premotor neurons). Experiments in virgin and pregnant rats will evaluate the CNS
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expression of Fos protein in identified neuronal populations involved in central cardiovascular control following manipulations which normally increase or decrease efferent sympathetic nerve activity. Efferent sympathetic nerve activity will be recorded in other experiments in which inhibitory afferent inputs, CNS inhibitory influences, and excitatory inputs to the RVLM will be altered. Understanding the mechanism for suppressed sympathoexcitatory responses in normal pregnant animals will have important implications for hypertensive disorders or pregnancy which are associated with exaggerated sympathoexcitatory responses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PATTERNS OF BEHAVIORAL AND HORMONAL DEVELOPMENT Principal Investigator & Institution: Glickman, Stephen E.; Professor; Psychology; University of California Berkeley Berkeley, Ca 94720 Timing: Fiscal Year 2002; Project Start 01-JUN-1984; Project End 30-JUN-2007 Summary: (provided by applicant): The proposed research program is focused on an unusual mammal, the spotted hyena, as a route to understanding general mechanisms of sexual differentiation and development. The female spotted hyena has no external vagina. The clitoris has hypertrophied until it is the approximate size and shape of the male penis, and is traversed by a central urogenital canal. Female spotted hyenas urinate, mate and give birth through the clitoris. Contemporary understanding of sexual differentiation requires the presence of androgens during fetal life to explain the "masculine" phenotype observed at birth in both sexes. The present proposal, focused on differentiation of the urogenital system and the brain, is designed to examine the following hypotheses: (1) Differentiation and development of the external genitalia of the spotted hyena are driven, either by an androgen-independent process, or by "unusual" steroids (e.g., A and E2) activating the hyena Androgen Receptor (AR)). (2) Sex differences in clitoral/penile morphology observed at birth are the result of differential secretions of the fetal ovaries, testes or adrenals, acting on a background of placental T/E2 arriving via the umbilical vein. (3) Growth of the genitalia during postnatal life is modulated by the same growth factors that control general skeletal growth (i.e., IGF-1). (4) Sex differences in the brain are the result of sex differences in steroid hormones, such as those responsible for dimorphisms in the genitalia. In order to achieve these ends: (A) Dr. Michael McPhaul will extend his studies of the unusual binding properties of the hyena AR in fibroblast culture. In addition, a team of investigators will explore fetal urogenital development with a variety of techniques, including (B) transplantation of genital tissues from fetal hyenas into the renal capsule of nude mice; (C) examination of androgenic/estrogenic activity of fetal ovaries, testes and adrenals, including ICC studies of metabolic enzymes, and assays of gonadal secretions in vitro; and (D) examination of steroid receptors in the UG system during fetal life. (E) Studies of sex differences in the CNS, involving both Nissl stains and ICC for various neuropeptides, will examine fetal and adult tissues from the hyena CNS, including tissues derived from mature hyenas that were exposed to flutamide/finasteride in utero. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PRIMARY PREVENTION VERSUS SCREENING FOR PROSTATE CANCER Principal Investigator & Institution: Etzioni, Ruth B.; Fred Hutchinson Cancer Research Center Box 19024, 1100 Fairview Ave N Seattle, Wa 98109
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Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2006 Summary: (provided by applicant): The objective of this research is to provide a quantitative framework for researchers and policy makers developing prevention and screening strategies to control prostate cancer. Research into prostate cancer prevention is expanding and maturing. The Prostate Cancer Prevention Trial (PCPT), a phase III trial of finasteride as a possible preventive agent, is scheduled for completion in 2004. A second Phase III prostate cancer prevention trial is currently under way to test the efficacy of selenium and vitamin E in preventing the disease. At the same time, ProstateSpecific Antigen (PSA) screening has become common practice in the US. Data on PSA utilization and prostate cancer incidence over the past decade are consistent with rapid dissemination of the test for early detection purposes. How should limited health care dollars be allocated when both screening and prevention are available for control of prostate cancer? The central theme of this proposal is that computer modeling provides an appropriate and powerful means to answer this important and timely question. Our primary Specific Aim is to develop a comprehensive computer model of prostate cancer prevention and screening at the level of the individual. The model will add a primary prevention component and an economics front end to an established model of prostate cancer natural history and PSA screening developed by the study investigators. For any strategy combining a specific screening schedule with a primary preventive agent, the model will project the years of life saved, the costs of the strategy less any savings in treatment costs, and the incremental cost per year of life saved. Our second Specific Aim is to use the model together with data from the PCPT to project the incremental costs and benefits of different strategies combining finasteride with PSA screening. In addition to illustrating the utility of our model, this aim will also allow us to estimate the cost-effectiveness of finasteride as a preventive agent for prostate cancer. As part of this aim, we will use the PCPT data to estimate the effects of finasteride on disease natural history, including disease onset, tumor metastasis, and PSA growth rates. The modeling infrastructure developed through the proposed work will be applicable to any potential preventive agent. The final model will be made available to investigators through a dedicated website which will allow users to run the model with their own settings for key cost and efficacy parameters. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PROSTATE CANCER PREVENTION TRIAL Principal Investigator & Institution: Paskett, Electra D.; Professor and Associate Director of Popu; Wake Forest University 2240 Reynolda Rd Winston-Salem, Nc 27106 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SAW PALMETTO EXTRACT IN BENIGN PROSTATIC HYPERPLASIA Principal Investigator & Institution: Avins, Andrew L.; Assistant Clinical Professor; Northern California Institute Res & Educ 4150 Clement Street (151-Nc) San Francisco, Ca 941211545 Timing: Fiscal Year 2001; Project Start 23-AUG-1999; Project End 31-AUG-2004 Summary: This proposal describes a double-blind, placebo-controlled randomized clinical trial of the effect of saw palmetto extract on symptoms, objective parameters of disease severity, and quality of life in men with moderate-to-severe benign prostatic hyperplasia. BPH, one of the most common morbid medical conditions in middle-aged
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and elderly men, is generally treated with alpha-adrenergic blocking agents, finasteride, surgical interventions, or no specific therapy ("watchful waiting"). In the past several years, however, many patients have begun to self-medicate with an extract of the saw palmetto plant (Serenoa repens), a medicinal herb grown in the southeastern United States. Saw palmetto has become the fifth leading medicinal herb consumed in the U.S. and is considered first-line therapy for BPH in several Western European countries. Several small studies suggest that saw palmetto may have clinical benefit, but the methodologic quality of most prior studies has been poor. Very few side effects of the herb have been observed, but few studies have been conducted for more than three months. We propose to conduct a high-quality clinical trial of saw palmetto, with careful attention to the methodologic deficiencies of prior studies. After a single-blind placebo run-in period, 224 patients with mode moderate-to-severe BPH (American Urological Association Symptom Index score greater than or equal to 8) and objective measurement of urinary obstruction, will be randomized to receive either 160mg BID of the herbal extract or an identical placebo. Patients will discontinue any other medical therapy for BPH prior to enrollment and all participants will undergo a trans-rectal ultrasound examination at baseline and closeout. Participants in the trial will be seen at 3-month intervals for a total one-year follow-up. Outcome measurements include changes in the AUASI score (the primary outcome measurement), the peak urinary flow rate, the postvoid residual urine volume, the BPH Impact Index, the Olmstead County Study Questionnaire of BPH-specific symptoms and quality of life, and the Short-Form 36 (a generic health status instrument). Numerous laboratory parameters will measured at intervals throughout the trial and symptomatic side effects will be assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SAW PALMETTO USE AND RISK OF PROSTATE CANCER Principal Investigator & Institution: Lee, I-Min; Assistant Professor of Medicine; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2003; Project Start 18-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): Apart from non-melanoma skin cancer, prostate cancer is the most commonly diagnosed cancer among men in the United States today. In spite of its importance, few modifiable predictors of this disease have been established. Well-established risk factors for prostate cancer (e.g., age) are not amenable to modification and, hence, have limited utility as targets of primary prevention strategies. There is a need to identify other risk factors that can be controlled. 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone, has been proposed to play a key role in the etiology of prostate cancer; thus, the NCI is currently testing finasteride, a 5-alpha reductase inhibitor, in the prevention of prostate cancer in an ongoing, randomized clinical trial. No information is available on other agents capable of inhibiting 5-alpha reductase and prostate cancer risk in men. Saw palmetto, derived from the berry of the American palm tree, can inhibit 5-alpha reductase activity. Saw palmetto has been shown to be as effective as finasteride in the treatment of urinary symptoms from benign prostatic hyperplasia. No data are available regarding its association with prostate cancer incidence in men; however, in vitro studies show inhibition of growth of prostate cancer cell lines. Therefore, we propose to conduct a retrospective cohort study among 16,700 physicians (mean age 67 years) to test the hypothesis that saw palmetto use reduces the risk of developing prostate cancer. These men currently are being followed as part of two other funded studies, the Physicians' Health Study I and II. Information on the development of prostate cancer is being collected in these two studies, as is a whole host of other information on health habits
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and medical history. In this application, we propose to retrospectively collect details on the use of saw palmetto (when started and stopped, dose, brand) by adding questions to the scheduled 72-month follow-up questionnaire in these two other studies. During the proposed period of study, we anticipate that 790 cases of prostate cancer will develop. Power calculations show adequate power to detect a 45% reduction in risk of prostate cancer associated with saw palmetto use. At little additional cost, the data from this study will contribute to the knowledge infrastructure regarding whether large scale, informative trials on saw palmetto use and prostate cancer risk should be supported in the future. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE EFFICACY OF TUMT AND NEOADJUVANT FINASTERIDE FOR BPH Principal Investigator & Institution: Mcvary, Kevin T.; Associate Professor; Urology; Northwestern University Office of Sponsored Research Chicago, Il 60611 Timing: Fiscal Year 2002; Project Start 30-SEP-2001; Project End 30-JUN-2006 Summary: (provided by applicant): Benign prostatic hyperplasia (BPH) is the most common neoplastic condition afflicting men and constitutes a major factor impacting the health of the American male. The objective of the Minimally Invasive Surgical Therapies (MIST) Consortium for BPH is to design and conduct up to several randomized, controlled, multicenter clinical trials to determine the long-term efficacy and safety of minimally invasive therapies for symptomatic BPH including Transurethral Microwave Thermotherapy (TUMT). The potential advantages of TUMT include the relief of LUTS with an in-office procedure using minimal anesthesia and a rapid recovery. TUMT has been enthusiastically applied to patients with BPH, but reports suffer from lack of uniform outcome measurements and little data on post-surgical pharmacological treatment. One of the goals stated in the RFA is to assess whether adjuvant medical therapy improves the long-term outcome of MIST. In this light, we hypothesize that finasteride can augment the necrosis of prostatic tissue undergoing TUMT by virtue of it ability to induce TGF-beta mediated apoptosis. We propose that this known effect of finasteride will increase the "thermal kill" when used in a neoadjuvant setting with TUMT and result in an improved outcome. This is a truly exciting research direction, with considerable potential ramifications for both the patient and the health care delivery system. We propose an initial clinical trial to address whether the apoptotic effect of neoadjuvant and adjuvant finasteride in combination with the thermal effect of TUMT act synergistically to destroy more BPH mass and improve outcome than either finasteride alone or TUMT alone. We are proposing a 3-arm, placebo/sham controlled, randomized clinical trial using changes in symptoms as the primary Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: UNIV OF IOWA CALGB INSTITUTIONAL GRANT Principal Investigator & Institution: Clamon, Gerald H.; Internal Medicine; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 01-APR-1988; Project End 31-MAR-2003 Summary: (adapted from the applicant's abstract): This application is to continue the University of Iowa participation in studies of Cancer and Leukemia Group B. Our goals over the next 5 year period will include: (1) maintenance of accrual to clinical trials of over 100 patients per year (2) add new studies to the CALGB program in the area of: (a) use of Perillyl alcohol as an inhibitor of RAS function both as an antineoplastic in
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combination with other agents and possibly as a chemopreventive agent, (b) assessment of RAS mutations in the peripheral blood of women who have had chemotherapy as an adjuvant for breast cancer and would be at risk for myelodysplastic syndrome and leukemia, (c) further trials of omega three fatty acids as therapy for cancer cachexia and as an adjuvant to therapy in cancer, (d) continue to develop combined modality therapy for stage 3 and 4 non-small cell lung cancer. In particularly, a pilot at the University of Iowa of Gemcitabine/Carboplatin for non-small cell lung cancer may be able to help CALGB in the future (3) expand CALGB trials to rural hospitals in Iowa where University of Iowa physicians are now providing oncology care (Washington, Iowa; Keosauqua, Iowa; Dubuque, Iowa; Muscatine, Iowa; Fairfield, Iowa; Fort Madison, Iowa) Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: WESTERN REGIONAL COMMUNITY CLINICAL ONCOLOGY PROGRAM Principal Investigator & Institution: King, David K.; Banner Good Samaritan Medical Center Phoenix, Az 85006 Timing: Fiscal Year 2002; Project Start 01-SEP-1983; Project End 31-MAY-2003 Summary: The Greater Phoenix Community Clinical Oncology Program (GPCCOP)is a consortium of five hospitals with 67 investigations led by principal investigator David K. King, M.D. Dr. King and many of the investigators have been associated with the CCOP since its initial planning stage in 1982. The continuing long-term goals and specific aims of the GPCCOP include: 1) increased clinical research activities; 2) access to additional clinical trials; 3) further development of cancer control research initiatives and patient accrual; 4) maintenance of quality data management; 5) pharmacy resources to coordinate and manage drug distribution; 6) involvement of primary care physicians in state-of-the- art cancer management and education; and 7) continued development of data management systems to support NCI evaluations. GPCCOP's organizational structure requires the involvement of the Co- Principal Investigators and hospital administrators from each of the participating institutions in the planning and policymaking decisions of the CCOP. The physicians, nurses and administrative staff have active roles in guiding the GPCCOP toward attainment of its goals. This experienced team has demonstrated their commitment and ability to accrue patients to both therapeutic and cancer control protocols while maintaining high levels of quality control and timely submissions. GPCCOP's data management systems were recognized by SWOG in 1991 with the Outstanding Achievement Award. Additional investigators, specializing in medical and radiation oncology, have been recruited to the GPCCOP to ensure the availability of total patient care for the 3000 average new patients seen each year. By adding investigators from the Tucson area and adding the GOG as a research base, a higher level of participation is expected. The above resources, the placement of 347 patients on treatment protocols and 1097 patients on cancer control trials during the period 1989 to present demonstrate GPCCOP's preparedness to continue its active participation in NCI's Community Oncology Program. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: WUSM CANCER AND LEUKEMIA GROUP B Principal Investigator & Institution: Bartlett, Nancy L.; Internal Medicine; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 08-MAY-1998; Project End 31-MAR-2003
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Summary: (adapted from the applicant's abstract): Washington University has been a CALGB main member institution since 1986. Due to loss of key personnel and limited groupwide CALGB funding, we were not funded during the previous grant cycle. Therefore, this proposal serves as a new institutional application to re-establish Washington University in the funded scientific activities of the CALGB. In 1994, Washington University recruited Dr. Daniel Ihde, a national expert in the treatment of lung cancer and Dr. John DiPersio, an expert in hematopoietic stem cell biology, as Chief of the Division of Bone Marrow Transplantation and Stem Cell Biology. Since joining the faculty, Dr. Ihde has served as Washington University's CALGB Principal Investigator. Both Drs. lhde and DiPersio have a strong commitment to clinical research and have recruited and fostered many new clinical Investigators. The University was awarded a National Cancer Institute Cancer Center Planning Grant in July, 1995. Dr. Ihde and Dr. Stanley Korsmeyer lead the Cancer Center planning efforts and have stimulated vigorous collaboration between clinical and basic science investigators over the last 18 months. Many of these collaborations have resulted in new institutional pilot studies, including studies of new multidrug resistance modulators and regulators of programmed cell death. Promising pilot studies will be presented to CALGB committees for possible incorporation into group protocols during the next grant cycle, Since Dr. lhde's recruitment, Washington University's commitment to CALGB has been demonstrated in several ways. Accrual has increased from 52 in 1994 to 118 in 1996. Our data management has improved substantially with our most recent IPEC report placing us in the top one third of CALGB institutions in completeness and consistency. The number of investigators on scientific committees has increased from five in 1993 to eighteen at present. Eleven current, recently closed, or proposed studies are chaired by Washington University investigators. Three members have participated in audit site visits, the membership committee, and the conflict of interest committee. Our large patient base will help us maintain excellent CALGB accrual during the coming years. Barnes-Jewish Hospital, the largest hospital in St. Louis, diagnoses more than 4,000 patients a year with cancer and is the major referral center for southeast Missouri and southern Illinois. We expect referrals to increase significantly over the next five years with the construction of our new approved and funded state-of-the-art clinical cancer center building which is projected to be completed in 2000. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “finasteride” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for finasteride in the PubMed Central database: 3 4
Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.
With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.
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Finasteride in the treatment of clinical benign prostatic hyperplasia: A systematic review of randomised trials. by Edwards JE, Moore RA.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=140032
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Human Prostate Tumor Growth in Athymic Mice: Inhibition by Androgens and Stimulation by Finasteride. by Umekita Y, Hiipakka RA, Kokontis JM, Liao S.; 1996 Oct 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=38139
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The effectiveness of reducing the daily dose of finasteride in men with benign prostatic hyperplasia. by Sullivan MJ, Geller J.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=65043
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with finasteride, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “finasteride” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for finasteride (hyperlinks lead to article summaries): •
A comparative study of a gonadotropin-releasing hormone agonist and finasteride on idiopathic hirsutism. Author(s): Bayhan G, Bahceci M, Demirkol T, Ertem M, Yalinkaya A, Erden AC. Source: Clin Exp Obstet Gynecol. 2000; 27(3-4): 203-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11214952&dopt=Abstract
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A double-blind, randomized, placebo-controlled pilot study to investigate the effects of finasteride combined with a biodegradable self-reinforced poly L-lactic acid spiral stent in patients with urinary retention caused by bladder outlet obstruction from benign prostatic hyperplasia. Author(s): Isotalo T, Talja M, Hellstrom P, Perttila I, Valimaa T, Tormala P, Tammela TL. Source: Bju International. 2001 July; 88(1): 30-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11446841&dopt=Abstract
6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A model for the turnover of dihydrotestosterone in the presence of the irreversible 5 alpha-reductase inhibitors GI198745 and finasteride. Author(s): Gisleskog PO, Hermann D, Hammarlund-Udenaes M, Karlsson MO. Source: Clinical Pharmacology and Therapeutics. 1998 December; 64(6): 636-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9871428&dopt=Abstract
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A pilot study of a bioabsorbable self-reinforced poly L-lactic acid urethral stent combined with finasteride in the treatment of acute urinary retention from benign prostatic enlargement. Author(s): Isotalo T, Talja M, Valimaa T, Tormala P, Tammela TL. Source: Bju International. 2000 January; 85(1): 83-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10619952&dopt=Abstract
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A prospective randomized trial comparing finasteride to spironolactone in the treatment of hirsute women. Author(s): Wong IL, Morris RS, Chang L, Spahn MA, Stanczyk FZ, Lobo RA. Source: The Journal of Clinical Endocrinology and Metabolism. 1995 January; 80(1): 2338. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7829618&dopt=Abstract
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A prospective randomized trial comparing low dose flutamide, finasteride, ketoconazole, and cyproterone acetate-estrogen regimens in the treatment of hirsutism. Author(s): Venturoli S, Marescalchi O, Colombo FM, Macrelli S, Ravaioli B, Bagnoli A, Paradisi R, Flamigni C. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 April; 84(4): 130410. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10199771&dopt=Abstract
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A prospective study of the natural history of hematuria associated with benign prostatic hyperplasia and the effect of finasteride. Author(s): Foley SJ, Soloman LZ, Wedderburn AW, Kashif KM, Summerton D, Basketter V, Holmes SA. Source: The Journal of Urology. 2000 February; 163(2): 496-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10647664&dopt=Abstract
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A prospective, 1-year trial using saw palmetto versus finasteride in the treatment of category III prostatitis/chronic pelvic pain syndrome. Author(s): Kaplan SA, Volpe MA, Te AE. Source: The Journal of Urology. 2004 January; 171(1): 284-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14665895&dopt=Abstract
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A prospective, randomized trial comparing flutamide (250 mg/d) and finasteride (5 mg/d) in the treatment of hirsutism. Author(s): Muderris II, Bayram F, Guven M. Source: Fertility and Sterility. 2000 May; 73(5): 984-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10785225&dopt=Abstract
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A risk-benefit assessment of treatment with finasteride in benign prostatic hyperplasia. Author(s): Ekman P. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 1998 March; 18(3): 161-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9530536&dopt=Abstract
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Acute pancreatitis possibly related to finasteride. Author(s): Lin YH, Perng CL, Lin HJ, Chang FY. Source: Journal of Clinical Gastroenterology. 2001 March; 32(3): 276. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11246366&dopt=Abstract
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Advances in the treatment of male androgenetic alopecia: a brief review of finasteride studies. Author(s): Whiting DA. Source: European Journal of Dermatology : Ejd. 2001 July-August; 11(4): 332-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11399540&dopt=Abstract
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An economic evaluation of finasteride for treatment of benign prostatic hyperplasia. Author(s): Baladi JF, Menon D, Otten N. Source: Pharmacoeconomics. 1996 May; 9(5): 443-54. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10160256&dopt=Abstract
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Anaemia in men receiving combined finasteride and flutamide therapy for advanced prostate cancer. Author(s): Ornstein DK, Beiser JA, Andriole GL. Source: Bju International. 1999 January; 83(1): 43-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10233450&dopt=Abstract
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Analyzing finasteride data. Author(s): Frankel S. Source: Neurourology and Urodynamics. 1995; 14(6): 619-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8750380&dopt=Abstract
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Androgen metabolism in men receiving finasteride before prostatectomy. Author(s): Norman RW, Coakes KE, Wright AS, Rittmaster RS. Source: The Journal of Urology. 1993 November; 150(5 Pt 2): 1736-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7692110&dopt=Abstract
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Androgen receptor gene alterations and chromosomal gains and losses in prostate carcinomas appearing during finasteride treatment for benign prostatic hyperplasia. Author(s): Koivisto PA, Schleutker J, Helin H, Ehren-van Eekelen C, Kallioniemi OP, Trapman J. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 1999 November; 5(11): 3578-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10589774&dopt=Abstract
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Androgen-independent basal cell re-epithelialization, c-erbB-2 mRNA expression and androgen-dependent EGFr mRNA expression in benign prostatic hyperplasia explant cultures treated with finasteride. Author(s): Schwartz S Jr, Caceres C, De Torres I, Morote J, Rodriguez-Vallejo JM, Gonzalez J, Reventos J. Source: International Journal of Cancer. Journal International Du Cancer. 1998 May 18; 76(4): 519-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9590128&dopt=Abstract
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Anti-androgenic effects of combination finasteride plus flutamide in patients with prostatic carcinoma. Author(s): Fleshner NE, Fair WR. Source: British Journal of Urology. 1996 December; 78(6): 907-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9014718&dopt=Abstract
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Apoptotic and proliferative index after Alpha-1-adrenoceptor antagonist and/or finasteride treatment in benign prostatic hyperplasia. Author(s): Erdogru T, Ciftcioglu MA, Emreoglu I, Usta MF, Koksal T, Ozbilim G, Gulkesen KH, Baykara M. Source: Urologia Internationalis. 2002; 69(4): 287-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444285&dopt=Abstract
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Assessment of the pharmacokinetic-pharmacodynamic interaction between terazosin and finasteride. Author(s): Samara EE, Hosmane B, Locke C, Eason C, Cavanaugh J, Granneman GR. Source: Journal of Clinical Pharmacology. 1996 December; 36(12): 1169-78. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9013375&dopt=Abstract
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Benign prostatic hyperplasia: natural history, endocrine pathogenesis, and medical treatment with finasteride. Author(s): Sherwood LM. Source: The Mount Sinai Journal of Medicine, New York. 1996 January; 63(1): 1-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8935843&dopt=Abstract
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Biochemical response to testicular androgen ablation among patients with prostate cancer for whom flutamide and/or finasteride therapy failed. Author(s): Ornstein DK, Smith DS, Andriole GL. Source: Urology. 1998 December; 52(6): 1094-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9836561&dopt=Abstract
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Bioequivalence study of finasteride. Determination in human plasma by highpressure liquid chromatography coupled to tandem mass spectrometry. Author(s): de Menezes FG, Ribeiro W, Ifa DR, de Moraes ME, de Moraes MO, De Nucci G. Source: Arzneimittel-Forschung. 2001 February; 51(2): 145-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11258044&dopt=Abstract
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Biologic variability of prostate-specific antigen and its usefulness as a marker for prostate cancer: effects of finasteride. Finasteride PSA Study Group. Author(s): Oesterling JE, Roy J, Agha A, Shown T, Krarup T, Johansen T, Lagerkvist M, Gormley G, Bach M, Waldstreicher J. Source: Urology. 1998 April; 51(4A Suppl): 58-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9586598&dopt=Abstract
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Biologic variability of prostate-specific antigen and its usefulness as a marker for prostate cancer: effects of finasteride. The Finasteride PSA Study Group. Author(s): Oesterling JE, Roy J, Agha A, Shown T, Krarup T, Johansen T, Lagerkvist M, Gormley G, Bach M, Waldstreicher J. Source: Urology. 1997 July; 50(1): 13-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9218012&dopt=Abstract
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Biotransformation of finasteride (MK-0906) by Selenastrum capricornutum (green algae). Author(s): Venkataramani ES, Carlin JR, Dolling U, Christofalo P, Magliette RJ, Arison BH, Stearns RA. Source: Annals of the New York Academy of Sciences. 1994 November 30; 745: 51-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7832532&dopt=Abstract
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Biotransformation of tirilazad in human: 4. effect of finasteride on tirilazad clearance and reduced metabolite formation. Author(s): Fleishaker JC, Pearson PG, Wienkers LC, Pearson LK, Moore TA, Peters GR. Source: The Journal of Pharmacology and Experimental Therapeutics. 1998 November; 287(2): 591-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9808685&dopt=Abstract
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Blood loss during transurethral resection of the prostate after 3 months of treatment with finasteride. Author(s): Sandfeldt L, Bailey DM, Hahn RG. Source: Urology. 2001 December; 58(6): 972-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11744471&dopt=Abstract
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Body dysmorphic disorder and life-style drugs. Overview and case report with finasteride. Author(s): Harth W, Linse R. Source: Int J Clin Pharmacol Ther. 2001 July; 39(7): 284-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11471771&dopt=Abstract
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Can finasteride reverse the progress of benign prostatic hyperplasia? A two-year placebo-controlled study. The Scandinavian BPH Study Group. Author(s): Andersen JT, Ekman P, Wolf H, Beisland HO, Johansson JE, Kontturi M, Lehtonen T, Tveter K. Source: Urology. 1995 November; 46(5): 631-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7495111&dopt=Abstract
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Case report: finasteride-induced gynecomastia in a 62-year-old man. Author(s): Volpi R, Maccarini PA, Boni S, Chiodera P, Coiro V. Source: The American Journal of the Medical Sciences. 1995 June; 309(6): 322-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7539584&dopt=Abstract
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Changes in hair weight and hair count in men with androgenetic alopecia after treatment with finasteride, 1 mg, daily. Author(s): Price VH, Menefee E, Sanchez M, Ruane P, Kaufman KD. Source: Journal of the American Academy of Dermatology. 2002 April; 46(4): 517-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11907500&dopt=Abstract
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Changes in HDL-cholesterol and lipoprotein Lp(a) after 6-month treatment with finasteride in males affected by benign prostatic hyperplasia (BPH). Author(s): Denti L, Pasolini G, Cortellini P, Sanfelici L, Benedetti R, Cecchetti A, Ferretti S, Bruschieri L, Ablondi F, Valenti G. Source: Atherosclerosis. 2000 September; 152(1): 159-66. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10996351&dopt=Abstract
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Changes in molecular forms of prostate-specific antigen during treatment with finasteride. Author(s): Espana F, Martinez M, Royo M, Estelles A, Alapont JM, Navarro S, Aznar J, Jimenez-Cruz JF. Source: Bju International. 2002 November; 90(7): 672-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12410745&dopt=Abstract
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Chemoprevention of prostate cancer with finasteride. Author(s): Thompson I, Feigl P, Coltman C. Source: Important Adv Oncol. 1995; : 57-76. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7672814&dopt=Abstract
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Chronic prostatic pain. A new treatment option with finasteride? Author(s): Holm M, Meyhoff HH. Source: Scandinavian Journal of Urology and Nephrology. 1997 April; 31(2): 213-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9165592&dopt=Abstract
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Chronic treatment with finasteride daily does not affect spermatogenesis or semen production in young men. Author(s): Overstreet JW, Fuh VL, Gould J, Howards SS, Lieber MM, Hellstrom W, Shapiro S, Carroll P, Corfman RS, Petrou S, Lewis R, Toth P, Shown T, Roy J, Jarow JP, Bonilla J, Jacobsen CA, Wang DZ, Kaufman KD. Source: The Journal of Urology. 1999 October; 162(4): 1295-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10492183&dopt=Abstract
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Clinical and endocrine effects of finasteride, a 5 alpha-reductase inhibitor, in women with idiopathic hirsutism. Author(s): Ciotta L, Cianci A, Calogero AE, Palumbo MA, Marletta E, Sciuto A, Palumbo G. Source: Fertility and Sterility. 1995 August; 64(2): 299-306. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7615107&dopt=Abstract
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Clinical and hormonal effects of the 5 alpha-reductase inhibitor finasteride in idiopathic hirsutism. Author(s): Moghetti P, Castello R, Magnani CM, Tosi F, Negri C, Armanini D, Bellotti G, Muggeo M. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 October; 79(4): 1115-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7962284&dopt=Abstract
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Clinical dose ranging studies with finasteride, a type 2 5alpha-reductase inhibitor, in men with male pattern hair loss. Author(s): Roberts JL, Fiedler V, Imperato-McGinley J, Whiting D, Olsen E, Shupack J, Stough D, DeVillez R, Rietschel R, Savin R, Bergfeld W, Swinehart J, Funicella T, Hordinsky M, Lowe N, Katz I, Lucky A, Drake L, Price VH, Weiss D, Whitmore E, Millikan L, Muller S, Gencheff C, et al. Source: Journal of the American Academy of Dermatology. 1999 October; 41(4): 555-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10495375&dopt=Abstract
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Clinical experience of the detection of prostate cancer in patients with benign prostate hyperplasia treated with finasteride. The Finasteride Study Group. Author(s): Stoner E, Round E, Ferguson D, Gormley GJ. Source: The Journal of Urology. 1994 May; 151(5): 1296-300. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7512661&dopt=Abstract
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Clinical pharmacokinetics and pharmacodynamics of finasteride. Author(s): Steiner JF. Source: Clinical Pharmacokinetics. 1996 January; 30(1): 16-27. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8846625&dopt=Abstract
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Clinical predictors in the use of finasteride for control of gross hematuria due to benign prostatic hyperplasia. Author(s): Kearney MC, Bingham JB, Bergland R, Meade-D'Alisera P, Puchner PJ. Source: The Journal of Urology. 2002 June; 167(6): 2489-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11992064&dopt=Abstract
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Clinical results with finasteride. Author(s): Gormley GJ, Stoner E. Source: Prog Clin Biol Res. 1994; 386: 205-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7528388&dopt=Abstract
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Cloning, expression and characterization of rhesus macaque types 1 and 2 5alphareductase: evidence for mechanism-based inhibition by finasteride. Author(s): Ellsworth KP, Azzolina BA, Cimis G, Bull HG, Harris GS. Source: The Journal of Steroid Biochemistry and Molecular Biology. 1998 September; 66(5-6): 271-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9749833&dopt=Abstract
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Combination finasteride and flutamide in advanced carcinoma of the prostate: effective therapy with minimal side effects. Author(s): Fleshner NE, Trachtenberg J. Source: The Journal of Urology. 1995 November; 154(5): 1642-5; Discussion 1645-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7563310&dopt=Abstract
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Combination of low-dose flutamide and finasteride for PSA-only recurrent prostate cancer after primary therapy. Author(s): Barqawi AB, Moul JW, Ziada A, Handel L, Crawford ED. Source: Urology. 2003 November; 62(5): 872-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14624911&dopt=Abstract
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Combined effect of terazosin and finasteride on apoptosis, cell proliferation, and transforming growth factor-beta expression in benign prostatic hyperplasia. Author(s): Glassman DT, Chon JK, Borkowski A, Jacobs SC, Kyprianou N. Source: The Prostate. 2001 January 1; 46(1): 45-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11170131&dopt=Abstract
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Combined finasteride and flutamide therapy in men with advanced prostate cancer. Author(s): Ornstein DK, Rao GS, Johnson B, Charlton ET, Andriole GL. Source: Urology. 1996 December; 48(6): 901-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8973674&dopt=Abstract
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Combined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia: analysis of prostate volume and therapeutic outcome. Author(s): Sokeland J. Source: Bju International. 2000 September; 86(4): 439-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10971268&dopt=Abstract
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Comment on the appropriateness of The Prostate publishing a trial comparing Permixon to finasteride without a placebo control group. Author(s): Gillenwater JY. Source: The Prostate. 1998 November 1; 37(3): 194. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9792137&dopt=Abstract
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Comparative study of human steroid 5alpha-reductase isoforms in prostate and female breast skin tissues: sensitivity to inhibition by finasteride and epristeride. Author(s): Ranjan M, Diffley P, Stephen G, Price D, Walton TJ, Newton RP. Source: Life Sciences. 2002 May 31; 71(2): 115-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12031682&dopt=Abstract
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Comparative study of therapeutic effect of dibenyline, finasteride, and combination drugs for symptomatic benign prostatic hyperplasia. Author(s): Kuo HC. Source: Urologia Internationalis. 1998; 60(2): 85-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9563145&dopt=Abstract
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Comparison of cyproterone acetate plus ethinyl estradiol and finasteride in the treatment of hirsutism. Author(s): Sahin Y, Bayram F, Kelestimur F, Muderris I. Source: J Endocrinol Invest. 1998 June; 21(6): 348-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9699125&dopt=Abstract
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Comparison of Diane 35 and Diane 35 plus finasteride in the treatment of hirsutism. Author(s): Sahin Y, Dilber S, Kelestimur F. Source: Fertility and Sterility. 2001 March; 75(3): 496-500. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11239530&dopt=Abstract
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Comparison of Diane 35 and Diane 35 plus finasteride in the treatment of hirsutism. Author(s): Tartagni M, Schonauer LM, De Salvia MA, Cicinelli E, De Pergola G, D'Addario V. Source: Fertility and Sterility. 2000 April; 73(4): 718-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10731531&dopt=Abstract
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Comparison of finasteride (Proscar) and Serenoa repens (Permixon) in the inhibition of 5-alpha reductase in healthy male volunteers. Author(s): Strauch G, Perles P, Vergult G, Gabriel M, Gibelin B, Cummings S, Malbecq W, Malice MP. Source: European Urology. 1994; 26(3): 247-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7805711&dopt=Abstract
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Comparison of finasteride and alpha-blockers as independent risk factors for erectile dysfunction. Author(s): Sadeghi-Nejad H, Sherman N, Lue J. Source: Int J Clin Pract. 2003 July-August; 57(6): 484-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12918887&dopt=Abstract
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Comparison of finasteride and flutamide in the treatment of idiopathic hirsutism. Author(s): Falsetti L, Gambera A. Source: Fertility and Sterility. 1999 July; 72(1): 41-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10428146&dopt=Abstract
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Comparison of finasteride versus flutamide in the treatment of hirsutism. Author(s): Falsetti L, Gambera A, Legrenzi L, Iacobello C, Bugari G. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 1999 October; 141(4): 361-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10526249&dopt=Abstract
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Comparison of finasteride versus spironolactone in the treatment of idiopathic hirsutism. Author(s): Erenus M, Yucelten D, Durmusoglu F, Gurbuz O. Source: Fertility and Sterility. 1997 December; 68(6): 1000-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9418687&dopt=Abstract
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Comparison of high-dose finasteride (5 mg/day) versus low-dose finasteride (2.5 mg/day) in the treatment of hirsutism. Author(s): Bayram F, Muderris II, Guven M, Kelestimur F. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 2002 October; 147(4): 467-71. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12370107&dopt=Abstract
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Comparison of percent free prostate-specific antigen levels in men with benign prostatic hyperplasia treated with finasteride, terazosin, or watchful waiting. Author(s): Keetch DW, Andriole GL, Ratliff TL, Catalona WJ. Source: Urology. 1997 December; 50(6): 901-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9426721&dopt=Abstract
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Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Author(s): Carraro JC, Raynaud JP, Koch G, Chisholm GD, Di Silverio F, Teillac P, Da Silva FC, Cauquil J, Chopin DK, Hamdy FC, Hanus M, Hauri D, Kalinteris A, Marencak J, Perier A, Perrin P. Source: The Prostate. 1996 October; 29(4): 231-40; Discussion 241-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8876706&dopt=Abstract
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Comparison of spironolactone and spironolactone plus finasteride in the treatment of hirsutism. Author(s): Unluhizarci K K, Everest H, Bayram F, Kelestimur F. Source: Fertility and Sterility. 2002 December; 78(6): 1331-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477537&dopt=Abstract
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Comparison of spironolactone, flutamide, and finasteride efficacy in the treatment of hirsutism: a randomized, double blind, placebo-controlled trial. Author(s): Moghetti P, Tosi F, Tosti A, Negri C, Misciali C, Perrone F, Caputo M, Muggeo M, Castello R. Source: The Journal of Clinical Endocrinology and Metabolism. 2000 January; 85(1): 8994. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10634370&dopt=Abstract
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Comparison of tamsulosin and finasteride for lower urinary tract symptoms associated with benign prostatic hyperplasia in Korean patients. Author(s): Lee E. Source: J Int Med Res. 2002 November-December; 30(6): 584-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12526285&dopt=Abstract
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Comparison of the efficacy and safety of finasteride in older versus younger men with benign prostatic hyperplasia. Author(s): Kaplan SA, Holtgrewe HL, Bruskewitz R, Saltzman B, Mobley D, Narayan P, Lund RH, Weiner S, Wells G, Cook TJ, Meehan A, Waldstreicher J; Proscar Long-Term Efficacy and Safety Study Group. Source: Urology. 2001 June; 57(6): 1073-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11377309&dopt=Abstract
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Continued improvement in pressure-flow parameters in men receiving finasteride for 2 years. Finasteride Urodynamics Study Group. Author(s): Schafer W, Tammela TL, Barrett DM, Abrams P, Hedlund H, Rollema HJ, Nordling J, Andersen JT, Hald T, Matos-Ferriera A, Bruskewitz R, Miller P, Mustonen S, Cannon A, Malice MP, Jacobsen CA, Bach MA. Source: Urology. 1999 August; 54(2): 278-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10443725&dopt=Abstract
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Cost-sharing for prescriptions of sildenafil and finasteride: a case study in veteran patients. Author(s): Yu EI, Glassman PA, Asch SM, Paige NM, Passman LJ, Shekelle PG. Source: Am J Manag Care. 2001 April; 7(4): 345-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11310190&dopt=Abstract
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Cytologic atypia in a 53-year-old man with finasteride-induced gynecomastia. Author(s): Zimmerman RL, Fogt F, Cronin D, Lynch R. Source: Archives of Pathology & Laboratory Medicine. 2000 April; 124(4): 625-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10747325&dopt=Abstract
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Decreased gene expression of steroid 5 alpha-reductase 2 in human prostate cancer: implications for finasteride therapy of prostate carcinoma. Author(s): Luo J, Dunn TA, Ewing CM, Walsh PC, Isaacs WB. Source: The Prostate. 2003 October 1; 57(2): 134-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12949937&dopt=Abstract
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Decreased suburethral prostatic microvessel density in finasteride treated prostates: a possible mechanism for reduced bleeding in benign prostatic hyperplasia. Author(s): Hochberg DA, Basillote JB, Armenakas NA, Vasovic L, Shevchuk M, Pareek G, Fracchia JA. Source: The Journal of Urology. 2002 April; 167(4): 1731-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11912398&dopt=Abstract
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Depression circumstantially related to the administration of finasteride for androgenetic alopecia. Author(s): Altomare G, Capella GL. Source: The Journal of Dermatology. 2002 October; 29(10): 665-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12433001&dopt=Abstract
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Determination of finasteride in human plasma by liquid-liquid extraction and highperformance liquid chromatography. Author(s): Ptacek P, Macek J, Klima J. Source: J Chromatogr B Biomed Sci Appl. 2000 February 11; 738(2): 305-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10718648&dopt=Abstract
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Differential effect of finasteride on the tissue androgen concentrations in benign prostatic hyperplasia. Author(s): Habib FK, Ross M, Tate R, Chisholm GD. Source: Clinical Endocrinology. 1997 February; 46(2): 137-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9135694&dopt=Abstract
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Direct-to-consumer advertising. Finasteride for male pattern hair loss. Author(s): Cassels A, Wright JM, Mintzes B, Jauca C. Source: Can Fam Physician. 2001 September; 47: 1751-5. English, French. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11570300&dopt=Abstract
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Discontinuation of alpha-blockade after initial treatment with finasteride and doxazosin for bladder outlet obstruction. Author(s): Baldwin KC, Ginsberg PC, Harkaway RC. Source: Urologia Internationalis. 2001; 66(2): 84-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11223749&dopt=Abstract
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Discontinuation of alpha-blockade after initial treatment with finasteride and doxazosin in men with lower urinary tract symptoms and clinical evidence of benign prostatic hyperplasia. Author(s): Baldwin KC, Ginsberg PC, Roehrborn CG, Harkaway RC. Source: Urology. 2001 August; 58(2): 203-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11489700&dopt=Abstract
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Does long-term finasteride therapy affect the histologic features of benign prostatic tissue and prostate cancer on needle biopsy? PLESS Study Group. Proscar Long-Term Efficacy and Safety Study. Author(s): Yang XJ, Lecksell K, Short K, Gottesman J, Peterson L, Bannow J, Schellhammer PF, Fitch WP, Hodge GB, Parra R, Rouse S, Waldstreicher J, Epstein JI. Source: Urology. 1999 April; 53(4): 696-700. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10197843&dopt=Abstract
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Down-regulation of prostate-specific antigen expression by finasteride through inhibition of complex formation between androgen receptor and steroid receptorbinding consensus in the promoter of the PSA gene in LNCaP cells. Author(s): Wang LG, Liu XM, Kreis W, Budman DR. Source: Cancer Research. 1997 February 15; 57(4): 714-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9044850&dopt=Abstract
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Doxazosin and finasteride alone or in combination: the PREDICT study. Author(s): Lynch TH; PREDICT study. Source: Bju International. 2003 May; 91(7): 591-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699463&dopt=Abstract
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Drug treatment for benign prostatic hyperplasia. Health authorities must audit use of finasteride. Author(s): Mendelsohn R, Thompson D. Source: Bmj (Clinical Research Ed.). 1997 August 9; 315(7104): 370-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9270473&dopt=Abstract
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Drug treatment for benign prostatic hyperplasia. Several trials have shown benefit of finasteride. Author(s): Collins GN. Source: Bmj (Clinical Research Ed.). 1997 August 9; 315(7104): 371. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9270474&dopt=Abstract
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Drug treatment for benign prostatic hyperplasia. To interpret PSA concentrations in patients taking finasteride, multiply them by two. Author(s): Taneja S. Source: Bmj (Clinical Research Ed.). 1997 August 9; 315(7104): 371. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9270475&dopt=Abstract
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Drugs recently released in Belgium. Eflornithine--finasteride. Author(s): Harvengt C. Source: Acta Clin Belg. 1994; 49(1): 42-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7514829&dopt=Abstract
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Early diagnosis of prostate cancer in finasteride treated BPH patients. Author(s): Tarle M, Kraus O, Trnski D, Reljic A, Ruzic B, Katusic J, Spajic B, Kusic Z. Source: Anticancer Res. 2003 January-February; 23(1B): 693-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12680169&dopt=Abstract
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Economic analysis of finasteride: a model-based approach using data from the Proscar Long-Term Efficacy and Safety Study. Author(s): Albertsen PC, Pellissier JM, Lowe FC, Girman CJ, Roehrborn CG. Source: Clinical Therapeutics. 1999 June; 21(6): 1006-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10440624&dopt=Abstract
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Economic modeling to assess the costs of treatment with finasteride, terazosin, and transurethral resection of the prostate for men with moderate to severe symptoms of benign prostatic hyperplasia. Author(s): Lowe FC, McDaniel RL, Chmiel JJ, Hillman AL. Source: Urology. 1995 October; 46(4): 477-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7571214&dopt=Abstract
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Effect of finasteride (Proscar) on the proliferation of cultured epithelial and stromal cells from normal and hyperplastic human prostates. Author(s): Lobaccaro JM, Boudon C, Lechevallier E, Mottet N, Rebillard X, Lumbroso S, Gibelin B, Sultan C. Source: Cell Mol Biol (Noisy-Le-Grand). 1996 June; 42(4): 511-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8828906&dopt=Abstract
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Effect of finasteride and/or terazosin on serum PSA: results of VA Cooperative Study #359. Author(s): Brawer MK, Lin DW, Williford WO, Jones K, Lepor H. Source: The Prostate. 1999 June 1; 39(4): 234-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10344212&dopt=Abstract
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Effect of finasteride in idiopathic hirsutism. Author(s): Faloia E, Filipponi S, Mancini V, Di Marco S, Mantero F. Source: J Endocrinol Invest. 1998 November; 21(10): 694-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9854686&dopt=Abstract
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Effect of finasteride on bother and other health-related quality of life aspects associated with benign prostatic hyperplasia. PLESS Study Group. Proscar Long-term Efficacy and Safety Study. Author(s): Bruskewitz R, Girman CJ, Fowler J, Rigby OF, Sullivan M, Bracken RB, Fusilier HA, Kozlowski D, Kantor SD, Johnson EL, Wang DZ, Waldstreicher J. Source: Urology. 1999 October; 54(4): 670-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510926&dopt=Abstract
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Effect of finasteride on free and total serum prostate-specific antigen in men with benign prostatic hyperplasia. Author(s): Matzkin H, Barak M, Braf Z. Source: British Journal of Urology. 1996 September; 78(3): 405-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8881951&dopt=Abstract
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Effect of finasteride on human testicular steroidogenesis. Author(s): Castro-Magana M, Angulo M, Fuentes B, Canas A, Sarrantonio M, Arguello R, Vitollo P. Source: Journal of Andrology. 1996 September-October; 17(5): 516-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8957695&dopt=Abstract
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Effect of finasteride on the ovulatory function of normal women. Author(s): Wong IL, Morris RS, Lobo RA. Source: Fertility and Sterility. 2003 June; 79(6): 1455-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12798901&dopt=Abstract
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Effect of long-term administration of finasteride (MK-906), an inhibitor of 5 alphareductase, in patients with benign prostatic hyperplasia. Author(s): Yoshida O, Oishi K, Okada Y, Mizutani Y, Itokawa Y, Tomoyoshi T, Okada K, Komatz Y, Matsuda T, Takeuchi H. Source: Hinyokika Kiyo. 1996 April; 42(4): 323-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8693970&dopt=Abstract
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Effect of MK-386, a novel inhibitor of type 1 5 alpha-reductase, alone and in combination with finasteride, on serum dihydrotestosterone concentrations in men. Author(s): Schwartz JI, Van Hecken A, De Schepper PJ, De Lepeleire I, Lasseter KC, Shamblen EC, Winchell GA, Constanzer ML, Chavez CM, Wang DZ, Ebel DL, Justice SJ, Gertz BJ. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 August; 81(8): 2942-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8768856&dopt=Abstract
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Effect of nonsteroidal anti-inflammatory agents and finasteride on prostate cancer risk. Author(s): Irani J, Ravery V, Pariente JL, Chartier-Kastler E, Lechevallier E, Soulie M, Chautard D, Coloby P, Fontaine E, Bladou F, Desgrandchamps F, Haillot O. Source: The Journal of Urology. 2002 November; 168(5): 1985-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394690&dopt=Abstract
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Effects of 5 alpha-reductase inhibition by finasteride on lipoproteins and body composition in males affected by benign prostatic hyperplasia (BPH). Author(s): Denti L, Pasolini G, Cortellini P, Sanfelici L, Benedetti R, Cecchetti A, Ferretti S, Banchini A, Ablondi F, Valenti G. Source: J Endocrinol Invest. 1999; 22(10 Suppl): 70-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10727053&dopt=Abstract
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Effects of finasteride and cyproterone acetate on hematuria associated with benign prostatic hyperplasia: a prospective, randomized, controlled study. Author(s): Perimenis P, Gyftopoulos K, Markou S, Barbalias G. Source: Urology. 2002 March; 59(3): 373-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11880073&dopt=Abstract
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Effects of finasteride in patients with inflammatory chronic pelvic pain syndrome: a double-blind, placebo-controlled, pilot study. Author(s): Leskinen M, Lukkarinen O, Marttila T. Source: Urology. 1999 March; 53(3): 502-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10096374&dopt=Abstract
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Effects of finasteride on apoptosis and regulation of the human hair cycle. Author(s): Sawaya ME, Blume-Peytavi U, Mullins DL, Nusbaum BP, Whiting D, Nicholson DW, Lotocki G, Keane RW. Source: Journal of Cutaneous Medicine and Surgery. 2002 January-February; 6(1): 1-9. Epub 2002 January 09. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11896416&dopt=Abstract
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Effects of finasteride on health-related quality of life in men with symptomatic benign prostatic hyperplasia. Finasteride Study Group. Author(s): Girman CJ, Kolman C, Liss CL, Bolognese JA, Binkowitz BS, Stoner E. Source: The Prostate. 1996 August; 29(2): 83-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8700804&dopt=Abstract
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Effects of finasteride on hematuria associated with benign prostatic hyperplasia: long-term follow-up. Author(s): Miller MI, Puchner PJ. Source: Urology. 1998 February; 51(2): 237-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9495704&dopt=Abstract
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Effects of finasteride on serum testosterone and body mass index in men with benign prostatic hyperplasia. Author(s): Roehrborn CG, Lee M, Meehan A, Waldstreicher J; PLESS Study Group. Source: Urology. 2003 November; 62(5): 894-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14624915&dopt=Abstract
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Effects of finasteride on vascular endothelial growth factor. Author(s): Haggstrom S, Torring N, Moller K, Jensen E, Lund L, Nielsen JE, Bergh A, Damber JE. Source: Scandinavian Journal of Urology and Nephrology. 2002; 36(3): 182-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12201932&dopt=Abstract
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Effects of finasteride, a 5 alpha-reductase inhibitor, on circulating androgens and gonadotropin secretion in hirsute women. Author(s): Fruzzetti F, de Lorenzo D, Parrini D, Ricci C. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 September; 79(3): 831-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8077369&dopt=Abstract
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Effects of finasteride, a type 2 5-alpha reductase inhibitor, on fetal development in the rhesus monkey (Macaca mulatta). Author(s): Prahalada S, Tarantal AF, Harris GS, Ellsworth KP, Clarke AP, Skiles GL, MacKenzie KI, Kruk LF, Ablin DS, Cukierski MA, Peter CP, vanZwieten MJ, Hendrickx AG. Source: Teratology. 1997 February; 55(2): 119-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9143092&dopt=Abstract
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Effects of the 5 alpha-reductase inhibitor finasteride on serum levels of gonadal, adrenal, and hypophyseal hormones and its clinical significance: a prospective clinical study. Author(s): Uygur MC, Arik AI, Altug U, Erol D. Source: Steroids. 1998 April; 63(4): 208-13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9589555&dopt=Abstract
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Effects of the anti-androgen finasteride on 5 alpha-reduction of androgens in the presence of progesterone in human gingival fibroblasts: modulatory actions of the alkaline phosphatase inhibitor levamisole. Author(s): Tilakaratne A, Soory M. Source: Journal of Periodontal Research. 2000 August; 35(4): 179-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10983877&dopt=Abstract
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Effects of the anti-androgen finasteride on 5alpha-reductase activity in human gingival fibroblasts in response to minocycline. Author(s): Soory M, Virdi H. Source: Journal of Clinical Periodontology. 1998 January; 25(1): 67-73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9477022&dopt=Abstract
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Effects of the anti-androgen finasteride on the modulatory actions of oestradiol on androgen metabolism by human gingival fibroblasts. Author(s): Tilakaratne A, Soory M. Source: Archives of Oral Biology. 2001 February; 46(2): 109-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11163318&dopt=Abstract
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Efficacy and safety of finasteride therapy for benign prostatic hyperplasia: results of a 2-year randomized controlled trial (the PROSPECT study). PROscar Safety Plus Efficacy Canadian Two year Study. Author(s): Nickel JC, Fradet Y, Boake RC, Pommerville PJ, Perreault JP, Afridi SK, Elhilali MM. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1996 November 1; 155(9): 1251-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8911291&dopt=Abstract
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Efficacy and safety of finasteride? Author(s): Durmusoglu F, Erenus M. Source: Fertility and Sterility. 1997 March; 67(3): 589-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9091357&dopt=Abstract
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Efficacy and tolerability of doxazosin and finasteride, alone or in combination, in treatment of symptomatic benign prostatic hyperplasia: the Prospective European Doxazosin and Combination Therapy (PREDICT) trial. Author(s): Kirby RS, Roehrborn C, Boyle P, Bartsch G, Jardin A, Cary MM, Sweeney M, Grossman EB; Prospective European Doxazosin and Combination Therapy Study Investigators. Source: Urology. 2003 January; 61(1): 119-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12559281&dopt=Abstract
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Efficacy and tolerability of finasteride 1 mg in men aged 41 to 60 years with male pattern hair loss. Author(s): Whiting DA, Olsen EA, Savin R, Halper L, Rodgers A, Wang L, Hustad C, Palmisano J; Male Pattern Hair Loss Study Group. Source: European Journal of Dermatology : Ejd. 2003 March-April; 13(2): 150-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12695131&dopt=Abstract
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Efficacy and tolerability of finasteride in symptomatic benign prostatic hyperplasia: a primary care study. Primary Care Investigator Study Group. Author(s): Tenover JL, Pagano GA, Morton AS, Liss CL, Byrnes CA. Source: Clinical Therapeutics. 1997 March-April; 19(2): 243-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9152564&dopt=Abstract
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Efficacy of finasteride 1 mg in the treatment of androgenetic alopecia in men. Author(s): Olsen EA. Source: Experimental Dermatology. 1999 August; 8(4): 302-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10439233&dopt=Abstract
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Efficacy of finasteride is maintained in patients with benign prostatic hyperplasia treated for 5 years. The North American Finasteride Study Group. Author(s): Hudson PB, Boake R, Trachtenberg J, Romas NA, Rosenblatt S, Narayan P, Geller J, Lieber MM, Elhilali M, Norman R, Patterson L, Perreault JP, Malek GH, Bruskewitz RC, Roy JB, Ko A, Jacobsen CA, Stoner E. Source: Urology. 1999 April; 53(4): 690-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10197842&dopt=Abstract
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Efficacy, tolerability, and effect on health-related quality of life of finasteride versus placebo in men with symptomatic benign prostatic hyperplasia: a community based study. CUSP Investigators. Community based study of Proscar. Author(s): Byrnes CA, Morton AS, Liss CL, Lippert MC, Gillenwater JY. Source: Clinical Therapeutics. 1995 September-October; 17(5): 956-69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8595647&dopt=Abstract
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Evaluation of men on finasteride. Author(s): Gormley GJ. Source: Semin Urol Oncol. 1996 August; 14(3): 139-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8865475&dopt=Abstract
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Evaluation of prostatic intraepithelial neoplasia after treatment with a 5-alphareductase inhibitor (finasteride). A methodologic approach. Author(s): Montironi R, Pomante R, Diamanti L, Hamilton PW, Thompson D, Bartels PH. Source: Anal Quant Cytol Histol. 1996 December; 18(6): 461-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8978870&dopt=Abstract
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Evaluation of sexual function in subjects taking finasteride for the treatment of androgenetic alopecia. Author(s): Tosti A, Piraccini BM, Soli M. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2001 September; 15(5): 418-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11763381&dopt=Abstract
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Evidence for atrophy and apoptosis in the prostates of men given finasteride. Author(s): Rittmaster RS, Norman RW, Thomas LN, Rowden G. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 February; 81(2): 814-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8636309&dopt=Abstract
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Expression of basic fibroblast growth factor and its receptors FGFR1 and FGFR2 in human benign prostatic hyperplasia treated with finasteride. Author(s): Saez C, Gonzalez-Baena AC, Japon MA, Giraldez J, Segura DI, RodriguezVallejo JM, Gonzalez-Esteban J, Miranda G, Torrubia F. Source: The Prostate. 1999 July 1; 40(2): 83-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10386468&dopt=Abstract
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Finasteride and flutamide as potency-sparing androgen-ablative therapy for advanced adenocarcinoma of the prostate. Author(s): Brufsky A, Fontaine-Rothe P, Berlane K, Rieker P, Jiroutek M, Kaplan I, Kaufman D, Kantoff P. Source: Urology. 1997 June; 49(6): 913-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9187700&dopt=Abstract
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Finasteride and flutamide therapy in patients with advanced prostate cancer: response to subsequent castration and long-term follow-up. Author(s): Oh WK, Manola J, Bittmann L, Brufsky A, Kaplan ID, Smith MR, Kaufman DS, Kantoff PW. Source: Urology. 2003 July; 62(1): 99-104. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12837431&dopt=Abstract
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Finasteride and tamsulosin used in benign prostatic hypertrophy: a review of the prescription-event monitoring data. Author(s): Shakir S, Pearce G, Mann RD. Source: Bju International. 2001 June; 87(9): 789-96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11412215&dopt=Abstract
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Finasteride and the hair cycle. Author(s): Tosti A, Piraccini BM. Source: Journal of the American Academy of Dermatology. 2000 May; 42(5 Pt 1): 848-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10775873&dopt=Abstract
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Finasteride as a therapy for hidradenitis suppurativa. Author(s): Farrell AM, Randall VA, Vafaee T, Dawber RP. Source: The British Journal of Dermatology. 1999 December; 141(6): 1138-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10722269&dopt=Abstract
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Finasteride cream in hirsutism. Author(s): Lucas KJ. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2001 January-February; 7(1): 5-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11250761&dopt=Abstract
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Finasteride following balloon dilatation of the prostate. A double-blind, placebocontrolled, multicenter study. Author(s): Lukkarinen O, Lehtonen T, Talja M, Lundstedt S, Tiitinen J, Taari K. Source: Ann Chir Gynaecol. 1999; 88(4): 299-303. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10661828&dopt=Abstract
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Finasteride for BPH. Author(s): Johnson KH, Casey CM. Source: The Journal of Family Practice. 1998 June; 46(6): 455-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9638104&dopt=Abstract
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Finasteride for female androgenetic alopecia. Author(s): Thai KE, Sinclair RD. Source: The British Journal of Dermatology. 2002 October; 147(4): 812-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12366441&dopt=Abstract
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Finasteride improves male pattern hair loss in a randomized study in identical twins. Author(s): Stough DB, Rao NA, Kaufman KD, Mitchell C. Source: European Journal of Dermatology : Ejd. 2002 January-February; 12(1): 32-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11809593&dopt=Abstract
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Finasteride in a 1-mg dose is safe and effective. Author(s): Roberts JL. Source: Archives of Dermatology. 1999 August; 135(8): 990. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10456355&dopt=Abstract
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Finasteride in association with either flutamide or goserelin as combination hormonal therapy in patients with stage M1 carcinoma of the prostate gland. International Prostate Health Council (IPHC) Trial Study Group. Author(s): Kirby R, Robertson C, Turkes A, Griffiths K, Denis LJ, Boyle P, Altwein J, Schroder F. Source: The Prostate. 1999 July 1; 40(2): 105-14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10386471&dopt=Abstract
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Finasteride in biological fluids: extraction and separation by a graphitized carbon black cartridge and quantification by high-performance liquid chromatography. Author(s): Carlucci G, Mazzeo P. Source: J Chromatogr B Biomed Sci Appl. 1997 May 23; 693(1): 245-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9200544&dopt=Abstract
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Finasteride in the treatment of benign prostatic hyperplasia. Author(s): Ekman P, Andersen JT, Wolf H. Source: Acta Urol Belg. 1996 March; 64(1): Ix-Xii. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8659328&dopt=Abstract
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Finasteride in the treatment of benign prostatic hypertrophy: an update. New indications for finasteride therapy. Author(s): Ekman P. Source: Scand J Urol Nephrol Suppl. 1999; 203: 15-20. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10636564&dopt=Abstract
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Finasteride in the treatment of clinical benign prostatic hyperplasia: a systematic review of randomised trials. Author(s): Edwards JE, Moore RA. Source: Bmc Urology [electronic Resource]. 2002 December 12; 2(1): 14. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477383&dopt=Abstract
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Finasteride in the treatment of hirsutism: new therapeutic perspectives. Author(s): Tolino A, Petrone A, Sarnacchiaro F, Cirillo D, Ronsini S, Lombardi G, Nappi C. Source: Fertility and Sterility. 1996 July; 66(1): 61-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8752612&dopt=Abstract
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Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. Author(s): Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W, Price VH, Van Neste D, Roberts JL, Hordinsky M, Shapiro J, Binkowitz B, Gormley GJ. Source: Journal of the American Academy of Dermatology. 1998 October; 39(4 Pt 1): 57889. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9777765&dopt=Abstract
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Finasteride in the treatment of men with frontal male pattern hair loss. Author(s): Leyden J, Dunlap F, Miller B, Winters P, Lebwohl M, Hecker D, Kraus S, Baldwin H, Shalita A, Draelos Z, Markou M, Thiboutot D, Rapaport M, Kang S, Kelly T, Pariser D, Webster G, Hordinsky M, Rietschel R, Katz HI, Terranella L, Best S, Round E, Waldstreicher J. Source: Journal of the American Academy of Dermatology. 1999 June; 40(6 Pt 1): 930-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10365924&dopt=Abstract
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Finasteride in the treatment of patients with moderate symptoms of benign prostatic hyperplasia. Author(s): Magoha GA. Source: East Afr Med J. 1998 May; 75(5): 260-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9746993&dopt=Abstract
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Finasteride in the treatment of Taiwanese men with androgenetic alopecia: a 12month open-label study. Author(s): Lin JH, Chen WC. Source: Kaohsiung J Med Sci. 2002 August; 18(8): 379-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12476680&dopt=Abstract
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Finasteride increases anagen hair in men with androgenetic alopecia. Author(s): Van Neste D, Fuh V, Sanchez-Pedreno P, Lopez-Bran E, Wolff H, Whiting D, Roberts J, Kopera D, Stene JJ, Calvieri S, Tosti A, Prens E, Guarrera M, Kanojia P, He W, Kaufman KD. Source: The British Journal of Dermatology. 2000 October; 143(4): 804-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11069460&dopt=Abstract
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Finasteride induced gynecomastia. Author(s): Carlin BI, Seftel AD, Resnick MI, Findlay J. Source: The Journal of Urology. 1997 August; 158(2): 547. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9224349&dopt=Abstract
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Finasteride is the main inhibitor of 5alpha-reductase activity in microdissected dermal papillae of human hair follicles. Author(s): Hoffmann R, Happle R. Source: Archives of Dermatological Research. 1999 February-March; 291(2-3): 100-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10195397&dopt=Abstract
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Finasteride may prevent prostate cancer. Author(s): Thompson CA. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2003 August 1; 60(15): 1511, 1515. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12951749&dopt=Abstract
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Finasteride plus flutamide for prostatic carcinoma. Author(s): Sandhu SS, Matveev VB, Kaisary AV. Source: British Journal of Urology. 1997 August; 80(2): 360. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9284230&dopt=Abstract
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Finasteride significantly reduces acute urinary retention and need for surgery in patients with symptomatic benign prostatic hyperplasia. Author(s): Andersen JT, Nickel JC, Marshall VR, Schulman CC, Boyle P. Source: Urology. 1997 June; 49(6): 839-45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9187688&dopt=Abstract
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Finasteride therapy does not alter bone turnover in men with benign prostatic hyperplasia--a Clinical Research Center study. Author(s): Tollin SR, Rosen HN, Zurowski K, Saltzman B, Zeind AJ, Berg S, Greenspan SL. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 March; 81(3): 10314. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8772571&dopt=Abstract
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Finasteride to prevent morbidity from benign prostatic hyperplasia. Author(s): Wasson JH. Source: The New England Journal of Medicine. 1998 February 26; 338(9): 612-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9475770&dopt=Abstract
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Finasteride treatment for one year in 35 hirsute patients. Author(s): Bayram F, Muderris II, Sahin Y, Kelestimur F. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 1999; 107(3): 195-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10376445&dopt=Abstract
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Finasteride treatment may not prevent telogen effluvium after minoxidil withdrawal. Author(s): Tosti A, Iorizzo M, Vincenzi C. Source: Archives of Dermatology. 2003 September; 139(9): 1221-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12975176&dopt=Abstract
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Finasteride, 1 mg (Propecia), is the optimal dose for the treatment of men with male pattern hair loss. Author(s): Kaufman KD. Source: Archives of Dermatology. 1999 August; 135(8): 989-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10456354&dopt=Abstract
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Finasteride. Does it affect spermatogenesis and pregnancy? Author(s): Pole M, Koren G. Source: Can Fam Physician. 2001 December; 47: 2469-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11785276&dopt=Abstract
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Finasteride: a long-term follow-up in the treatment of recurrent hematuria associated with benign prostatic hyperplasia. Author(s): Delakas D, Lianos E, Karyotis I, Cranidis A. Source: Urologia Internationalis. 2001; 67(1): 69-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11464120&dopt=Abstract
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Finasteride: a review of its use in male pattern hair loss. Author(s): McClellan KJ, Markham A. Source: Drugs. 1999 January; 57(1): 111-26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9951956&dopt=Abstract
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Finasteride: a steroid-unsparing drug? Author(s): Persey M, Payne L, Webley M. Source: Rheumatology (Oxford, England). 1999 March; 38(3): 285. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10325672&dopt=Abstract
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Finasteride: an update of its use in the management of symptomatic benign prostatic hyperplasia. Author(s): Wilde MI, Goa KL. Source: Drugs. 1999 April; 57(4): 557-81. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10235693&dopt=Abstract
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Finasteride--an update and review. Author(s): Cather JC, Lane D, Heaphy MR Jr, Nelson BR. Source: Cutis; Cutaneous Medicine for the Practitioner. 1999 September; 64(3): 167-72. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10500917&dopt=Abstract
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Finasteride-induced thrombocytopenia. Author(s): Kouriefs C, Betambeau N, Rowbotham C, Coyne K, Rowley M, Jones CR. Source: Bju International. 2002 August; 90(3): 348-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12133077&dopt=Abstract
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Finasteride-related cutaneous vaculitis. Author(s): Lear JT, Byrne JP. Source: Postgraduate Medical Journal. 1996 February; 72(844): 127. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8871471&dopt=Abstract
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Gynecomastia and breast cancer during finasteride therapy. Author(s): Green L, Wysowski DK, Fourcroy JL. Source: The New England Journal of Medicine. 1996 September 12; 335(11): 823. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8778596&dopt=Abstract
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Hair loss in women with hyperandrogenism: four cases responding to finasteride. Author(s): Shum KW, Cullen DR, Messenger AG. Source: Journal of the American Academy of Dermatology. 2002 November; 47(5): 733-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12399766&dopt=Abstract
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High-performance liquid chromatographic determination of finasteride in human plasma using direct injection with column switching. Author(s): Takano T, Hata S. Source: Journal of Chromatography. B, Biomedical Applications. 1996 February 9; 676(1): 141-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8852054&dopt=Abstract
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High-performance liquid chromatographic method for the determination of finasteride in human plasma at therapeutic doses. Author(s): Constanzer ML, Matuszewski BK, Bayne WF. Source: Journal of Chromatography. 1991 May 3; 566(1): 127-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1653258&dopt=Abstract
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Hormonal effects of a 5 alpha-reductase inhibitor (finasteride) on hormonal levels in normal men and in patients with benign prostatic hyperplasia. Author(s): Vermeulen A, Giagulli VA, De Schepper P, Buntinx A. Source: European Urology. 1991; 20 Suppl 1: 82-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1722168&dopt=Abstract
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How do we investigate haematuria and what role has finasteride? Author(s): Donohue JF, Barber NJ. Source: Bju International. 2004 January; 93(1): 3-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14678355&dopt=Abstract
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Human prostate tumor growth in athymic mice: inhibition by androgens and stimulation by finasteride. Author(s): Umekita Y, Hiipakka RA, Kokontis JM, Liao S. Source: Proceedings of the National Academy of Sciences of the United States of America. 1996 October 15; 93(21): 11802-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8876218&dopt=Abstract
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I am a 64-year-old man, and I've always been proud of my perfect health record. I've also been proud of my full head of hair, even after the gray started creeping in. Four months ago I caught pneumonia and spent eight days in the hospital (three in intensive care). It took a while, but I'm finally back to normal - except that my hair is falling out. It comes out in clumps when I shampoo or even comb it, and it's gotten noticeably thin all over. I remember reading about Propecia in your newsletter but I don't have the old issue. Should I try the medication? Author(s): Simon HB. Source: Harvard Men's Health Watch. 2002 June; 6(11): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12079806&dopt=Abstract
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Identification of human cytochrome P450 isozymes responsible for the in vitro oxidative metabolism of finasteride. Author(s): Huskey SW, Dean DC, Miller RR, Rasmusson GH, Chiu SH. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 1995 October; 23(10): 1126-35. Erratum In: Drug Metab Dispos 1996 June; 24(6): 695. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8654202&dopt=Abstract
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Immunohistochemical expression of pi class glutathione S-transferase in the basal cell layer of benign prostate tissue following chronic treatment with finasteride. Author(s): Montironi R, Mazzucchelli R, Pomante R, Thompson D, Duval da Silva V, Vaught L, Bartels PH. Source: Journal of Clinical Pathology. 1999 May; 52(5): 350-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10560354&dopt=Abstract
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Impact of baseline symptom severity on future risk of benign prostatic hyperplasiarelated outcomes and long-term response to finasteride. The Pless Study Group. Author(s): Kaplan S, Garvin D, Gilhooly P, Koppel M, Labasky R, Milsten R, Reddy P, Rosenberg S, Sussman D, White C, Lee M, Pappas F, Waldstreicher J. Source: Urology. 2000 October 1; 56(4): 610-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11018616&dopt=Abstract
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Improvement in androgenetic alopecia (stage V) using topical minoxidil in a retinoid vehicle and oral finasteride. Author(s): Walsh DS, Dunn CL, James WD. Source: Archives of Dermatology. 1995 December; 131(12): 1373-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7492124&dopt=Abstract
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Improvement in androgenetic alopecia in 53-76-year-old men using oral finasteride. Author(s): Brenner S, Matz H. Source: International Journal of Dermatology. 1999 December; 38(12): 928-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10632776&dopt=Abstract
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Improvement of pressure flow parameters with finasteride is greater in men with large prostates. Finasteride Urodynamics Study Group. Author(s): Abrams P, Schafer W, Tammela TL, Barrett DM, Hedlund H, Rollema HJ, Matos-Ferreira A, Nordling J, Bruskewitz R, Andersen JT, Hald T, Miller P, Kirby R, Mustonen S, Cannon A, Jacobsen CA, Gormley GJ, Malice MP, Bach MA. Source: The Journal of Urology. 1999 May; 161(5): 1513-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10210385&dopt=Abstract
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In vitro inhibition of androstenedione 5alpha-reduction by finasteride in epithelium and stroma of human benign prostatic hyperplasia. Author(s): Weisser H, Krieg M. Source: The Journal of Steroid Biochemistry and Molecular Biology. 1998 October; 67(1): 49-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9780029&dopt=Abstract
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In vivo time-dependent inhibition of human steroid 5 alpha-reductase by finasteride. Author(s): Tian G. Source: Journal of Pharmaceutical Sciences. 1996 January; 85(1): 106-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8926574&dopt=Abstract
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Incidence and severity of sexual adverse experiences in finasteride and placebotreated men with benign prostatic hyperplasia. Author(s): Wessells H, Roy J, Bannow J, Grayhack J, Matsumoto AM, Tenover L, Herlihy R, Fitch W, Labasky R, Auerbach S, Parra R, Rajfer J, Culbertson J, Lee M, Bach MA, Waldstreicher J; PLESS Study Group. Source: Urology. 2003 March; 61(3): 579-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12639651&dopt=Abstract
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Influence of finasteride on free and total serum prostate specific antigen levels in men with benign prostatic hyperplasia. Author(s): Pannek J, Marks LS, Pearson JD, Rittenhouse HG, Chan DW, Shery ED, Gormley GJ, Subong EN, Kelley CA, Stoner E, Partin AW. Source: The Journal of Urology. 1998 February; 159(2): 449-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9649261&dopt=Abstract
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Inhibition of steroid 5 alpha-reductase with finasteride: sleep-related erections, potency, and libido in healthy men. Author(s): Cunningham GR, Hirshkowitz M. Source: The Journal of Clinical Endocrinology and Metabolism. 1995 June; 80(6): 1934-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7775644&dopt=Abstract
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Lack of correlation between prostate-specific antigen density and prostatic shrinkage in response to finasteride therapy. Author(s): Kirschenbaum A, Pacheco E, Schuval BJ, Levine AC. Source: World Journal of Urology. 1996; 14(6): 360-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8986036&dopt=Abstract
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Lack of effect of topical finasteride suggests an endocrine role for dihydrotestosterone. Author(s): Price TM, Allen S, Pegram GV. Source: Fertility and Sterility. 2000 August; 74(2): 414-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10927075&dopt=Abstract
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Lack of efficacy of finasteride in postmenopausal women with androgenetic alopecia. Author(s): Price VH, Roberts JL, Hordinsky M, Olsen EA, Savin R, Bergfeld W, Fiedler V, Lucky A, Whiting DA, Pappas F, Culbertson J, Kotey P, Meehan A, Waldstreicher J. Source: Journal of the American Academy of Dermatology. 2000 November; 43(5 Pt 1): 768-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11050579&dopt=Abstract
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Lipids and finasteride. Author(s): Blumenfeld Z. Source: Fertility and Sterility. 1996 March; 65(3): 677-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8774311&dopt=Abstract
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Long-term (5-year) multinational experience with finasteride 1 mg in the treatment of men with androgenetic alopecia. Author(s): Finasteride Male Pattern Hair Loss Study Group. Source: European Journal of Dermatology : Ejd. 2002 January-February; 12(1): 38-49. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11809594&dopt=Abstract
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Long-term (7 to 8-year) experience with finasteride in men with benign prostatic hyperplasia. Author(s): Vaughan D, Imperato-McGinley J, McConnell J, Matsumoto AM, Bracken B, Roy J, Sullivan M, Pappas F, Cook T, Daurio C, Meehan A, Stoner E, Waldstreicher J. Source: Urology. 2002 December; 60(6): 1040-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12475666&dopt=Abstract
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Long-term 6-year experience with finasteride in patients with benign prostatic hyperplasia. Author(s): Lowe FC, McConnell JD, Hudson PB, Romas NA, Boake R, Lieber M, Elhilali M, Geller J, Imperto-McGinely J, Andriole GL, Bruskewitz RC, Walsh PC, Bartsch G, Nacey JN, Shah S, Pappas F, Ko A, Cook T, Stoner E, Waldstreicher J; Finasteride Study Group. Source: Urology. 2003 April; 61(4): 791-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12670567&dopt=Abstract
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Long-term effects of finasteride in patients with benign prostatic hyperplasia: a double-blind, placebo-controlled, multicenter study. PROWESS Study Group. Author(s): Marberger MJ. Source: Urology. 1998 May; 51(5): 677-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9610579&dopt=Abstract
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Long-term effects of finasteride on invasive urodynamics and symptoms in the treatment of patients with bladder outflow obstruction due to benign prostatic hyperplasia. Author(s): Tammela TL, Kontturi MJ. Source: The Journal of Urology. 1995 October; 154(4): 1466-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7544845&dopt=Abstract
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Long-term effects of finasteride on prostate tissue composition. Author(s): Marks LS, Partin AW, Dorey FJ, Gormley GJ, Epstein JI, Garris JB, Macairan ML, Shery ED, Santos PB, Stoner E, deKernion JB. Source: Urology. 1999 March; 53(3): 574-80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10096387&dopt=Abstract
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Long-term treatment with finasteride in men with symptomatic benign prostatic hyperplasia: 10-year follow-up. Author(s): Lam JS, Romas NA, Lowe FC. Source: Urology. 2003 February; 61(2): 354-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12597947&dopt=Abstract
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Long-term urodynamic effects of finasteride in benign prostatic hyperplasia: a pilot study. Author(s): Kirby RS, Vale J, Bryan J, Holmes K, Webb JA. Source: European Urology. 1993; 24(1): 20-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7689971&dopt=Abstract
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Low-dose (2.5 mg/day) finasteride treatment in hirsutism. Author(s): Bayram F, Muderris I, Guven M, Ozcelik B, Kelestimur F. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 2003 October; 17(5): 419-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14710591&dopt=Abstract
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Maintenance of clinical efficacy with finasteride therapy for 24 months in patients with benign prostatic hyperplasia. The Finasteride Study Group. Author(s): Stoner E. Source: Archives of Internal Medicine. 1994 January 10; 154(1): 83-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7505563&dopt=Abstract
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Male breast cancer during finasteride therapy. Author(s): Lee SC, Ellis RJ. Source: Journal of the National Cancer Institute. 2004 February 18; 96(4): 338-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14970289&dopt=Abstract
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Matrix effect in quantitative LC/MS/MS analyses of biological fluids: a method for determination of finasteride in human plasma at picogram per milliliter concentrations. Author(s): Matuszewski BK, Constanzer ML, Chavez-Eng CM. Source: Analytical Chemistry. 1998 March 1; 70(5): 882-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9511465&dopt=Abstract
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Maximum efficacy of finasteride is obtained within 6 months and maintained over 6 years. Follow-up of the Scandinavian Open-Extension Study. The Scandinavian Finasteride Study Group. Author(s): Ekman P. Source: European Urology. 1998; 33(3): 312-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9555559&dopt=Abstract
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Measuring finasteride efficacy. Author(s): Amato FG, Bono G. Source: Dermatology (Basel, Switzerland). 2003; 207(2): 214. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12920382&dopt=Abstract
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Measuring reversal of hair miniaturization in androgenetic alopecia by follicular counts in horizontal sections of serial scalp biopsies: results of finasteride 1 mg treatment of men and postmenopausal women. Author(s): Whiting DA, Waldstreicher J, Sanchez M, Kaufman KD. Source: The Journal of Investigative Dermatology. Symposium Proceedings / the Society for Investigative Dermatology, Inc. [and] European Society for Dermatological Research. 1999 December; 4(3): 282-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10674382&dopt=Abstract
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Merck offers money back guarantee on finasteride. Author(s): Tonks A. Source: Bmj (Clinical Research Ed.). 1994 November 12; 309(6964): 1252-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7888840&dopt=Abstract
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Meta-analysis of randomized clinical trials of finasteride. Author(s): Roehrborn CG. Source: Urology. 1998 April; 51(4A Suppl): 46-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9586596&dopt=Abstract
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Minoxidil vs finasteride in the treatment of men with androgenetic alopecia. Author(s): Saraswat A, Kumar B. Source: Archives of Dermatology. 2003 September; 139(9): 1219-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12975174&dopt=Abstract
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Multicenter, randomized, double-blind, placebo controlled study to investigate the effect of finasteride (MK-906) on stage D prostate cancer. Author(s): Presti JC Jr, Fair WR, Andriole G, Sogani PC, Seidmon EJ, Ferguson D, Ng J, Gormley GJ. Source: The Journal of Urology. 1992 October; 148(4): 1201-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1383574&dopt=Abstract
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Nodular hyperplasia of the prostate. Quantitative evaluation of secretory cell changes after treatment with finasteride. Author(s): Pomante R, Santinelli A, Muzzonigro G, Montironi R. Source: Anal Quant Cytol Histol. 1999 February; 21(1): 63-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10068778&dopt=Abstract
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Outcome of long-term treatment with the 5 alpha-reductase inhibitor finasteride in idiopathic hirsutism: clinical and hormonal effects during a 1-year course of therapy and 1-year follow-up. Author(s): Castello R, Tosi F, Perrone F, Negri C, Muggeo M, Moghetti P. Source: Fertility and Sterility. 1996 November; 66(5): 734-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8893676&dopt=Abstract
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Patient satisfaction with finasteride in the treatment of symptomatic benign prostatic hyperplasia. Author(s): Kaplan SA, Olsson CA. Source: Clinical Therapeutics. 1996 January-February; 18(1): 73-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8851454&dopt=Abstract
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Pharmacodynamic modeling of finasteride, a 5 alpha-reductase inhibitor. Author(s): Ko HC, Jusko WJ. Source: Pharmacotherapy. 1995 July-August; 15(4): 509-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7479205&dopt=Abstract
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Pharmacokinetic interaction between finasteride and terazosin, but not finasteride and doxazosin. Author(s): Vashi V, Chung M, Hilbert J, Lawrence V, Phillips K. Source: Journal of Clinical Pharmacology. 1998 November; 38(11): 1072-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9824790&dopt=Abstract
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Pharmacological treatment of benign prostatic hyperplasia with finasteride: a clinical review. Author(s): Ekman P. Source: Arch Esp Urol. 1994 November; 47(9): 883-7; Discussion 887-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7530944&dopt=Abstract
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Phenytoin-mediated androgen metabolism in gingival fibroblasts. Effects of the antiandrogen finasteride and the alkaline phosphatase inhibitor levamisole. Author(s): Soory M, Suchak A. Source: Journal of Clinical Periodontology. 2002 October; 29(10): 955-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12445228&dopt=Abstract
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Picogram determination of finasteride in human plasma and semen by highperformance liquid chromatography with atmospheric-pressure chemical-ionization tandem mass spectrometry. Author(s): Constanzer ML, Chavez CM, Matuszewski BK. Source: Journal of Chromatography. B, Biomedical Applications. 1994 August 19; 658(2): 281-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7820256&dopt=Abstract
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Plasma androsterone/epiandrosterone sulfates as markers of 5 alpha-reductase activity: effect of finasteride in normal men. Author(s): Lewis JG, George PM, Elder PA. Source: Steroids. 1997 August-September; 62(8-9): 632-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9292937&dopt=Abstract
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Possible autocrine loop of the epidermal growth factor system in patients with benign prostatic hyperplasia treated with finasteride: a placebo-controlled randomized study. Author(s): Torring N, Moller-Ernst Jensen K, Lund L, Nielsen JE, Djurhuus JC, Poulsen SS, Nexo E. Source: Bju International. 2002 April; 89(6): 583-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11942969&dopt=Abstract
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Pretreatment with finasteride decreases perioperative bleeding associated with transurethral resection of the prostate. Author(s): Cochrane Database Syst Rev. 2002;(3):CD001423 Source: Urology. 2000 May; 55(5): 684-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12137626
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Pretreatment with finasteride decreases perioperative bleeding associated with transurethral resection of the prostate. Author(s): Hagerty JA, Ginsberg PC, Harmon JD, Harkaway RC. Source: Urology. 2000 May; 55(5): 684-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10792079&dopt=Abstract
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Prevalent decrease of the EGF content in the periurethral zone of BPH tissue induced by treatment with finasteride or flutamide. Author(s): Monti S, Sciarra F, Adamo MV, Toscano V, Trotta MC, Martini C, Lanzara S, Silverio FD. Source: Journal of Andrology. 1997 September-October; 18(5): 488-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9349746&dopt=Abstract
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Preventing prostate cancer. Finasteride shrinks enlarged prostates and may prevent some cases of prostate cancer. But it's no panacea. Author(s): Beer TM. Source: Health News. 2003 August; 9(8): 1-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12971313&dopt=Abstract
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Prevention of prostate cancer with finasteride. Author(s): Schwartz DT. Source: The New England Journal of Medicine. 2003 October 16; 349(16): 1569-72; Author Reply 1569-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14562808&dopt=Abstract
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Prevention of prostate cancer with finasteride. Author(s): Ross RK, Skinner E, Cote RJ. Source: The New England Journal of Medicine. 2003 October 16; 349(16): 1569-72; Author Reply 1569-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14562807&dopt=Abstract
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Prevention of prostate cancer with finasteride. Author(s): Burke HB. Source: The New England Journal of Medicine. 2003 October 16; 349(16): 1569-72; Author Reply 1569-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14562806&dopt=Abstract
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Prevention of prostate cancer with finasteride. Author(s): Lee SC, Ellis RJ. Source: The New England Journal of Medicine. 2003 October 16; 349(16): 1569-72; Author Reply 1569-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14562805&dopt=Abstract
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Prevention of prostate cancer with finasteride. Author(s): Roehrborn CG. Source: The New England Journal of Medicine. 2003 October 16; 349(16): 1569-72; Author Reply 1569-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14562804&dopt=Abstract
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Prevention of prostate cancer with finasteride. Author(s): Barzell WE. Source: The New England Journal of Medicine. 2003 October 16; 349(16): 1569-72; Author Reply 1569-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14562803&dopt=Abstract
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Prevention of prostate cancer with finasteride. Author(s): Rubin MA, Kantoff PW. Source: The New England Journal of Medicine. 2003 October 16; 349(16): 1569-72; Author Reply 1569-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14561801&dopt=Abstract
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Prolonged treatment with finasteride (a 5 alpha-reductase inhibitor) does not affect bone density and metabolism. Author(s): Matzkin H, Chen J, Weisman Y, Goldray D, Pappas F, Jaccard N, Braf Z. Source: Clinical Endocrinology. 1992 November; 37(5): 432-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1283117&dopt=Abstract
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Prostate tissue composition and response to finasteride in men with symptomatic benign prostatic hyperplasia. Author(s): Marks LS, Partin AW, Gormley GJ, Dorey FJ, Shery ED, Garris JB, Subong EN, Stoner E, deKernion JB. Source: The Journal of Urology. 1997 June; 157(6): 2171-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9146609&dopt=Abstract
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Prostate volume predicts outcome of treatment of benign prostatic hyperplasia with finasteride: meta-analysis of randomized clinical trials. Author(s): Boyle P, Gould AL, Roehrborn CG. Source: Urology. 1996 September; 48(3): 398-405. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8804493&dopt=Abstract
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Prostatic expression of human 5alpha-reductase type 2 during finasteride therapy: a randomized, double-blind, placebo-controlled study. Author(s): Vaarala MH, Lukkarinen O, Marttila T, Kyllonen AP, Porvari KS, Vihko PT. Source: World Journal of Urology. 2000 December; 18(6): 406-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11204259&dopt=Abstract
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Prostatic involution in men taking finasteride is associated with elevated levels of insulin-like growth factor-binding proteins (IGFBPs)-2, -4, and -5. Author(s): Thomas LN, Wright AS, Lazier CB, Cohen P, Rittmaster RS. Source: The Prostate. 2000 February 15; 42(3): 203-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10639191&dopt=Abstract
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PSA response to finasteride challenge in men with a serum PSA greater than 4 ng/ml and previous negative prostate biopsy: preliminary study. Author(s): Kaplan SA, Ghafar MA, Volpe MA, Lam JS, Fromer D, Te AE. Source: Urology. 2002 September; 60(3): 464-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12350485&dopt=Abstract
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Qualitative and quantitative evaluation of prostatic histomorphology in rats following chronic treatment with finasteride, a 5-alpha reductase inhibitor. Author(s): Prahalada SR, Keenan KP, Hertzog PR, Gordon LR, Peter CP, Soper KA, van Zwieten MJ, Bokelman DL. Source: Urology. 1994 May; 43(5): 680-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7513109&dopt=Abstract
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Re: A prospective study of the natural history of hematuria associated with benign prostatic hyperplasia and the effect of finasteride. Author(s): Harrison RH 3rd. Source: The Journal of Urology. 2000 November; 164(5): 1670-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11203073&dopt=Abstract
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Re: chronic treatment with finasteride daily does not affect spermatogenesis or semen production in young men. Author(s): Freidlin V, Ko HS, Wilkin JK. Source: The Journal of Urology. 2000 October; 164(4): 1319-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10992402&dopt=Abstract
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Re: Effect of nonsteroidal anti-inflammatory agents and finasteride on prostate cancer risk. Author(s): Pruthi RS, Derksen JE, Gaston K. Source: The Journal of Urology. 2003 June; 169(6): 2304; Author Reply 2304-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12771783&dopt=Abstract
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Re: Effect of nonsteroidal anti-inflammatory agents and finasteride on prostate cancer risk. Author(s): Jacobsen SJ, Roberts RO. Source: The Journal of Urology. 2003 May; 169(5): 1798-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12686844&dopt=Abstract
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Re: Prostate tissue composition and response to finasteride in men with symptomatic benign prostatic hyperplasia. Author(s): Atan A. Source: The Journal of Urology. 1998 July; 160(1): 134. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9628630&dopt=Abstract
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Re: The treatment of gross hematuria secondary to prostatic bleeding with finasteride. Author(s): Sorrentino F, Sorrentino M. Source: The Journal of Urology. 1998 December; 160(6 Pt 1): 2164. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9817358&dopt=Abstract
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Regressive changes in finasteride-treated human hyperplastic prostates correlate with an upregulation of TGF-beta receptor expression. Author(s): Saez C, Gonzalez-Baena AC, Japon MA, Giraldez J, Segura DI, Miranda G, Rodriguez-Vallejo JM, Gonzalez-Esteban J, Torrubia F. Source: The Prostate. 1998 October 1; 37(2): 84-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9759702&dopt=Abstract
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Repeated pressure-flow studies in the evaluation of bladder outlet obstruction due to benign prostatic enlargement. Finasteride Urodynamics Study Group. Author(s): Tammela TL, Schafer W, Barrett DM, Abrams P, Hedlund H, Rollema HJ, Matos-Ferreira A, Nordling J, Bruskewitz R, Miller P, Kirby R, Andersen JT, Jacobsen C, Gormley GJ, Malice MP, Bach MA. Source: Neurourology and Urodynamics. 1999; 18(1): 17-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10090123&dopt=Abstract
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Response to article “Depression circumstantially related to the administration of finasteride for androgenetic alopecia” (J Dermatol, 29, 665-669, 2002). Author(s): Pope JE, Makela EH. Source: The Journal of Dermatology. 2003 November; 30(11): 837-9; Author Reply 840-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14684944&dopt=Abstract
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Reversible painful gynaecomastia induced by low dose finasteride (1 mg/day) Author(s): Wade MS, Sinclair RD. Source: The Australasian Journal of Dermatology. 2000 February; 41(1): 55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10715905&dopt=Abstract
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Reversible severe myopathy during treatment with finasteride. Author(s): Haan J, Hollander JM, van Duinen SG, Saxena PR, Wintzen AR. Source: Muscle & Nerve. 1997 April; 20(4): 502-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9121510&dopt=Abstract
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Role of finasteride in the treatment of recurrent hematuria secondary to benign prostatic hyperplasia. Author(s): Carlin BI, Bodner DR, Spirnak JP, Resnick MI. Source: The Prostate. 1997 May 15; 31(3): 180-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9167770&dopt=Abstract
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Scandinavian clinical study of finasteride in the treatment of benign prostatic hyperplasia. Author(s): Beisland HO, Binkowitz B, Brekkan E, Ekman P, Kontturi M, Lehtonen T, Lundmo P, Pappas F, Round E, Shapiro D, et al. Source: European Urology. 1992; 22(4): 271-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1283370&dopt=Abstract
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Selectivity of finasteride as an in vivo inhibitor of 5alpha-reductase isozyme enzymatic activity in the human prostate. Author(s): Span PN, Voller MC, Smals AG, Sweep FG, Schalken JA, Feneley MR, Kirby RS. Source: The Journal of Urology. 1999 January; 161(1): 332-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10037433&dopt=Abstract
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Serum prostate-specific antigen and prostate volume predict long-term changes in symptoms and flow rate: results of a four-year, randomized trial comparing finasteride versus placebo. PLESS Study Group. Author(s): Roehrborn CG, Boyle P, Bergner D, Gray T, Gittelman M, Shown T, Melman A, Bracken RB, deVere White R, Taylor A, Wang D, Waldstreicher J. Source: Urology. 1999 October; 54(4): 662-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510925&dopt=Abstract
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Study of the association between ischemic heart disease and use of alpha-blockers and finasteride indicated for the treatment of benign prostatic hyperplasia. Author(s): Souverein PC, Herings RM, Man in 't Veld AJ, de la Rosette JJ, Farmer RD, Leufkens HG. Source: European Urology. 2002 September; 42(3): 254-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12234510&dopt=Abstract
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Suppression of spermatogenesis with desogestrel and testosterone pellets is not enhanced by addition of finasteride. Author(s): Kinniburgh D, Anderson RA, Baird DT. Source: Journal of Andrology. 2001 January-February; 22(1): 88-95. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11191092&dopt=Abstract
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Sustained-release alfuzosin, finasteride and the combination of both in the treatment of benign prostatic hyperplasia. European ALFIN Study Group. Author(s): Debruyne FM, Jardin A, Colloi D, Resel L, Witjes WP, Delauche-Cavallier MC, McCarthy C, Geffriaud-Ricouard C. Source: European Urology. 1998 September; 34(3): 169-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9732187&dopt=Abstract
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Tamoxifen for flutamide/finasteride-induced gynecomastia. Author(s): Staiman VR, Lowe FC. Source: Urology. 1997 December; 50(6): 929-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9426725&dopt=Abstract
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Terazosin vs finasteride for BPH. Author(s): Zacks M. Source: The Journal of Family Practice. 1996 December; 43(6): 533. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8969692&dopt=Abstract
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Terazosin, finasteride, or both in benign prostatic hyperplasia. Author(s): Thien T, Lenders JW. Source: The New England Journal of Medicine. 1997 January 23; 336(4): 294. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9005318&dopt=Abstract
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Terazosin, finasteride, or both in benign prostatic hyperplasia. Author(s): Kuchel GA, DuBeau CE, Resnick NM. Source: The New England Journal of Medicine. 1997 January 23; 336(4): 293-4; Author Reply 294. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9005317&dopt=Abstract
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The benefits of finasteride for hirsute women with polycystic ovary syndrome or idiopathic hirsutism. Author(s): Lakryc EM, Motta EL, Soares JM Jr, Haidar MA, de Lima GR, Baracat EC. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 2003 February; 17(1): 57-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12724020&dopt=Abstract
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The concentrations of the endogenous C19-steroids in hyperplastic prostatic tissue and the effect of finasteride treatment. Author(s): Hill M, Petrik R, Hampl R, Starka L. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 1996 October; 28(10): 562-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8934217&dopt=Abstract
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The effect of finasteride in men with benign prostatic hyperplasia. 1992. Author(s): Gormley GJ, Stoner E, Bruskewitz RC, Imperato-McGinley J, Walsh PC, McConnell JD, Andriole GL, Geller J, Bracken BR, Tenover JS, Vaughan ED, Pappas F, Taylor A, Binkowitz B, Ng J; Finasteride Study Group. Source: The Journal of Urology. 2002 February; 167(2 Pt 2): 1102-7; Discussion 1108. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11905882&dopt=Abstract
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The effect of finasteride on prostate specific antigen: review of available data. Author(s): Guess HA, Gormley GJ, Stoner E, Oesterling JE. Source: The Journal of Urology. 1996 January; 155(1): 3-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7490873&dopt=Abstract
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The effect of finasteride on prostate volume, urinary flow rate and symptom score in men with benign prostatic hyperplasia. Author(s): Stoner E, Guess H. Source: The Australian and New Zealand Journal of Surgery. 1995 May; 65(5): 360. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7537957&dopt=Abstract
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The effect of finasteride on prostate volume, urinary flow rate and symptom score in men with benign prostatic hyperplasia. Author(s): Nacey JN, Meffan PJ, Delahunt B. Source: The Australian and New Zealand Journal of Surgery. 1995 January; 65(1): 35-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7529489&dopt=Abstract
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The effect of finasteride on the expression of vascular endothelial growth factor and microvessel density: a possible mechanism for decreased prostatic bleeding in treated patients. Author(s): Pareek G, Shevchuk M, Armenakas NA, Vasjovic L, Hochberg DA, Basillote JB, Fracchia JA. Source: The Journal of Urology. 2003 January; 169(1): 20-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12478093&dopt=Abstract
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The effect of finasteride on the prostate gland in men with elevated serum prostatespecific antigen level. Author(s): Coltman CA. Source: British Journal of Cancer. 1999 September; 81(1): 184-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10487632&dopt=Abstract
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The effect of finasteride on the prostate gland in men with elevated serum prostatespecific antigen levels. Author(s): Cote RJ, Skinner EC, Salem CE, Mertes SJ, Stanczyk FZ, Henderson BE, Pike MC, Ross RK. Source: British Journal of Cancer. 1998 August; 78(3): 413-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9703292&dopt=Abstract
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The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride LongTerm Efficacy and Safety Study Group. Author(s): McConnell JD, Bruskewitz R, Walsh P, Andriole G, Lieber M, Holtgrewe HL, Albertsen P, Roehrborn CG, Nickel JC, Wang DZ, Taylor AM, Waldstreicher J. Source: The New England Journal of Medicine. 1998 February 26; 338(9): 557-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9475762&dopt=Abstract
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The effect of finasteride, a 5 alpha-reductase inhibitor, on scalp skin testosterone and dihydrotestosterone concentrations in patients with male pattern baldness. Author(s): Dallob AL, Sadick NS, Unger W, Lipert S, Geissler LA, Gregoire SL, Nguyen HH, Moore EC, Tanaka WK. Source: The Journal of Clinical Endocrinology and Metabolism. 1994 September; 79(3): 703-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8077349&dopt=Abstract
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The effect of low dose finasteride therapy in a man with prostatism. Author(s): Sullivan MJ, Smith RC. Source: The Journal of Urology. 1996 February; 155(2): 652. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8558692&dopt=Abstract
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The effect of minocycline on the metabolism of androgens by human oral periosteal fibroblasts and its inhibition by finasteride. Author(s): Soory M, Tilakaratne A. Source: Archives of Oral Biology. 2000 April; 45(4): 257-65. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10708666&dopt=Abstract
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The effectiveness of reducing the daily dose of finasteride in men with benign prostatic hyperplasia. Author(s): Sullivan MJ, Geller J. Source: Bmc Urology [electronic Resource]. 2002; 2(1): 2. Epub 2002 January 15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11818031&dopt=Abstract
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The effects of finasteride on hematuria associated with benign prostatic hyperplasia: a preliminary report. Author(s): Puchner PJ, Miller MI. Source: The Journal of Urology. 1995 November; 154(5): 1779-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7563345&dopt=Abstract
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The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia. Author(s): Drake L, Hordinsky M, Fiedler V, Swinehart J, Unger WP, Cotterill PC, Thiboutot DM, Lowe N, Jacobson C, Whiting D, Stieglitz S, Kraus SJ, Griffin EI, Weiss D, Carrington P, Gencheff C, Cole GW, Pariser DM, Epstein ES, Tanaka W, Dallob A, Vandormael K, Geissler L, Waldstreicher J. Source: Journal of the American Academy of Dermatology. 1999 October; 41(4): 550-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10495374&dopt=Abstract
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The efficacy of finasteride in the treatment of symptomatic benign prostatic hyperplasia. Author(s): Wu TT, Lee YH, Jiaan BP, Huang JK. Source: Zhonghua Yi Xue Za Zhi (Taipei). 1995 December; 56(6): 399-403. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8851481&dopt=Abstract
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The efficacy of terazosin, finasteride, or both in benign prostatic hyperplasia. Veterans Affairs Cooperative Studies Benign Prostatic Hyperplasia Study Group. Author(s): Lepor H, Williford WO, Barry MJ, Brawer MK, Dixon CM, Gormley G, Haakenson C, Machi M, Narayan P, Padley RJ. Source: The New England Journal of Medicine. 1996 August 22; 335(8): 533-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8684407&dopt=Abstract
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The expression of insulin-like growth factor 1 in follicular dermal papillae correlates with therapeutic efficacy of finasteride in androgenetic alopecia. Author(s): Tang L, Bernardo O, Bolduc C, Lui H, Madani S, Shapiro J. Source: Journal of the American Academy of Dermatology. 2003 August; 49(2): 229-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894070&dopt=Abstract
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The influence of finasteride on the development of prostate cancer. Author(s): Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, Lieber MM, Cespedes RD, Atkins JN, Lippman SM, Carlin SM, Ryan A, Szczepanek CM, Crowley JJ, Coltman CA Jr. Source: The New England Journal of Medicine. 2003 July 17; 349(3): 215-24. Epub 2003 June 24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12824459&dopt=Abstract
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The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. Author(s): McConnell JD, Roehrborn CG, Bautista OM, Andriole GL Jr, Dixon CM, Kusek JW, Lepor H, McVary KT, Nyberg LM Jr, Clarke HS, Crawford ED, Diokno A, Foley JP, Foster HE, Jacobs SC, Kaplan SA, Kreder KJ, Lieber MM, Lucia MS, Miller GJ, Menon M, Milam DF, Ramsdell JW, Schenkman NS, Slawin KM, Smith JA; Medical Therapy of Prostatic Symptoms (MTOPS) Research Group. Source: The New England Journal of Medicine. 2003 December 18; 349(25): 2387-98. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14681504&dopt=Abstract
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The long-term effect of specific type II 5alpha-reductase inhibition with finasteride on bone mineral density in men: results of a 4-year placebo controlled trial. Author(s): Matsumoto AM, Tenover L, McClung M, Mobley D, Geller J, Sullivan M, Grayhack J, Wessells H, Kadmon D, Flanagan M, Zhang GK, Schmidt J, Taylor AM, Lee M, Waldstreicher J; Pless Study Group. Source: The Journal of Urology. 2002 May; 167(5): 2105-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11956450&dopt=Abstract
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The medication minute: Finasteride. Author(s): Bartek JK. Source: Urologic Nursing : Official Journal of the American Urological Association Allied. 1994 March; 14(1): 29-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7512281&dopt=Abstract
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The potential application of finasteride for chemoprevention of prostate cancer. Author(s): Gormley GJ, Brawley O, Thompson I. Source: Annals of the New York Academy of Sciences. 1995 September 30; 768: 163-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8526345&dopt=Abstract
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The safety of finasteride used in benign prostatic hypertrophy: a non-interventional observational cohort study in 14,772 patients. Author(s): Wilton L, Pearce G, Edet E, Freemantle S, Stephens MD, Mann RD. Source: British Journal of Urology. 1996 September; 78(3): 379-84. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8881946&dopt=Abstract
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The treatment of gross hematuria secondary to prostatic bleeding with finasteride. Author(s): Sieber PR, Rommel FM, Huffnagle HW, Breslin JA, Agusta VE, Harpster LE. Source: The Journal of Urology. 1998 April; 159(4): 1232-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9507842&dopt=Abstract
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Therapeutic effects of finasteride in benign prostatic hyperplasia: a randomized double-blind controlled trial. Author(s): Yu HJ, Chiu TY, Lai MK. Source: J Formos Med Assoc. 1995 January-February; 94(1-2): 37-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7542109&dopt=Abstract
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Tissue effects of saw palmetto and finasteride: use of biopsy cores for in situ quantification of prostatic androgens. Author(s): Marks LS, Hess DL, Dorey FJ, Luz Macairan M, Cruz Santos PB, Tyler VE. Source: Urology. 2001 May; 57(5): 999-1005. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11337315&dopt=Abstract
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Topical finasteride therapy in hirsutism. Author(s): Rodriguez-Rigau LJ. Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2001 January-February; 7(1): 64-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11250772&dopt=Abstract
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Transition zone volume and transition zone ratio: predictor of uroflow response to finasteride therapy in benign prostatic hyperplasia patients. Author(s): Tewari A, Shinohara K, Narayan P. Source: Urology. 1995 February; 45(2): 258-64; Discussion 265. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7531900&dopt=Abstract
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Transurethral prostate resection and bleeding: a randomized, placebo controlled trial of role of finasteride for decreasing operative blood loss. Author(s): Donohue JF, Sharma H, Abraham R, Natalwala S, Thomas DR, Foster MC. Source: The Journal of Urology. 2002 November; 168(5): 2024-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12394700&dopt=Abstract
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Treating benign prostatic hyperplasia with finasteride in Chinese men: one-year experience. Author(s): Chueh SC, Yu HJ, Chiu TY, Huang CY, Lai MK. Source: J Formos Med Assoc. 1996 August; 95(8): 650-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8870441&dopt=Abstract
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Treatment of hirsutism by finasteride and flutamide in women with polycystic ovary syndrome. Author(s): Falsetti L, De Fusco D, Eleftheriou G, Rosina B. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1997 August; 11(4): 251-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9272421&dopt=Abstract
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Treatment with finasteride following radical prostatectomy for prostate cancer. Author(s): Andriole G, Lieber M, Smith J, Soloway M, Schroeder F, Kadmon D, DeKernion J, Rajfer J, Boake R, Crawford D, et al. Source: Urology. 1995 March; 45(3): 491-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7533461&dopt=Abstract
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Treatment with finasteride preserves usefulness of prostate-specific antigen in the detection of prostate cancer: results of a randomized, double-blind, placebocontrolled clinical trial. Author(s): Walsh PC. Source: The Journal of Urology. 1999 January; 161(1): 350-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10037436&dopt=Abstract
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Treatment with finasteride preserves usefulness of prostate-specific antigen in the detection of prostate cancer: results of a randomized, double-blind, placebocontrolled clinical trial. PLESS Study Group. Proscar Long-term Efficacy and Safety Study. Author(s): Andriole GL, Guess HA, Epstein JI, Wise H, Kadmon D, Crawford ED, Hudson P, Jackson CL, Romas NA, Patterson L, Cook TJ, Waldstreicher J. Source: Urology. 1998 August; 52(2): 195-201; Discussion 201-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9697781&dopt=Abstract
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Unilateral gynecomastia induced by treatment with 1 mg of oral finasteride. Author(s): Ferrando J, Grimalt R, Alsina M, Bulla F, Manasievska E. Source: Archives of Dermatology. 2002 April; 138(4): 543-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11939831&dopt=Abstract
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Urinary retention in patients with BPH treated with finasteride or placebo over 4 years. Characterization of patients and ultimate outcomes.The PLESS Study Group. Author(s): Roehrborn CG, Bruskewitz R, Nickel GC, Glickman S, Cox C, Anderson R, Kandzari S, Herlihy R, Kornitzer G, Brown BT, Holtgrewe HL, Taylor A, Wang D, Waldstreicher J. Source: European Urology. 2000 May; 37(5): 528-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10765090&dopt=Abstract
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Urodynamic effects of finasteride in the treatment of bladder outlet obstruction due to benign prostatic hyperplasia. Author(s): Tammela TL, Kontturi MJ. Source: The Journal of Urology. 1993 February; 149(2): 342-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7678871&dopt=Abstract
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Use of cyproterone acetate, finasteride, and spironolactone to treat idiopathic hirsutism. Author(s): Lumachi F, Rondinone R. Source: Fertility and Sterility. 2003 April; 79(4): 942-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12749435&dopt=Abstract
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Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss). Author(s): Shapiro J, Kaufman KD. Source: The Journal of Investigative Dermatology. Symposium Proceedings / the Society for Investigative Dermatology, Inc. [and] European Society for Dermatological Research. 2003 June; 8(1): 20-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894990&dopt=Abstract
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CHAPTER 2. NUTRITION AND FINASTERIDE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and finasteride.
Finding Nutrition Studies on Finasteride 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 “finasteride” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “finasteride” (or a synonym): •
A comparative study of a gonadotropin-releasing hormone agonist and finasteride on idiopathic hirsutism. Author(s): Department of Obstetrics and Gynecology, Dicle University, Diyarbakir Turkey. Source: Bayhan, G Bahceci, M Demirkol, T Ertem, M Yalinkaya, A Erden, A C Clin-ExpObstet-Gynecol. 2000; 27(3-4): 203-6 0390-6663
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Biochemical response to testicular androgen ablation among patients with prostate cancer for whom flutamide and/or finasteride therapy failed. Author(s): Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. Source: Ornstein, D K Smith, D S Andriole, G L Urology. 1998 December; 52(6): 1094-7 0090-4295
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Chemoprevention of prostate carcinogenesis by DFMO and/or finasteride treatment in male Wistar rats. Author(s): Department of Biochemistry, Faculty of Science, Ain Shams University, Cairo, Egypt. Source: Esmat, A Y Refaie, F M Shaheen, M H Said, M M Tumori. 2002 Nov-December; 88(6): 513-21 0300-8916
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Combined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia: analysis of prostate volume and therapeutic outcome. Author(s): Urological Clinic of Dortmund, Training Hospital of the University of Munster, Germany. Source: Sokeland, J BJU-Int. 2000 September; 86(4): 439-42 1464-4096
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Effect of finasteride, a 5 alpha-reductase inhibitor on prostate tissue androgens and prostate-specific antigen. Author(s): Department of Medical Education, Mercy Hospital and Medical Center, San Diego, California 92103-2180. Source: Geller, J J-Clin-Endocrinol-Metab. 1990 December; 71(6): 1552-5 0021-972X
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Effect of nonsteroidal anti-inflammatory agents and finasteride on prostate cancer risk. Author(s): University Hospital of Poitiers, France. Source: Irani, J Ravery, V Pariente, J L Chartier Kastler, E Lechevallier, E Soulie, M Chautard, D Coloby, P Fontaine, E Bladou, F Desgrandchamps, F Haillot, O J-Urol. 2002 November; 168(5): 1985-8 0022-5347
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Finasteride in association with either flutamide or goserelin as combination hormonal therapy in patients with stage M1 carcinoma of the prostate gland. International Prostate Health Council (IPHC) Trial Study Group. Author(s): Department of Urology, St. George's Hospital, Tooting, United Kingdom. Source: Kirby, R Robertson, C Turkes, A Griffiths, K Denis, L J Boyle, P Altwein, J Schroder, F Prostate. 1999 July 1; 40(2): 105-14 0270-4137
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Finasteride in the treatment of benign prostatic hyperplasia. A urodynamic evaluation. Author(s): Department of Urology, St Bartholomew's Hospital, London. Source: Kirby, R S Bryan, J Eardley, I Christmas, T J Liu, S Holmes, S A Vale, J A Shanmuganathan, K Webb, J A Br-J-Urol. 1992 July; 70(1): 65-72 0007-1331
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Human prostate tumor growth in athymic mice: inhibition by androgens and stimulation by finasteride. Author(s): Ben May Institute for Cancer Research, Department of Biochemistry and Molecular Biology, University of Chicago, IL 60637, USA. Source: Umekita, Y Hiipakka, R A Kokontis, J M Liao, S Proc-Natl-Acad-Sci-U-S-A. 1996 October 15; 93(21): 11802-7 0027-8424
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Pharmacological effects of the lipidosterolic extract of Serenoa repens (Permixon) on rat prostate hyperplasia induced by hyperprolactinemia: comparison with finasteride. Author(s): Laboratoire de Physiologie Cellulaire, USTL, INSERM EPI 9938, Villeneuve d'Ascq, France.
[email protected] Source: Van Coppenolle, F Le Bourhis, X Carpentier, F Delaby, G Cousse, H Raynaud, J P Dupouy, J P Prevarskaya, N Prostate. 2000 April 1; 43(1): 49-58 0270-4137
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Prolonged treatment with finasteride (a 5 alpha-reductase inhibitor) does not affect bone density and metabolism. Author(s): Department of Urology, Ichilov Hospital, Tel Aviv, Israel. Source: Matzkin, H Chen, J Weisman, Y Goldray, D Pappas, F Jaccard, N Braf, Z ClinEndocrinol-(Oxf). 1992 November; 37(5): 432-6 0300-0664
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Suppression of spermatogenesis with desogestrel and testosterone pellets is not enhanced by addition of finasteride. Author(s): Contraceptive Development Network, Centre for Reproductive Biology, University of Edinburgh, United Kingdom. Source: Kinniburgh, D Anderson, R A Baird, D T J-Androl. 2001 Jan-February; 22(1): 8895 0196-3635
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Tissue effects of saw palmetto and finasteride: use of biopsy cores for in situ quantification of prostatic androgens. Author(s): Urological Sciences Research Foundation, Culver City, California, USA. Source: Marks, L S Hess, D L Dorey, F J Luz Macairan, M Cruz Santos, P B Tyler, V E Urology. 2001 May; 57(5): 999-1005 1527-9995
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
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CHAPTER 3. ALTERNATIVE MEDICINE AND FINASTERIDE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to finasteride. At the conclusion of this chapter, we will provide additional sources.
The Combined Health Information Database The Combined Health Information Database (CHID) is a bibliographic database produced by health-related agencies of the U.S. federal government (mostly from the National Institutes of Health) that can offer concise information for a targeted search. The CHID database is updated four times a year at the end of January, April, July, and October. Check the titles, summaries, and availability of CAM-related information by using the “Simple Search” option at the following Web site: http://chid.nih.gov/simple/simple.html. In the drop box at the top, select “Complementary and Alternative Medicine.” Then type “finasteride” (or synonyms) in the second search box. We recommend that you select 100 “documents per page” and to check the “whole records” options. The following was extracted using this technique: •
Saw Palmetto Extracts for Treatment of Benign Prostatic Hyperplasia: A Systematic Review Source: JAMA. Journal of the American Medical Association. 280(18): 1604-1609. November 11, 1998. Summary: This journal article reviews the research on the efficacy and safety of saw palmetto extract (Serenoa repens) in men with symptomatic benign prostatic hyperplasia (BPH). A comprehensive search of the literature identified 18 randomized controlled trials involving 2,393 men who met inclusion criteria. Studies were included if the participants had symptomatic BPH, the intervention was a preparation of Serenoa repens alone or in combination with other phytotherapeutic agents, a control group received a placebo or other pharmacological therapies for BPH, and the treatment duration was at least 30 days. Results from doctor and participant assessments showed that Serenoa repens was superior to a placebo and comparable with finasteride in improving urinary tract symptom scores, nocturia, peak and mean urine flow rates, and
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residual urine volume. Adverse effects due to Serenoa repens generally were mild and comparable with a placebo. Erectile dysfunction was more common with finasteride (4.9 percent) than with S repens (1.1 percent). The withdrawal rates in men receiving Serenoa repens, a placebo, and finasteride were 9.1 percent, 7 percent, and 11.2 percent, respectively. The authors conclude that Serenoa repens appears to improve urologic symptoms and flow measures in men with BPH; its efficacy is similar to that of finasteride but with fewer adverse effects. The article has 4 figures and 51 references.
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 finasteride 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 “finasteride” (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 finasteride: •
A prospective, 1-year trial using saw palmetto versus finasteride in the treatment of category III prostatitis/chronic pelvic pain syndrome. Author(s): Kaplan SA, Volpe MA, Te AE. Source: The Journal of Urology. 2004 January; 171(1): 284-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14665895&dopt=Abstract
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Anxiolytic effect of Kami-Shoyo-San (TJ-24) in mice: possible mediation of neurosteroid synthesis. Author(s): Mizowaki M, Toriizuka K, Hanawa T. Source: Life Sciences. 2001 September 21; 69(18): 2167-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11669460&dopt=Abstract
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Benign prostatic hyperplasia. Patient evaluation and relief of obstructive symptoms. Author(s): Chow RD. Source: Geriatrics. 2001 March; 56(3): 33-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11252759&dopt=Abstract
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By the way, doctor. I'm 77 and have an enlarged prostate. I take Proscar once a day and saw palmetto three times a day. Yet I still have to get up two to seven times a night to urinate. What can I do to reduce the frequency of urination? Author(s): O'Leary MP. Source: Harvard Health Letter / from Harvard Medical School. 2003 April; 28(6): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777237&dopt=Abstract
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Cancer chemoprevention. Part 1: Retinoids and carotenoids and other classic antioxidants. Author(s): Singh DK, Lippman SM.
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Source: Oncology (Huntingt). 1998 November; 12(11): 1643-53, 1657-8; Discussion 165960. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9834941&dopt=Abstract •
Cancer chemoprevention. Part 2: Hormones, nonclassic antioxidant natural agents, NSAIDs, and other agents. Author(s): Singh DK, Lippman SM. Source: Oncology (Huntingt). 1998 December; 12(12): 1787-800; Discussion 1802, 1805. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9874850&dopt=Abstract
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Chemoprevention of prostate cancer. Author(s): Kucuk O. Source: Cancer and Metastasis Reviews. 2002; 21(2): 111-24. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12465750&dopt=Abstract
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Chemopreventive drug development: perspectives and progress. Author(s): Kelloff GJ, Boone CW, Crowell JA, Steele VE, Lubet R, Sigman CC. Source: Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. 1994 January-February; 3(1): 85-98. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8118391&dopt=Abstract
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Chronic prostatitis and chronic pelvic pain in men: aetiology, diagnosis and management. Author(s): Luzzi GA. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 May; 16(3): 253-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12195565&dopt=Abstract
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Combined sabal and urtica extract compared with finasteride in men with benign prostatic hyperplasia: analysis of prostate volume and therapeutic outcome. Author(s): Sokeland J. Source: Bju International. 2000 September; 86(4): 439-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10971268&dopt=Abstract
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Comment on the appropriateness of The Prostate publishing a trial comparing Permixon to finasteride without a placebo control group. Author(s): Gillenwater JY. Source: The Prostate. 1998 November 1; 37(3): 194. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9792137&dopt=Abstract
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Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Author(s): Carraro JC, Raynaud JP, Koch G, Chisholm GD, Di Silverio F, Teillac P, Da Silva FC, Cauquil J, Chopin DK, Hamdy FC, Hanus M, Hauri D, Kalinteris A, Marencak J, Perier A, Perrin P. Source: The Prostate. 1996 October; 29(4): 231-40; Discussion 241-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8876706&dopt=Abstract
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Comparison of Saw Palmetto (extract and whole berry) and Cernitin on prostate growth in rats. Author(s): Talpur N, Echard B, Bagchi D, Bagchi M, Preuss HG. Source: Molecular and Cellular Biochemistry. 2003 August; 250(1-2): 21-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12962139&dopt=Abstract
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Conservative non-instrumental treatment of benign prostatic hyperplasia. Author(s): Ruud Bosch JL. Source: Urological Research. 1997; 25 Suppl 2: S107-14. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9144895&dopt=Abstract
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Current treatment of BPH. Author(s): Roylance P, Gibelin B, Espie J. Source: Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 1995; 49(7-8): 332-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8562858&dopt=Abstract
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Diet and herbs for BPH? Author(s): Cerrato PL. Source: Rn. 2000 February; 63(2): 63-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10745888&dopt=Abstract
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Dietary supplement use in the Prostate Cancer Prevention Trial: implications for prevention trials. Author(s): Neuhouser ML, Kristal AR, Patterson RE, Goodman PJ, Thompson IM. Source: Nutrition and Cancer. 2001; 39(1): 12-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11588893&dopt=Abstract
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Docetaxel followed by hormone therapy after failure of definitive treatments for clinically localized/locally advanced prostate cancer: preliminary results. Author(s): Hussain A, Dawson N, Amin P, Naslund M, Engstrom C, Chen T. Source: Seminars in Oncology. 2001 August; 28(4 Suppl 15): 22-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11685725&dopt=Abstract
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EDTA-induced pseudothrombocytopenia. Author(s): Allerheiligen D, Houston R, Vermedahl B. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1996 May-June; 9(3): 212-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8743235&dopt=Abstract
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Effect of beta-sitosterol as inhibitor of 5 alpha-reductase in hamster prostate. Author(s): Cabeza M, Bratoeff E, Heuze I, Ramirez E, Sanchez M, Flores E. Source: Proc West Pharmacol Soc. 2003; 46: 153-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14699915&dopt=Abstract
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Effects of long-term treatment with Serenoa repens (Permixon) on the concentrations and regional distribution of androgens and epidermal growth factor in benign prostatic hyperplasia. Author(s): Di Silverio F, Monti S, Sciarra A, Varasano PA, Martini C, Lanzara S, D'Eramo G, Di Nicola S, Toscano V. Source: The Prostate. 1998 October 1; 37(2): 77-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9759701&dopt=Abstract
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Efficacy and tolerability of drugs for treatment of benign prostatic hyperplasia. Author(s): Dutkiewics S. Source: International Urology and Nephrology. 2001; 32(3): 423-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11583366&dopt=Abstract
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Enzyme induction and dietary chemicals as approaches to cancer chemoprevention: the Seventh DeWitt S. Goodman Lecture. Author(s): Conney AH. Source: Cancer Research. 2003 November 1; 63(21): 7005-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14612489&dopt=Abstract
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From the Food and Drug Administration. Author(s): Nightingale SL. Source: Jama : the Journal of the American Medical Association. 1992 September 16; 268(11): 1390. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1380995&dopt=Abstract
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Gateways to clinical trials. Author(s): Bayes M, Rabasseda X, Prous JR. Source: Methods Find Exp Clin Pharmacol. 2002 December; 24(10): 703-29. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616965&dopt=Abstract
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Tissue effects of saw palmetto and finasteride: use of biopsy cores for in situ quantification of prostatic androgens. Author(s): Marks LS, Hess DL, Dorey FJ, Luz Macairan M, Cruz Santos PB, Tyler VE. Source: Urology. 2001 May; 57(5): 999-1005. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11337315&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 finasteride; 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 Alopecia Source: Integrative Medicine Communications; www.drkoop.com Benign Prostatic Hyperplasia Source: Healthnotes, Inc.; www.healthnotes.com Benign Prostatic Hyperplasia Source: Integrative Medicine Communications; www.drkoop.com
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Benign Prostatic Hyperplasia Alternative names: Prostate Enlargement Source: Prima Communications, Inc.www.personalhealthzone.com BPH Source: Integrative Medicine Communications; www.drkoop.com Hair Loss Source: Integrative Medicine Communications; www.drkoop.com Prostate Enlargement Source: Integrative Medicine Communications; www.drkoop.com Prostate Infection Source: Integrative Medicine Communications; www.drkoop.com Prostatitis Source: Integrative Medicine Communications; www.drkoop.com •
Herbs and Supplements Finasteride Source: Healthnotes, Inc.; www.healthnotes.com Pygeum Alternative names: African Prune; Pygeum africanum Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Sabal Serrulata Alternative names: Saw Palmetto Source: Integrative Medicine Communications; www.drkoop.com Saw Palmetto Alternative names: Serenoa serrulata, Serenoa repens, Sabal serrulata Source: Healthnotes, Inc.; www.healthnotes.com Saw Palmetto Alternative names: Sabal serrulata Source: Integrative Medicine Communications; www.drkoop.com Saw Palmetto Source: Prima Communications, Inc.www.personalhealthzone.com Saw Palmetto Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,819,00.html Serenoa Repens Alternative names: Saw Palmetto Source: Integrative Medicine Communications; www.drkoop.com
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General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. PATENTS ON FINASTERIDE 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.8 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 “finasteride” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on finasteride, we have not necessarily excluded nonmedical patents in this bibliography.
Patents on Finasteride By performing a patent search focusing on finasteride, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 8Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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example of the type of information that you can expect to obtain from a patent search on finasteride: •
Medicaments comprising relaxin and their use Inventor(s): Lurie; Raziel (33 Mota Gur St., Tel Aviv, IL) Assignee(s): None Reported Patent Number: 6,075,005 Date filed: July 6, 1999 Abstract: The present invention relates to a hair growth compositions which contain relaxin or a relaxin analog and an anti-androgenic agent such as finasteride, SKL105657, estrogen, cyproterone acetate, spironolactor, flutamide, minoxidil or RU58841 as well as to methods for treating androgenic alopecia using such compositions. Excerpt(s): In humans, each hair follicle goes through repeated cyclical periods of growth including an active growth stage (anagen), which can persist for approximately 2 to 6 years; a transition phase (catagen), which lasts for only a week or two; and a resting period (telogen), which lasts 3 to 4 months. The hair is shed at the end of the telogen phase, and a new hair is grown as the cycle repeats. In the human scalp, which contains approximately 100,000 hair follicles, normally about 86% are in anagen, 1% are in catagen and 13% are in telogen. Therefore, in a normal human adult, approximately 100 hairs are shed from the scalp per day. Excessive hair loss, or alopecia, may be classified as being one of two types, non-scarring alopecia and scarring alopecia, and can be caused by a wide variety of factors. For example, non-scarring alopecia has been attributed to genetics and advanced age; administration of drugs such as anti-cancer chemotherapeutic drugs and contraceptives; topical use of chemical treatments, such as hair dyes, permanent wave solutions, and straighteners; diseases, such as leprosy or syphilis; illness; allergy; and hair follicle infection. Scarring alopecia may be a consequence of burns (accidental or post surgical from cryosurgery or laser surgery) or trauma, which often causes destruction of follicles. The most common type of human hair loss is androgenetic alopecia (also known as androgenic alopecia), which is a nonscarring hair loss of telogen hairs caused by an excessive androgen effect in genetically susceptible men and women. Androgens trigger the miniaturization or atrophy of terminal follicles that normally produce thick scalp hair and transforms them into vellus-like follicles, eventually yielding fine, downy hair that is barely perceptible. Androgenetic alopecia is expressed in males as baldness of the vertex of the scalp and is commonly referred to as male pattern baldness. In females, androgenetic alopecia appears as diffuse hair loss or thinning of the frontoparietal areas. As alopecia progresses with age, hairs in these predisposed areas miniaturize and appear to change from terminal hairs to resemble vellus hairs. In addition, as androgenetic alopecia continues, the number of hairs in the active growth anagen phase decreases while there is an increase the number of hairs in the telogen phase. Web site: http://www.delphion.com/details?pn=US06075005__
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Method of treating androgenic alopecia with 5-.alpha. reductase inhibitors Inventor(s): Gormley; Glenn J. (Westfield, NJ), Kaufman; Keith D. (Westfield, NJ), Stoner; Elizabeth (Westfield, NJ), Waldstreicher; Joanne (Scotch Plains, NJ) Assignee(s): Merck & Co., Inc. (rahway, Nj) Patent Number: 5,547,957 Date filed: March 17, 1994 Abstract: The instant invention involves a method of treating and/or reversing androgenic alopecia and promoting hair growth, and methods of treating acne vulgaris, seborrhea, and female hirsutism, by administering to a patient in need of such treatment a 5.alpha.-reductase 2 inhibitor, such as finasteride, in a dosage amount under 5 mgs/day. Excerpt(s): The present invention is concerned with the treatment of androgenic alopecia, including male pattern baldness, with compounds that are 5-alpha reductase isozyme 2 inhibitors. Certain undesirable physiological manifestations, such as acne vulgaris, seborrhea, female hirsutism, androgenic alopecia which includes female and male pattern baldness, and benign prostatic hyperplasia, are the result of hyperandrogenic stimulation caused by an excessive accumulation of testosterone ("T") or similar androgenic hormones in the metabolic system. Early attempts to provide a chemotherapeutic agent to counter the undesirable results of hyperandrogenicity resulted in the discovery of several steroidal antiandrogens having undesirable hormonal activities of their own. The estrogens, for example, not only counteract the effect of the androgens but have a feminizing effect as well. Non-steroidal antiandrogens have also been developed, for example, 4'-nitro-3'trifluoromethylisobutyranilide. See Neri, et al., Endocrinol. 1972, 91 (2). However, these products, though devoid of hormonal effects, compete with all natural androgens for receptor sites, and hence have a tendency to feminize a male host or the male fetus of a female host and/or initiate feed-back effects which would cause hyperstimulation of the testes. The principal mediator of androgenic activity in some target organs, e.g. the prostate, is 5.alpha.-dihydrotestosterone ("DHT"), formed locally in the target organ by the action of testosterone-5.alpha.-reductase. Inhibitors of testosterone-5.alpha.reductase will serve to prevent or lessen symptoms of hyperandrogenic stimulation in these organs. See especially U.S. Pat. No. 4,377,584 assigned to Merck & Co., Inc., issued Mar. 22, 1983. It is now known that a second 5.alpha.-reductase isozyme exists, which interacts with skin tissues, especially in scalp tissues. See, e.g., G. Harris, et al., Proc. Natl. Acad. Sci. USA, Vol. 89, pp. 10787-10791 (Nov. 1992). The isozyme that principally interacts in skin tissues is conventionally designated as 5.alpha.-reductase 1 (or 5.alpha.reductase type 1 ), while the isozyme that principally interacts within the prostatic tissues is designated as 5.alpha.-reductase 2 (or 5.alpha.-reductase type 2). Web site: http://www.delphion.com/details?pn=US05547957__
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Method of treating sweat-related conditions using finasteride, epristeride and a cholestan-3-one Inventor(s): Waldstreicher; Joanne (Scotch Plains, NJ) Assignee(s): Merck & Co., Inc. (rahway, Nj) Patent Number: 5,512,555 Date filed: July 21, 1994
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Abstract: The instant invention involves methods of treating sweat related conditions with compounds that are 5.alpha.-reductase inhibitors. The 5.alpha.-reductase inhibitors may be administered alone or in combination with other active agents to treat conditions such as apocrine gland sweating, hyperhidrosis, and hydradenitis suppurativa. Excerpt(s): The present invention is concerned with the treatment of sweat-related conditions with compounds that are 5.alpha.-reductase inhibitors. Apocrine sweat glands, comprised of ducts that open directly into the hair follicle, are largely confined to regions of the axilla and perineum (genital-anal area) and become functional just before puberty. Although this suggests that gonadal steroids (i.e. androgens and estrogens) play a role in their development, the exact hormones have not been identified. In man, the role of the apocrine gland is unclear, since the eccrine sweat glands (which open directly onto the surface of the skin and which are distributed over nearly the entire body surface) perform the thermoregulatory function. The odor, which results from bacterial action on aprocrine sweat, may have had a role in man in the past, but is now clearly vestigial. Sweat collected from the surface of the skin is contaminated by sebum (since there is a common opening to the surface of the skin), secretions from eccrine sweat glands, as well as bacteria. Based on animal data, it is thought that aprocrine sweat contains protein, nitrogen, potassium, sodium, calcium, magnesium, chloride, bicarbonate and lactate. Sweat is secreted in a pulsatile manner, presumably due to synchronous contraction of myoepithelial cells across the body. Web site: http://www.delphion.com/details?pn=US05512555__ •
Method of treatment for prostatic cancer Inventor(s): Gormley; Glenn J. (Westfield, NJ), Stoner; Elizabeth (Westfield, NJ) Assignee(s): Merck & Co., Inc. (rahway, Nj) Patent Number: 5,994,362 Date filed: June 2, 1995 Abstract: Disclosed is a new treatment for men with prostatic cancer involving combination therapy of a 5.alpha.-reductase inhibitor, i.e., a 17.beta.-substituted 4azasteroid, a 17.beta.-substituted non-azasteroid, 17.beta.-acyl-3-carboxyandrost-3,5diene, benzoylaminophenoxybutanoic acid derivative, fused benz(thio)amide or cinnamoylamide derivative, aromatic 1,2-diethers or thioethers, aromatic ortho acylaminophenoxy alkanoic acids, ortho thioalkylacylamino-phenoxy alkanoic acids, pharmaceutically acceptable salts and esters thereof, and particularly finasteride, in combination with an antiandrogen, i.e. flutamide. Pharmaceutical compositions useful for treatment are also disclosed. Excerpt(s): This invention relates to a new method of treatment for patients, i.e. men having prostatic cancer, which treatment involves a combination therapy of administering therapeutically effective amounts of a 5.alpha.-reductase inhibitor in combination with an antiandrogenic agent. It is known that testosterone (T) is secreted by the testes and adrenal glands but can undergo a 5.alpha.-reductase mediated conversion to dihydrotestosterone (DHT) in peripheral sites including the liver, skin, and prostate. DHT is preferentially bound by the nucleus of prostatic cells and so it is generally accepted that DHT, rather than T, is the androgen required by the prostate for its growth and function. Finasteride, 17.beta.(N-t-butyl)carbamoyl-4-aza-5.alpha.androst-1-en-3-one was developed as the culmination of a search for compounds which
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would inhibit 5.alpha.-reductase and thus have the potential for being useful against benign prostatic hyperplasia. Finasteride is a 4-azasteroid and a competitive inhibitor of the enzyme. It shows no affinity for the androgen receptor and so would not be expected to interfere with the binding and action of T in those tissues, such as muscle, which respond to T. Web site: http://www.delphion.com/details?pn=US05994362__ •
New finasteride processes Inventor(s): Dolling; Ulf H. (Westfield, NJ), McCauley; James A. (Belle Mead, NJ), Varsolona; Richard J. (Scotch Plains, NJ) Assignee(s): Merck & Co., Inc. (rahway, Nj) Patent Number: 5,468,860 Date filed: January 29, 1993 Abstract: Disclosed is a new process for producing finasteride which involves reacting the magnesium halide salt of 17.beta.B-carboalkoxy-4-aza-5.alpha.-androst-1-en-3-one with t-butylamino magnesium halide, present in at least a 2:1 molar ratio to the ester, formed from t-butyl amine and an aliphatic/aryl magnesium halide at ambient temperature in an inert organic solvent under an inert atmosphere followed by heating and recovering said product finasteride.Also disclosed are two polymorphic crystalline Forms I and II of finasteride, and methods of their production. Excerpt(s): Finasteride, marketed under the tradename of PROSCAR.RTM., by Merck & Co., Inc. is 17.beta.-(N-tert-butyl carbamoyl)-4-aza-5.alpha.-androst-1-en-3-one and is a 5.alpha.-reductase inhibitor for use in treating acne, female hirsutism, and particularly benign prostatic hyperplasia. See U.S. Pat. No. 4,760,071 (1988), the entire disclosure of which is incorporated herein by reference. The synthesis of finasteride in U.S. Pat. No. 4,760,071 involves reacting the 17.beta.-(2-pyridylthio) carboxylate of 4-aza-5.alpha.androst-1-ene-3one with t-butylamine. A further synthesis of finasteride is described in Synthetic Communications, 30 (17), p. 2683-2690 (1990), the entire disclosure of which is incorporated herein by reference. including the reacting of the 17-acylimidazole of 4aza-5.alpha.-androst-1-en-3-one with t-butylamine. Web site: http://www.delphion.com/details?pn=US05468860__
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Process for the production of finasteride Inventor(s): McCauley; James A. (Belle Meade, NJ), Varsolona; Richard J. (Scotch Plains, NJ) Assignee(s): Merck & Co., Inc. (rahway, Nj) Patent Number: 5,652,365 Date filed: March 30, 1995 Abstract: A process for producing polymorphic Form I of finasteride, 17B-(N-tert-butyl carbamoyl)-4-aza-5.alpha.-androst-1-en-3-one, in substantially pure form comprising the steps of: (1) crystallization from a solution of finasteride in a water immiscible organic solvent and 0% or more by weight of water, producing solvated and non-solvated finasteride in solution, such that the amount of organic solvent and water in the solution is sufficient to cause the solubility of the non-solvated form of finasteride to be
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exceeded and the non-solvated form of finasteride to be less soluble than any other form of finasteride in the organic solvent and water solution: (2) recovering the resultant solid phase; and (3) removing the solvent therefrom; wherein the water immiscible organic solvent is ethyl acetate or isopropyl acetate and the amount of water in the solvent mixture is below 4 mg./ml. Excerpt(s): Finasteride, marketed under the tradename of PROSCAR.RTM., by Merck & Co., Inc. is 17.beta.-(N-tert-butyl carbamoyl)-4-aza-5.alpha.-androst-1-en-3-one and is a 5.alpha.-reductase inhibitor for use in treating acne, female hirsutism, and particularly benign prostatic hyperplasia. See U.S. Pat. No. 4,760,071 (1988), the entire disclosure of which is incorporated herein by reference. The synthesis of finasteride in U.S. Pat. No. 4,760,071 involves reacting the 17.beta.-(2-pyridylthio)carboxylate of 4-aza-5.alpha.androst-1-ene-3-one with t-butylamine. A further synthesis of finasteride is described in Synthetic Communications, 30 (17), p. 2683-2690 (1990), the entire disclosure of which is incorporated herein by reference including the reacting of the 17-acylimidazole of 4-aza5.alpha.-androst-1-en-3-one with t-butylamine. However, both of these reactions require the use of heterocyclic aromatic amines which are expensive and give rise to environmental safety and toxicity considerations. Both of these intermediates are prepared from the 17.beta.-carboxylic acid. Web site: http://www.delphion.com/details?pn=US05652365__ •
Production of polymorphic forms I and II of finasteride by complexation with group I or II metal salts Inventor(s): Slemon; Clarke (Montreal, CA) Assignee(s): Torcan Chemical Ltd (aurora, Ca) Patent Number: 6,677,453 Date filed: June 18, 2002 Abstract: Polymorphic Form (I) finasteride is prepared by first forming a substantially insoluble complex of finasteride and a Group (I) or Group (II) metal salt, such as lithium bromide, and then dissociating the complex by dissolving away the salt component with water, so as to obtain substantially pure Form (I) polymorphic crystalline finasteride. Excerpt(s): This invention relates to finasteride, a 4-aza-steroid compound which exhibits pharmaceutical activity as an inhibitor of the enzyme testosterone 5-.alpha.reductase, and is useful in the treatment of prostate cancer. More specifically, it relates to processes for preparing finasteride in a specific, polymorphic form. It is reported to be active in inhibiting the activity of the enzyme testosterone-5-.alpha.-reductase, which causes reduction of testosterone in the body to dihydrotestosterone, DHT, implicated in the enlargement of the prostate and consequent development of malignant conditions namely prostate cancer. Accordingly, finasteride is prescribed for alleviation of prostate cancer. Finasteride can exist in two different polymorphic forms, Form I and Form II, which differ from one another in respect of their crystalline structure. The different polymorphic forms can be prepared by control of the crystallization conditions. Finasteride polymorphic Form I is the usual form and is the form which is marketed as the active ingredient of the finasteride drug formulation PROSCAR.RTM. According to Canadian Patent Application 2,103,107 Dolling et al. (equivalent to European patent application 0599376), finasteride polymorphic Form I is characterized by an X-ray powder diffraction pattern having d-spacings of 6.44, 5.69, 5.36, 4.89, 4.55,4.31, 3.85, 3.59 and 3.14. According to the same Canadian patent, finasteride polymorphic Form II is
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characterized by an X-ray powder diffraction pattern having d-spacings of 14.09, 10.36, 7.92, 7.18, 6.40, 5.93, 5.66, 5.31, 4.68, 3.90, 3.60 and 3.25. Web site: http://www.delphion.com/details?pn=US06677453__ •
Therapeutic uses of finasteride Inventor(s): Goldberg; Michael (20 Aspen Dr., Ivyland, PA 18974), Weisman; Kenneth M. (30 Springton Point Dr., Newtown Square, PA 19073) Assignee(s): None Reported Patent Number: 6,090,409 Date filed: March 13, 1998 Abstract: The method of decreasing atherosclerosis and its complications, such as, myocardial infarction, stroke and peripheral vascular disease involving administering to a human or animal an amount of finasteride sufficient to decrease atherosclerosis and its complications. Excerpt(s): Finasteride, a synthetic 4-azasteroid compound. 4-azaandrost-1-ene-17carboxamide, N-(1,1-dimethylethyl)-3-oxo-(5a 17B)-, sold under the trade name Proscar, as identified by U.S. Pat. No. 5,175,155, the entire disclosure is incorporated by reference herein, is known for use in treatment of benign prostatic hypertrophy (BPH). Said U.S. Pat. No. 5, 175,155 discloses the combination of finasteride and another agent, but preferably in the present invention finasteride is the only active ingredient, although combinations with other active ingredients are contemplated. The present invention involves the use of finasteride in the prevention and treatment of atherosclerosis, coronary artery heart disease, stroke, and peripheral vascular disease in humans and animals. It was observed that patients to whom finasteride was being administered for treatment of benign prostatic hypertrophy seemed to have a lower incidence of atherosclerosis and heart disease. Web site: http://www.delphion.com/details?pn=US06090409__
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Win 49596-finasteride method of use and compositions Inventor(s): Berger; Bruce M. (Radnor Township, Delaware County, PA), Juniewicz; Paul E. (Clifton Park, NY) Assignee(s): Sterling Winthrop Inc. (new York, Ny) Patent Number: 5,175,155 Date filed: October 7, 1991 Abstract: The method of use of a combination of the antiandrogen (5.alpha.,17.alpha.)-1'(methylsulfonyl)-1'H-pregn-20-yno[3,2-c]pyrazol-17 -ol (Win 49596) and the 5.alpha.reductase inhibitor (5.alpha.,17.beta.)-N-(1,1-dimethylethyl)-3-oxo-4-azaandrost-1-ene17-carb oxamide (finasteride) for treating prostate disease in a male mammal and pharmaceutical compositions thereof are disclosed. Excerpt(s): The invention relates to method of use of a combination of the antiandrogen (5.alpha.,17.alpha.)-1'-(methylsulfonyl)-1'H-pregn-20-yno[3,2-c]pyrazol-17 -ol (Win 49596) and the 5.alpha.-reductase inhibitor (5.alpha.,17.beta.)-N-(1,1-dimethylethyl)-3oxo-4-azaandrost-1-ene-17-carb oxamide (finasteride) for treating prostatic disease in a
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male mammal and pharmaceutical compositions thereof. Christiansen et al. U.S. Pat. No. 4,684,636 issued Aug. 4, 1987 describes antiandrogenic sulfonylsteroidopyrazoles including (5.alpha.,17.alpha.)-1'-(methylsulfonyl)-1'H-pregn-20-yno[3,2-c]pyrazol-17 -ol as the product of EXAMPLE 1 and method of use thereof "for effecting an antiandrogenic response in a mammal" and as being "contemplated to be carried out in the human male in the treatment of benign prostatic hypertrophy" and pharmaceutical compositions thereof. The patent does not describe the combination of any sulfonylsteroidopyrazole thereof with any 5.alpha.-reductase inhibitor. (5.alpha.,17.alpha.)-1'-(methylsulfonyl)-1'H-pregn-20-yno[3,2-c]pyrazol-17 -ol has been described by several publications in the pharmaceutical literature as Win 49596. The generic name zanoterone was recently approved by the United States Adopted Name Council for (5.alpha.,17.alpha.)-1'-(methylsulfonyl)-1'H-pregn-20-yno[3,2-c]pyrazol-17 ol. Rassmusson et al. U.S. Pat. No. 4,760,071 issued Jul. 26, 1988 describes "17.beta.-Nmonosubstituted carbamoyl-4-aza-5.alpha.-androst-1-en-3-one compounds and the use of such compounds as testosterone-5.alpha.-reductase inhibitors" including as EXAMPLE 1a N-tert-butyl-3-oxo-4-aza-5.alpha.-androst-1-ene-17.beta.-carboxamide and method of use thereof for "treating the hyperandrogenic condition[s] of acne vulgaris, seborrhea, femal[e] hirsutism, and benign prostatic hypertrophy" and pharmaceutical compositions "comprising a pharmaceutical carrier and an effective amount" thereof. The patent does not describe the combination of any 17.beta.-N-monosubstituted carbamoyl-4-aza-5.alpha.-androst-1-en-3-one thereof with any antiandrogen. Web site: http://www.delphion.com/details?pn=US05175155__
Patent Applications on Finasteride As of December 2000, U.S. patent applications are open to public viewing.9 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 finasteride: •
Process for obtaining 17 beta-(N-tert-butylcarbamoyl)-3-one4-aza-steroids Inventor(s): Blanco Fernandez, Cristina; (Boecillo, ES), Bonde-Larsen, Antonio Lorente; (Boecillo, ES), Martin Juarez, Jorge; (Boecillo, ES), Silva Guisasola, Luis Octavio; (Boecillo, ES) Correspondence: Akin, Gump, Strauss, Hauer & Feld, L.L.P.; One Commerce Square; 2005 Market Street, Suite 2200; Philadelphia; PA; 19103; US Patent Application Number: 20010008895 Date filed: March 5, 2001 Abstract: 17.beta.-(N-tert-butylcarbamoyl)-3-one-4-aza-steroids (I) can be obtained by a process which comprises the reaction of 17.beta.-(alkoxycarbonyl)-3-- one-4-aza-steroid with lithium tert-butylamide in an organic solvent. Some compounds of formula (I), for example, finasteride, are useful as inhibitors of 5.alpha.-reductase, and can be used in the treatment of benign prostatic hyperplasia and alopecia. 1 Excerpt(s): This invention relates to a process for obtaining 17.beta.-(N-tertbutylcarbamoyl) -3-one-4-aza-steroids, optionally unsaturated between carbons 1-2 or 5-
9
This has been a common practice outside the United States prior to December 2000.
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6, useful as inhibitors of 5.alpha.-reductase or synthetic intermediates thereof. 4-azasteroids are known that are useful as inhibitors of the enzyme 5.alpha.-reductase, an enzyme that converts testosterone into the more potent androgen, 5.alpha.-dihydrotestosterone, which is the main mediator of the androgenic activity in some organs. The inhibitors of testosterone-5.alpha.-reductase may prevent or reduce the symptoms of hyperandrogenic stimulation. U.S. Pat. No. 4,760,071 describes some 17.beta.-(N-alkylcarbamoyl)- -4-aza-5.alpha.-androst-1-en-3-ones useful as inhibitors of 5.alpha.reductase. A representative example of said compounds is finasteride [17.beta.-(N-tertbutyl-carbamoyl)-4-aza-5.alpha.-androst-1-e- n-3-one], an active substance with multiple therapeutic applications, for example, in the treatment of benign prostatic hyperplasia and alopecia. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Therapeutic uses of hormonal manipulation using combinations of various agents to treat atherosclerosis Inventor(s): Goldberg, Michael E.; (Ivyland, PA), Weisman, Kenneth; (Newtown Square, PA) Correspondence: Caesar, Rivise, Bernstein, Cohen & Pokotilow, LTD.; 12th Floor; Seven Penn Center; 1635 Market Street; Philadelphia; PA; 19103-2212; US Patent Application Number: 20020006399 Date filed: December 26, 2000 Abstract: A method of decreasing atherosclerosis and its complications involving administering to a human or animal various combinations of medications with Finasteride, Bicalutamide, Flutamide and Nilutamide. Excerpt(s): This application claims the benefit of the filing date of Dec. 27, 1999 of Provisional Patent Applications Ser. No. 60/173,204. Finasteride, a synthetic 4azasteroid compound, 4-azaandrost-1-ene-17-carboxamide, N-(1,1-dimethylethyl)-3oxo(5alpha 17beta)-. The empirical formula is C23H36N2O2. Finasteride is sold under the trade name Proscar, as identified by U.S. Pat. No. 5,175,155, the entire disclossure is incorporated by reference herein, is known for use in treatment of prostatic carcinoma. Bicalutamide, a non-steroidal anti-androgen, chemical name is propanamide, N-[14cyano-3-(trifluoromethyl)phenyl]-3-[(4-fluorophenyl)su- lfonyl]-2-hydroxy-2-methyl-(+), sold under the trade name Casodex, as identified by U.S. Pat. No. 4,636,505, the entire disclosure is incorporated by reference herein, is known for use in treatment of prostatic carcinoma. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Transdermal treatment with 5-alpha reductase inhibitors Inventor(s): Gormley, Glenn J.; (Westfield, NJ), Kaufman, Keith D.; (Westfield, NJ), Stoner, Elizabeth; (Westfield, NJ), Waldstreicher, Joanne; (Scotch Plains, NJ) Correspondence: Merck And CO Inc; P O Box 2000; Rahway; NJ; 070650907 Patent Application Number: 20020042425 Date filed: December 7, 2001
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Abstract: The instant invention involves a method of treating and/or reversing androgenic alopecia and promoting hair growth, and methods of treating acne vulgaris, seborrhea, and female hirsutism, by administering to a patient in need of such treatment a 5.alpha.-reductase 2 inhibitor, such as finasteride, in a dosage amount under 5 mgs/day. Excerpt(s): This application is a continuation-in-part of Ser. No. 08/138,520 filed Oct. 15, 1993. The present invention is concerned with the treatment of androgenic alopecia, including male pattern baldness, with compounds that are 5-alpha reductase isozyme 2 inhibitors. Certain undesirable physiological manifestations, such as acne vulgaris, seborrhea, female hirsutism, androgenic alopecia which includes female and male pattern bkdness, and benign prostatic hyperplasia, are the result of hyperandrogenic stimulation caused by an excessive accumulation of testosterone ("T") or similar androgenic hormones in the metabolic system. Early attempts to provide a chemotherapeutic agent to counter the undesirable results of hyperandrogenicity resulted in the discovery of several steroidal antiandrogens having undesirable hormonal activities of their own. The estrogens, for example, not only counteract the effect of the androgens but have a feminizing effect as well. Non-steroidal antiandrogens have also been developed, for example, 4'-nitro-3'-trifluoromethylisobutyranilide. See Neri, et al., Endocrinol. 1972, 91 (2). However, these products, though devoid of hormonal effects, compete with all natural androgens for receptor sites, and hence have a tendency to feminize a male host or the male fetus of a female host and/or initiate feed-back effects which would cause hyperstimulation of the testes. 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 finasteride, 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 “finasteride” (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 finasteride. You can also use this procedure to view pending patent applications concerning finasteride. 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 5. BOOKS ON FINASTERIDE Overview This chapter provides bibliographic book references relating to finasteride. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on finasteride include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “finasteride” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “finasteride” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “finasteride” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Finasteride, Msd: Innovation in the Management of Benign Prostatic Hyperplasia: Proceedings of a Symposium Held in Seville, Spain (European Urology) by L.J. Denis (Editor), J. E. Altwein (Editor); ISBN: 3805559143; http://www.amazon.com/exec/obidos/ASIN/3805559143/icongroupinterna
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Propecia : The Hair-Growth Breakthrough by M.D. Othniel J. Seiden (Author); ISBN: 0761515364; http://www.amazon.com/exec/obidos/ASIN/0761515364/icongroupinterna
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Prostate and Finasteride: Index of New Information With Authors, Subjects, and References by Patrick James Mullin; ISBN: 0788310402; http://www.amazon.com/exec/obidos/ASIN/0788310402/icongroupinterna
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Chapters on Finasteride In order to find chapters that specifically relate to finasteride, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and finasteride 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 “finasteride” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on finasteride: •
Nonsurgical Management of Benign Prostatic Hyperplasia Source: in Weiss, R.M.; George, N.JR.; O'Reilly, P.H. Comprehensive Urology. Orlando, FL: Mosby, Inc. 2001. p. 465-475. Contact: Available from Mosby, Inc. Order Fulfillment Department, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 321-5068. Fax (800)874-6418. E-mail:
[email protected] Website: www.elsevierhealth.com. PRICE: $249.00. ISBN: 723429499. Summary: Benign prostatic hyperplasia (BPH) is part of the normal male aging process and the most common neoplasm that occurs in men. Surgery remains the most effective treatment for complicated or severe symptomatic BPH. However, the invasive nature and potential side effects of surgery have led to the search for nonsurgical alternatives. This chapter on the nonsurgical management of BPH is from a comprehensive urology textbook. Alpha-blockers continue to evolve. Refinements are aimed at achieving reduced frequency dosage and achieving preferential side effects, while maintaining clinical efficacy. Finasteride has also been applied to the treatment of prostatic bleeding and may positively affect the natural history of clinical BPH. The popularity of phytotherapeutic (from plants) agents and relative lack of information into their safety profiles, mode of action, and clinical efficacy suggests this to be an area with tremendous potential for study. Heat-based treatments are being explored with the aim of developing durable office-based alternatives to surgery. The chapter is illustrated with full-color drawings and photographs. 11 figures. 86 references.
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Hormonal Therapy in Benign Prostatic Hyperplasia Source: in Narayan, P. Benign Prostatic Hyperplasia. London, England: Churchill Livingstone. 2000. p. 181-195. Contact: Available from Harcourt Publishers. Foots Cray High Street, Sidcup, Kent DA14 5HP UK. 02083085700. Fax 02083085702. E-mail:
[email protected]. Website: www.harcourt-international.com. PRICE: $149.00 plus shipping and handling. ISBN: 0443056374. Summary: The prostate gland is dependent on androgenic (male hormones) stimulation. Depriving the prostate of its testosterone support is an established treatment for benign prostatic hyperplasia (BPH). This chapter on the hormonal therapy in the clinical management of BPH is from a textbook that compiles data and commentary from the world's leading experts in this field. The author describes the development of finasteride, a 5 alpha reductase inhibitor, the studies that investigated the safety and efficacy of finasteride, the use of finasteride to reduce acute urinary retention and the need for surgery, combination therapy, the composition of the prostate response to
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finasteride, the biological variability of serum prostate specific antigen (PSA) and finasteride, and other types of hormonal therapy used in men with BPH. Approximately one third to one half of patients with BPH who are treated with finasteride in clinical studies have clinically significant improvements, while modest benefits overall were seen in the study population. Uncontrolled studies suggest that the response to therapy may be sustained for up to 6 years, although it is yet to be determined whether the progression of BPH with time can be prevented. Given its minimal side effects, finasteride should be considered an acceptable treatment option for a select group of patients with BPH. There also appears to be a benefit to finasteride in reducing the incidence of acute urinary retention and BPH related surgical interventions by up to nearly 50 percent when used chronically for over 2 years. With regard to prostate cancer, patients should be informed of the effect that finasteride has in lowering serum PSA levels and the potential impact this may have on the detection of prostate cancer. 6 figures. 53 references. •
Medication Use Source: in Dierich, M. and Froe, F. Overcoming Incontinence: A Straightforward Guide to Your Options. Somerset, NJ: John Wiley and Sons, Inc. 2000. p. 49-56. Contact: Available from John Wiley and Sons, Inc. Distribution Center, 1 Wiley Drive, Somerset, NJ 08875-1272. (800) 225-5945 or (732) 469-4400. Fax (732) 302-2300. E-mail:
[email protected]. Website: www.wiley.com. PRICE: $14.95 plus shipping and handling. ISBN: 0471347957. Summary: This chapter on medication use is from a practical guide that dispels the many myths associated with urinary incontinence, offering readers information about the latest options for treatment, from simple lifestyle changes and exercises to devices, medications, and surgery. The authors emphasize that incontinence can be prevented, is almost always treatable, and is often curable. In this chapter, the authors review the numerous medications used to treat incontinence. In general, drug therapy is used to treat urge incontinence (UI), sometimes for stress urinary incontinence (SUI), and occasionally for overflow incontinence. Specific drugs covered are oxybutynin (Ditropan and Ditropan XL) which is an antispasmodic; tolterodine (Detrol), an antispasmodic with fewer side effects; hyoscyamine (Levsinex), an antispasmodic that can be taken on an as-needed basis; dicyclomine (Bentyl), traditionally used for intestinal spasms; imipramine (Tofranil), an antidepressant with side effects that can be beneficial to patients with incontinence; propantheline (Probanthine), similar to oxybutynin; flavoxate (Urispas), similar to oxybutynin; phenylpropanolamine, which increases the tone of the sphincter muscle that closes the urethra; pseudoephedrine (Sudafed), similar to phenylpropanolamine; terazoxin (Hytrin), for overflow incontinence caused by prostate or urethral blockage; doxazosin (Cardura), similar to terazoxin; tamsulosin (Flomax), similar to terazosin but with quick response rate; finasteride (Proscar) for treatment of bladder symptoms caused by enlarged prostate; and urecholine, for overflow incontinence due to poor bladder muscle function. The authors also include a section on estrogen, notably estrogen replacement therapy, and a section on herbal treatments for incontinence. The authors caution that, with any medication, interactions and side effects are possible. 2 tables.
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Medical Treatment Options Source: in Kirby, R.S.; Christmas, T.J. Benign Prostatic Hyperplasia. New York, NY: Gower Medical Publishing. 1993. p. 84-106.
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Contact: Available from Gower Medical Publishing. c/o Raven Press, Department 5B, 1185 Avenue of the Americas, New York, NY 10036. PRICE: $95 (NY and CA residents, add applicable sales tax). Order number GM0316. ISBN: 1563755114. Summary: This chapter, from a medical textbook about benign prostatic hyperplasia (BPH), covers medical treatments for the condition. The first section discusses the use of alpha-adrenoceptor blockers; the effects of the drugs on urodynamic parameters; and specific drugs including phenoxybenzamine, phentolamine, prazosin, nicergoline, thymoxamine, ketanserin, alfuzosin, indoramin, terazosin, YM 617, and doxazosin. The second section discusses endocrine therapy for BPH, including the use of 5-alphareductase inhibitors, finasteride, and other 5-alpha-reductase inhibitors currently under development. Two final sections consider aromatase inhibition and anti-estrogens, and phytotherapy. 18 figures. 84 references.
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CHAPTER 6. MULTIMEDIA ON FINASTERIDE Overview In this chapter, we show you how to keep current on multimedia sources of information on finasteride. 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 finasteride is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “finasteride” 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 “finasteride” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on finasteride: •
Benign Prostatic Hyperplasia: AHCPR Clinical Practice Guideline Source: Secaucus, NJ: Network for Continuing Medical Education (NCME). 1994. Contact: Available from NCME. One Harmon Plaza, Secaucus, NJ 07094. (800) 223-0272 or, in New Jersey, (800) 624-2102, or (201) 867-3550. PRICE: $50 for 2-week rental or $75 for purchase. Available only to NCME subscribers; subscriber fees as of 1995 are $1,920 for VHS subscription, $2,120 for U-matic subscription. Summary: In this continuing education videotape, Dr. John Wasson presents highlights of the 1994 Clinical Practice Guidelines and how to implement them. Topics include epidemiology, including incidence, the number of surgeries, and the use of drug therapies; the diagnostic process, including the initial evaluation, patient history, physical examination, use of the AUA Symptom Index, symptom assessment, urinalysis, serum creatinine test, and prostate-specific antigen (PSA) test; the symptoms of prostatism; optional tests used in diagnosis; patient education and the patient's role in decision-making; noninvasive therapeutic options, including watchful waiting, alpha
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blocker drugs, finasteride, and lifestyle changes; invasive therapeutic options, including balloon dilation and surgery; the success and failure rates for each therapeutic option, including the probability of retrograde ejaculation; investigational modalities, including hyperthermia, thermal therapy, laser prostatectomy, hormonal manipulation, and prostatic stents; and a review of treatment recommendations.
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CHAPTER 7. PERIODICALS AND NEWS ON FINASTERIDE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover finasteride.
News Services and Press Releases One of the simplest ways of tracking press releases on finasteride 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 “finasteride” (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 finasteride. 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 “finasteride” (or synonyms). The following was recently listed in this archive for finasteride: •
Finasteride lowers risk of prostate cancer but increases risk of high-grade tumors Source: Reuters Industry Breifing Date: June 24, 2003
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Glaxo prices Avodart same as Merck's Proscar in Europe Source: Reuters Industry Breifing Date: March 13, 2003
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Doxazosin plus finasteride stalls progression of BPH Source: Reuters Industry Breifing Date: May 29, 2002
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Finasteride for male pattern hair loss improves hair weight more than hair count Source: Reuters Industry Breifing Date: May 24, 2002
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Finasteride pretreatment reduces bleeding from transurethral prostate resection Source: Reuters Medical News Date: June 07, 2000
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Flutamide superior to finasteride in treating female hirsutism Source: Reuters Medical News Date: June 06, 2000
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Stent plus finasteride treats urinary retention in prostatic enlargement Source: Reuters Medical News Date: January 28, 2000
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Flutamide better than finasteride for treatment of hirsutism Source: Reuters Medical News Date: July 14, 1999
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Propecia approved for marketing in France Source: Reuters Medical News Date: December 29, 1998
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Merck pulls Propecia advertisement following FDA letter Source: Reuters Medical News Date: August 11, 1998
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Finasteride use may promote progression of prostatic intraepithelial neoplasia Source: Reuters Medical News Date: August 10, 1998
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Finasteride 1 mg no benefit in balding postmenopausal women Source: Reuters Medical News Date: July 02, 1998
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Improvements in prostate symptoms with finasteride persist Source: Reuters Medical News Date: June 08, 1998
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FDA Approves Merck's Proscar To Reduce Need For Prostate Surgery Source: Reuters Medical News Date: March 27, 1998
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Finasteride Recommended As First-Line Therapy For BPH-Associated Hematuria Source: Reuters Medical News Date: March 09, 1998
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Long-Term Finasteride Reduces Need For Prostate Surgery Source: Reuters Medical News Date: February 26, 1998
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Finasteride And Casodex Prevent Prostate Cancer Progression In Rats Source: Reuters Medical News Date: January 30, 1998
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FDA Panel Says Finasteride Effective For Male Pattern Baldness Source: Reuters Medical News Date: November 14, 1997
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Finasteride Controls Idiopathic Hirsutism In Women Source: Reuters Medical News Date: November 05, 1996
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Finasteride Most Beneficial In Men With Large Prostate Volumes Source: Reuters Medical News Date: October 03, 1996
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Finasteride Link To Breast Cancer In Men Deemed Uncertain Source: Reuters Medical News Date: September 13, 1996
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Terazosin Better Than Finasteride In Subset Of Benign Prostatic Hyperplasia Patients Source: Reuters Medical News Date: August 22, 1996
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Finasteride Appears Effective Against Idiopathic Hirsutism Source: Reuters Medical News Date: August 22, 1995 The NIH
Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “finasteride” (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.
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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 “finasteride” (or synonyms). If you know the name of a company that is relevant to finasteride, 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 “finasteride” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “finasteride” (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 finasteride: •
Terazosin Shows Lasting Effects on BPH: Effects on Practice Remain To Be Seen (editorial) Source: Urology Times. 22(4): 11. February 1994. Contact: Available from Advanstar Communications, Inc. Corporate and Editorial Offices, 7500 Old Oak Boulevard, Cleveland, OH 44130. (216) 243-8100. Summary: This brief article examines current findings that terazosin (Hytrin) is not only effective but also may last as much as 30 months in the treatment for benign prostatic hyperplasia (BPH). The author discusses the pros and cons of this finding, covering topics including problems with masking the diagnosis of carcinoma in men treated with terazosin, the role of digital rectal exams (DRE), the results of a long-term, open-label study of terazosin,; side effects and how to avoid them; patients who do not respond to the drug, optimum dosage and administration of terazosin, and patient selection issues for terazosin versus finasteride or a combination of the two drugs.
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Enlarged Prostate Gland: Many Treatment Options Source: Mayo Clinic Health Letter. 19(4): 1-3. April 2001. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037 or (303) 604-1465.
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Summary: This health newsletter article discusses enlarged prostate gland (benign prostatic hyperplasia), a common problem that affects half of men in their 60s and close to 80 percent of men in their 80s. The prostate gland is located just below the bladder and surrounds the urethra, the tube that drains the bladder. This gland often enlarges with age and constricts the urethra, making it more difficult for urine to pass through. Signs and symptoms of benign prostatic hyperplasia (BPH) may include excessive urination at night, a weak urine stream, stopping and starting while urinating, a frequent urge to urinate, and a feeling that the bladder has not been emptied completely. Diagnosis includes a symptom questionnaire, a urine test to rule out infection, a prostate specific antigen (PSA) test, and a digital rectal exam (DRE) to rule out prostate cancer, and sometimes more tests including cystoscopy and urine flow tests. Generally, no treatment is required for mild BPH symptoms. Monitoring the situation and simple lifestyle changes may be all that is necessary. For men with moderate to severe symptoms, treatment options include oral medications, surgery, and minimally invasive techniques. Drug options include alpha blockers, finasteride, and plant extracts (including saw palmetto). Surgical treatments include transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), open prostatectomy (removal of the prostate), microwave and radiofrequency, laser therapy, and stents. One sidebar summarizes lifestyle changes that may be recommended to help men deal with symptoms of BPH. 1 figure. 1 table. •
Male Pattern Baldness Drug Works Slowly Source: Skin and Allergy News. 29(2): 1. February 1998. Summary: This newsletter article provides health professionals with information on the efficacy of Propecia for treating male pattern baldness. Propecia is the 1 milligram version of finasteride. The latter drug inhibits the steroid 5 alpha-reductase, which converts testosterone into 5-alpha dihydrotestosterone. This androgen plays a role in male pattern hair loss. Clinical trials of Propecia show that men should not expect any results for at least 6 months. After 3 months men may notice at most some diminished shedding. In addition, not all men respond. After 2 years of therapy, about 17 percent of men have hair counts below baseline. The remaining men either maintain the status quo or gain hair. In two studies on vertex baldness, the men treated with Propecia had significant increases in hair counts at 6 and 12 months. The effect on frontal hair was not as great as it was on vertex hair loss, and the effect was greatest in Caucasian men. So far, no serious safety issues have arisen in Propecia treated patients. Overall, Propecia seems well tolerated. The drug is contraindicated in women during pregnancy because of the risk of giving birth to boys with ambiguous genitalia. In addition, men taking Propecia and undergoing prostate specific antigen (PSA) screens may need to have their PSA values adjusted. 2 figures.
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Baldness: Medical Solutions for Men and Women Source: Mayo Clinic Health Letter. 19(11): 4-5. November 2001. Contact: Available from Mayo Clinic Health Letter. 200 First Street, SW, Rochester, MN 55905. (800) 333-9037 or (303) 604-1465. E-mail:
[email protected]. Summary: This newsletter article provides people who are losing their hair with information on new treatment options for this problem. Male and female pattern baldness accounts for 99 percent of hair loss. Pattern baldness in both genders tends to have a significant genetic link. Although this type of hair loss is permanent, if treatment is sought before growth stops, it is possible to slow hair loss, and, in some cases, regrow
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hair. The drugs minoxidil (Rogaine) and finasteride (Propecia) have been approved by the Food and Drug Administration to treat pattern baldness. Minoxidil, which can be used by men or women, is a nonprescription liquid that is rubbed into the scalp twice a day to regrow hair and prevent further loss. This drug seems to be most effective in the early stages of baldness, and it usually must be used for 6 months or more to be effective. If the drug is discontinued, new hair may stop growing. Finasteride, which comes in prescription pill form, is approved only for men. The drug usually needs to be used for several months before results are seen. Surgical options in the form of hair transplants and scalp reduction may also be considered to treat baldness. 1 figure.
Academic Periodicals covering Finasteride Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to finasteride. In addition to these sources, you can search for articles covering finasteride 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 8. 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 finasteride. 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 finasteride. 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 finasteride: Finasteride •
Systemic - U.S. Brands: Propecia; Proscar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202649.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. 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 Institute10: •
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/
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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.11 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:12 •
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
11
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). 12 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway13 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.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “finasteride” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 1210 3 11 4 4 1232
HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 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.17 Simply search by “finasteride” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
13
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
14
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). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists18 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.19 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.20 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
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Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
18 Adapted 19
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on finasteride 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 finasteride. 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 finasteride. 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 “finasteride”:
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Other guides Cancer http://www.nlm.nih.gov/medlineplus/cancer.html Hair Diseases and Hair Loss http://www.nlm.nih.gov/medlineplus/hairdiseasesandhairloss.html Prostate Cancer http://www.nlm.nih.gov/medlineplus/prostatecancer.html Prostate Diseases http://www.nlm.nih.gov/medlineplus/prostatediseases.html Uterine Cancer http://www.nlm.nih.gov/medlineplus/uterinecancer.html Uterine Fibroids http://www.nlm.nih.gov/medlineplus/tutorials/uterinefibroidsloader.html Uterine Fibroids http://www.nlm.nih.gov/medlineplus/uterinefibroids.html
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on finasteride. 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: •
Benign Prostatic Hyperplasia: Diagnosis and Treatment Source: Silver Spring, MD: Agency for Health Care Policy and Research. 1994. 13 p. Contact: Available from Agency for Health Care Policy and Research Publications Clearinghouse. P.O. Box 8547, Silver Spring, MD 20907. (800)358-9295. PRICE: Single copy free. Summary: Benign prostatic hyperplasia (BPH) is the most common benign neoplasm in the aging human male. This quick reference guide, excerpted from the Clinical Practice Guideline, was developed to apply to the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction. The guide includes diagnostic issues; the Symptom Index of the American Urological Association; treatment modalities; a decision diagram; and a balance sheet of treatment outcomes. The guideline details the relative benefits and
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harms associated with all diagnostic and treatment approaches. Treatment options discussed include: watchful waiting, alpha blocker and finasteride medications, balloon dilatation, and the surgical options of transurethral incision, transurethral resection, and open prostatectomy. 3 figures. (AA-M). •
To Treat Symptomatic Benign Prostate Enlargement: Only One Medicine Can Shrink the Prostate Source: Rahway, NJ: Merck and Co., Inc. 1994. 9 p. Contact: Available from Merck and Co., Inc. P.O. Box 2000, RY7-220, Rahway, NJ 07065. (908) 594-4600. PRICE: Single copy free. Distribution may be limited to health professionals. Summary: Finasteride (Proscar) is an oral drug indicated for the treatment of symptomatic benign prostatic hyperplasia (BPH). This brochure provides patient education for men who are considering finasteride. Topics include the symptoms of prostate enlargement; the prevalence of prostate enlargement; the importance of seeking health care for BPH; medical options for the treatment of BPH; how finasteride works and for whom; and patient leaflet information from the drug insert sheet. The brochure includes a self-evaluation test that can be used in screening for BPH.
•
Understanding Prostate Changes: A Health Guide for All Men Source: Bethesda, MD: National Cancer Institute (NCI), National Institutes of Health. 1999. 38 p. Contact: Available from National Cancer Institute Public Inquiries Office. Building 31, Room 10A03, 31 Center Drive, MSC 2580, Bethesda MD 20892-2580. (301) 435-3848. Website: www.nci.nih.gov. PRICE: Single copy free. Summary: Issues surrounding the prostate, and prostate cancer in particular, are immersed in uncertainty. For example, it is not known if the potential benefits of prostate cancer screening outweigh the risks, if surgery is better than radiation, or if treatment is better than no treatment in some cases. By providing some insight into the prostate and prostate disorders, this booklet aims to help readers consult knowledgeably with their doctors when faced with diagnosis and treatment decisions. After an introduction that reviews the anatomy and physiology of the prostate, the booklet reviews prostatitis, benign prostatic hyperplasia (BPH), evaluating prostate health, and prostate cancer. Prostatitis (inflammation of the prostate) can cause difficult or painful urination that is often accompanied by a burning sensation, by a strong and frequent urge to urinate that often results in only small amounts of urine, and by pain in the lower back or abdomen. When prostatitis is the result of a bacterial infection, it usually can be cleared up with antibiotics. BPH is a noncancerous overgrowth of tissue of the prostate which can block the flow of urine. About half of men with BPH develop symptoms that warrant treatment; the remainder opt for watchful waiting (regular monitoring checkups but no intervention). Treatment includes drug therapy, with alpha adrenergic blockers or finasteride; and surgical options, including transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), transurethral needle ablation (TUNA), and open prostatectomy. Tests used for evaluating prostate health include the digital rectal examination (DRE), the prostate specific antigen (PSA) test, and transrectal ultrasound (TRUS). Risk factors for prostate cancer are outlined; they include advancing age, family history, race (African American men have a higher risk than white Americans; Asian immigrants to the United States have much lower rates), hormonal factors, diet, vasectomy, and environmental
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exposures. Prostate cancer is identified and diagnosed by screening tests, PSA tests, and biopsy; diagnosis includes staging, which helps determine the level of cancer and thus the appropriate treatment approach. The booklet includes numerous sidebars with quotes from men who have survived prostate cancer, lists of questions to consider and to ask one's health care provider, a self test for BPH symptoms, and related research studies. The booklet concludes with a glossary of terms and a brief list of sources for additional information. 2 figures. 23 references. •
Treating Your Enlarged Prostate: Benign Prostatic Hyperplasia Patient Guide Source: Rockville, MD: Agency for Health Care Policy and Research. 1994. 21 p. Contact: Available from AHCPR Publications Clearinghouse. P.O. Box 8547, Silver Spring, MD 20907. (800) 358-9295. PRICE: Single copy free. Summary: This booklet is designed to help readers understand benign prostatic hyperplasia (BPH) and how it can be treated. The booklet describes the benefits and risks of the various treatments available for BPH. Specific topics include a description of the anatomy and physiology of the prostate; a definition of BPH; the symptoms and etiology of BPH; how to know when to consult a health care provider; diagnostic tests used to confirm BPH; and treatment choices, including watchful waiting, alpha blocker treatment, finasteride drug treatment, balloon dilation, and surgery. One chart summarizes the outcomes of these five BPH treatments. 8 figures.
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Important Information About Prostate-Specific Antigen (PSA) Source: Baltimore, MD: Prostate Health Council, American Foundation for Urologic Disease. 1998. 12 p. Contact: Available from American Foundation for Urologic Disease. 1128 North Charles Street, Baltimore, MD 21201. (800) 242-2383 or (410) 468-1800. Fax (410) 468-1808. E-mail:
[email protected]. Website: www.afud.org. PRICE: Single copy free. Summary: This booklet provides readers with basic information about prostate-specific antigen (PSA). Topics include a definition of PSA and its physiology; the measurement of PSA; typical normal PSAs; the causes of an elevated PSA level, including benign prostatic hyperplasia (BPH), prostate cancer, prostate infection, and prostate biopsy; the role of PSA testing; the value of early prostate cancer detection; determining the need and scheduling for PSA testing; information about the PSA for men taking finasteride (Proscar); and information about the PSA for men who have been treated for prostate cancer. The booklet includes a brief posttest with answers and a glossary of terms. Simple line drawings illustrate some of the concepts. 5 figures. 1 table.
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Treatment Choices for BPH: Enlarged Prostate Source: Baltimore, MD: Prostate Health Council. American Foundation for Urologic Disease. 1996. 10 p. Contact: Available from American Foundation for Urologic Disease. 1126 North Charles Street, Baltimore, MD 21201. (800) 242-2383 or (410) 468-1800. Fax (410) 468-1808. Website: www.afud.org. PRICE: Single copy free. Summary: This booklet was written to help patients make informed choices about treatment options for their benign prostatic hyperplasia (BPH). The brochure begins with a description of the prostate and its role. More than half of men over age 60 have BPH, an enlarged prostate that is not cancerous. BPH affects the inner part of the
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prostate first. As a result, the prostate may begin to squeeze the urethra. This sometimes causes problems in urinating. BPH generally does not interfere with sexual functioning. BPH should be treated only if the symptoms are severe enough to affect lifestyle or if the urinary tract is seriously affected. Currently, the main ways of dealing with BPH are watchful waiting, alpha-blocker drug treatment, finasteride drug treatment, and surgery. Surgery often does the best job of relieving symptoms, but it also has more risk than the other treatments. The brochure also describes laser surgery and other new treatments, including electrovaporization and thermal therapy. The brochure outlines the benefits and risks of each type of traditional therapy. The booklet concludes with a glossary of related terms; a pretest and answers are also included. •
Enlarged Prostate: Medication or Surgery Source: Hanover, MD: American Prostate Society. 1994. 4 p. Contact: Available from American Prostate Society. 1340-F Charwood Road, Hanover, MD 21076-3169. (410) 859-3735. E-mail:
[email protected]. Web site: http://www.ameripros.org. PRICE: Single copy free; bulk copies available. Summary: This brochure helps men with prostatic enlargement make the decision between medications or surgery for treatment. The brochure first describes the use of flutamide, finasteride (Proscar), and terazosin (Hytrin) and the drawbacks to each. The authors discuss two main objections to medication: cost factors and the lack of opportunity to detect prostatic cancer. The man's health, age, and degree of prostatic enlargement will affect the decision regarding treatment modality. Up to half of all men, properly evaluated for medication, could avoid surgery using Proscar or Hytrin under a physician's care. The remainder of the brochure outlines the steps taken prior to, during, and after surgery for prostatic enlargement. More than 400,000 men each year undergo surgery to correct prostate enlargement, at a cost of more than three billion dollars per year. The brochure lists the conditions that might require surgery (as opposed to watchful waiting): hesitating or difficult urination; incomplete voiding; recurring bladder infections; inability to control urination; and reduced kidney function. The brochure focuses on the transurethral resection of the prostate, or TURP, procedure. One series of diagrams illustrates how the enlarging prostate affects urination at different points in its enlargement. 5 references. (AA-M).
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Hair Loss Source: Schaumberg, IL: American Academy of Dermatology. 1999. 8 p. Contact: Available from American Academy of Dermatology. 930 N. Meacham Road, P.O. Box 4014, Schaumberg, IL 60168. (888) 462-DERM ext. 22. Website: www.aad.org. PRICE: Single copy free. Summary: This brochure reviews normal hair growth and causes of excessive hair loss. Hair loss can be caused by improper cosmetic use or improper hair care, hereditary thinning or baldness, alopecia areata, childbirth, high fever, severe infection, severe flu, thyroid disease, poor nutrition, medications, cancer treatments, birth control pills, fungus infections, chronic illness, major surgery, or hair pulling. Treatment for hereditary thinning or baldness includes hair transplantation and medications such as minoxidil and finasteride. 2 figures.
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Benign Prostatic Hypertrophy Source: in Sodeman, W.A., Jr. Instructions for Geriatric Patients. Philadelphia, PA: W.B. Saunders Company. 1995. p. 253-254. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. PRICE: $38.95. ISBN: 0721643353. Summary: This chapter, from a handbook of instructions for older people and their caregivers, provides an overview of benign prostatic hypertrophy. As men get older, the prostate gland gets larger, a condition known as benign prostatic hyperplasia (BPH). In some men, an enlarged prostate may cause problems because it can put pressure on the bladder, resulting in the frequent release of small quantities of urine. Sometimes the interference of the enlarged prostate with the bladder area causes minor incontinence, or dribbling. Other symptoms may be hesitancy, frequency of urination, nocturia (increased urination at night), and urgency. Surgical removal of part of the enlarged prostate is the usual treatment for BPH. An alternative, nonsurgical treatment with drugs alone can be used when surgery poses a risk to the patient. Drugs used include finasteride (Proscar), which acts by decreasing the level of a male hormone in the prostate gland, and terazosin (Hytrin), which relaxes the muscles where the bladder empties, reducing the obstruction caused by prostate gland enlargement. The section concludes with a description of the symptoms which should prompt a call to the health care provider's office. These include a change in the ability to urinate, blood in the urine, loss of sex drive, weakness or dizziness, and nasal stuffiness (terazosin-treated patients). The chapter appears in large print text to promote ease of reading. (AA-M).
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Prostate Enlargement: Benign Prostatic Hyperplasia Source: Bethesda, MD: National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH). 1998. 12 p. Contact: Available from National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). 3 Information Way, Bethesda, MD 20892-3580. (800) 891-5390 or (301) 654-4415. Fax (301)634-0716. E-mail:
[email protected]. Website: http://www.niddk.nih.gov/health/kidney/nkudic.htm. PRICE: Full-text available online at no charge; single copy free; bulk orders available. Order number: KU-22. Summary: This fact sheet describes benign prostatic hyperplasia (BPH), the enlargement of the prostate gland associated with aging. Though the prostate continues to grow during most of a man's life, the enlargement does not usually cause problems until late in life. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra, like a clamp on a garden hose. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH. The fact sheet describes the theories regarding the cause of BPH, the symptoms, diagnostic tests used to confirm the condition (including the digital rectal exam, the prostate specific antigen, or PSA, blood test, rectal ultrasound, urine flow study, intravenous pyelogram or IVP, and cystoscopy), and treatment options. Treatment options include watchful waiting, which entails monitoring the patient regularly but not undertaking any interventions; drug therapy, including the use of finasteride and the alpha blockers terazosin, doxazosin, and tamsulosin; transurethral microwave procedures (TUMT); transurethral needle ablation (TUNA); and surgical options, including transurethral (TURP), open, or laser surgery. The fact sheet then reviews the postoperative recovery time and what patients can
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expect during this process. Additional topics covered include postoperative problems with urinating, bleeding, and sexual function after surgery (including erections, ejaculation, and orgasm). The fact sheet encourages men to continue to have a rectal exam once a year, even after surgery. Although some signs of BPH and prostate cancer are the same, having BPH does not seem to increase the chances of getting prostate cancer. Nevertheless, a man who has BPH may have undetected prostate cancer at the same time or may develop prostate cancer in the future. The fact sheet concludes with a brief overview of the current research activities on BPH. Appended to the text are a reading list, a glossary of terms, and a brief description of the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). 3 figures. 7 references. •
What Should I Know About Hair Loss? Source: American Family Physician. July 1, 2003. 2 p. Summary: This fact sheet discusses alopecia, temporary or permanent hair loss that may occur on any part of the body. Alopecia can have many causes including stress, prolonged fever, childbirth, hormonal problems, improper hair care, and drugs used to treat cancer and other prescription medications. Local hair loss may be caused by fungal infections, trichotillomania, traction alopecia, or alopecia areata. Hair loss may also be genetic. Alopecia can be treated with medication such as minoxidil and finasteride (in men only). Hair transplant surgery and hairpieces are other options. Other treatments focus on treating the underlying condition causing the alopecia.
•
Skin, Hair, and Nail Insights Source: Schaumberg, IL: American Academy of Dermatology. 2000. 4 p. Contact: Available online from American Academy of Dermatology. Website: www.aad.org. Summary: This fact sheet discusses common causes of hair loss and treatment for these conditions. Male pattern hair loss is a hereditary condition affecting twice as many men as women. Currently this condition is treated with the medications minoxidil and finasteride and surgical hair transplants. Telogen effluvium is a condition marked by temporary hair loss due to physiologic stress to the body such as pregnancy, surgery, dieting, or medications. After the stress has been alleviated, the hair grows back. In alopecia areata, scalp hair falls out in smooth, round, patches. This condition is hereditary and commonly affects people under 30 years of age. In some cases, hair regrows spontaneously without treatment. When hair does not regrow, treatment is based on the severity of the case and may include cortisone injections, steroid creams, minoxidil, and scalp treatments.
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New Approach to Prostate Problems Source: Washington, DC: Physicians Committee for Responsible Medicine. 1998. 4 p. Contact: Available from Physicians Committee for Responsible Medicine. 5100 Wisconsin Avenue, NW, Suite 404, Washington, DC 20016. (202) 686-2210. Fax (202) 6862216. E-mail:
[email protected]. Full text available at www.pcrm.org/health/Preventative_Medicine/prostate.html. PRICE: Single copy free. Summary: This fact sheet from the Physicians Committee for Responsible Medicine outlines the use of diet therapy for preventing and treating prostate problems, notably benign prostatic hyperplasia (BPH). The fact sheet first describes the anatomy and physiology of the prostate, noting that mild prostate symptoms sometimes improve
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with no treatment at all. However, men with difficulty urinating are advised to seek medical care in order to avoid kidney problems and continued discomfort. The fact sheet considers the drugs that are sometimes prescribed to relax the pressure in the prostate or to block the hormones that lead to enlargement (finasteride is in the latter category). The fact sheet also briefly reviews the traditional treatments for BPH, including transurethral resection of the prostate (TURP) surgery. The author then describes the role of the diet in creating and, possibly, in treating prostate problems. In the prostate cells, testosterone is turned into a powerful hormone called DHT (dihydrotestosterone), which drives prostate enlargement. Foods can strongly influence sex hormones, including testosterone. The author hypothesizes that eliminating meats and dairy products and adding more vegetables to the diet can turn down the hormonal stimulation of the prostate and prevent prostate problems. The remainder of the fact sheet discusses research that supports this hypothesis. One section focuses on the role of diet therapy in cancer, particularly prostatic cancer. A final section briefly reviews the use of prostate-specific antigen (PSA) levels to monitor prostatic disease activity. 21 references. •
Treating Baldness in Men Source: American Family Physician. 59(8): 2196. April 15, 1999. Contact: 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 men who are bald with information on treatments for baldness. Male pattern baldness occurs because the male hormone testosterone changes the hair roots. Although there is no cure for baldness, the medications finasteride and minoxidil help many men regrow some, but not all, lost hair. These medications work better on the crown of the head than on the front hairline. Minoxidil is sprayed or rubbed into the scalp twice per day, and finasteride is a pill that is taken daily. There is no way to predict whether a man will respond to these medications, and it may take up to 6 months before a man can tell whether the medication is having any effect. Side effects of these medications may include a decrease in sexual urges and an itchy scalp. 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: •
Prostate Cancer Prevention Trial Summary: The Prostate Cancer Prevention Trial, or PCPT, is a study designed to see whether the drug finasteride (trade name Proscar) can prevent prostate cancer in men ages 55 and older. Source: National Cancer Institute, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7561
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The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to finasteride. 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
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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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/
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WebMD®Health: http://my.webmd.com/health_topics
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to finasteride. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with finasteride. 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 finasteride. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at
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http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “finasteride” (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 “finasteride”. 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 “finasteride” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “finasteride” (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.21
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
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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)22: •
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/
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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
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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/
Finding Medical Libraries 137 •
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
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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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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
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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/
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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).
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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FINASTERIDE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 5-alpha: Enzyme converting testosterone to dihydrotestosterone. [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] Ablation: The removal of an organ by surgery. [NIH] Academic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc. [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] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acne Vulgaris: A chronic disorder of the pilosebaceous apparatus associated with an increase in sebum secretion. It is characterized by open comedones (blackheads), closed comedones (whiteheads), and pustular nodules. The cause is unknown, but heredity and age are predisposing factors. [NIH] Acute leukemia: A rapidly progressing cancer of the blood-forming tissue (bone marrow). [NIH]
Acute myelogenous leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute nonlymphocytic leukemia. [NIH] Acute myeloid leukemia: AML. A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myelogenous leukemia or acute nonlymphocytic leukemia. [NIH] Acute nonlymphocytic leukemia: A quickly progressing disease in which too many immature blood-forming cells are found in the blood and bone marrow. Also called acute myeloid leukemia or acute myelogenous leukemia. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [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] Adjuvant Therapy: Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, or hormone therapy. [NIH]
Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids,
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androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [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 Metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, oxidative metabolism, or cell respiration. [NIH] Aerobic Respiration: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as oxidative metabolism, cell respiration, or aerobic metabolism. [NIH] Aetiology: Study of the causes of disease. [EU] Afferent: Concerned with the transmission of neural impulse toward the central part of the 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 Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] 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] Agoraphobia: Obsessive, persistent, intense fear of open places. [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] Alkaline Phosphatase: An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [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,
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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] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [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] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Aminocamptothecin: An anticancer drug that belongs to the family of drugs called topoisomerase inhibitors. [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] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] 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] Anaplasia: Loss of structural differentiation and useful function of neoplastic cells. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgen suppression: Treatment to suppress or block the production of male hormones. Androgen suppression is achieved by surgical removal of the testicles, by taking female sex hormones, or by taking other drugs. Also called androgen ablation. [NIH] Androgenic: Producing masculine characteristics. [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] Androstenedione: A steroid with androgenic properties that is produced in the testis, ovary,
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and adrenal cortex. It is a precursor to testosterone and other androgenic hormones. [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] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [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] Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Anthracyclines: Organic compounds that have a tetrahydronaphthacenedione ring structure attached by a glycosidic linkage to the amino sugar daunosamine. [NIH] Antiandrogens: Drugs used to block the production or interfere with the action of male sex hormones. [NIH] 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] Antidote: A remedy for counteracting a poison. [EU] Antiemetics: Drugs used to prevent nausea or vomiting. Antiemetics act by a wide range of mechanisms. Some act on the medullary contol centers (the vomiting center and the chemoreceptive trigger zone) while others affect the peripheral receptors. [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 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] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress 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] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU]
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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] Antispasmodic: An agent that relieves spasm. [EU] Anuria: Inability to form or excrete urine. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Apocrine Glands: Large, branched, specialized sweat glands that empty into the upper portion of a hair follicle instead of directly onto the skin. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [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] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Approximate: Approximal [EU] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatase: An enzyme which converts androgens to estrogens by desaturating ring A of the steroid. This enzyme complex is located in the endoplasmic reticulum of estrogenproducing cells including ovaries, placenta, testicular Sertoli and Leydig cells, adipose, and brain tissues. The enzyme complex has two components, one of which is the CYP19 gene product, the aromatase cytochrome P-450. The other component is NADPH-cytochrome P450 reductase which transfers reducing equivalents to P-450(arom). EC 1.14.13.-. [NIH] Aromatase inhibition: Prevention of the formation of estradiol, a female hormone, by interfering with an aromatase enzyme. Aromatase inhibition is a type of hormone therapy used in postmenopausal women who have hormone-dependent breast cancer. [NIH] Aromatic: Having a spicy odour. [EU] 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] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH]
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Autologous: Taken from an individual's own tissues, cells, or DNA. [NIH] Axilla: The underarm or armpit. [NIH] Azasteroids: Steroidal compounds in which one or more carbon atoms in the steroid ring system have been substituted with nitrogen atoms. [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] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] Balloon Dilatation: Nonoperative repair of occluded vessels, ducts, or valves by insertion of a balloon catheter. It is used, amoung other things, to treat varices, torn retinas, renal and biliary calculi, gastric, bronchial and rectal stenoses, and heart valves, and includes catheterization with Fogarty and Foley catheters. [NIH] Balloon dilation: A treatment for benign prostatic hyperplasia or prostate enlargement. A tiny balloon is inflated inside the urethra to make it wider so urine can flow more freely from the bladder. [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]
Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign prostatic hyperplasia: A benign (noncancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hypertrophy or BPH. [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] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to
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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] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] 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 vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] 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 Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH]
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Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Bronchial: Pertaining to one or more bronchi. [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]
Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic disease. [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] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [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] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] Carboplatin: An organoplatinum compound that possesses antineoplastic activity. [NIH] Carcinogenesis: The process by which normal cells are transformed into cancer cells. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] 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] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carotenoids: Substance found in yellow and orange fruits and vegetables and in dark green, leafy vegetables. May reduce the risk of developing cancer. [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] Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group. [NIH] Castration: Surgical removal or artificial destruction of gonads. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] 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 Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] 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] 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] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Chemoprevention: The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer. [NIH] Chemopreventive: Natural or synthetic compound used to intervene in the early precancerous stages of carcinogenesis. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH]
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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] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Chondrocytes: Polymorphic cells that form cartilage. [NIH] 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] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [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] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cicatricial: Ectropion due to scar tissue on the margins or the surrounding surfaces of the eyelids. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [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] Clitoral: Pertaining to the clitoris. [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] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup
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characteristics. [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] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Combined Modality Therapy: The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, radioimmunotherapy, chemoradiotherapy, cryochemotherapy, and salvage therapy are seen most frequently, but their combinations with each other and surgery are also used. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as
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standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Conflict of Interest: A situation in which an individual might benefit personally from official or professional actions. It includes a conflict between a person's private interests and official responsibilities in a position of trust. The term is not restricted to government officials. The concept refers both to actual conflict of interest and the appearance or perception of conflict. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Contraceptive Agents: Chemical substances that prevent or reduce the probability of conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled 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]
Cooperative group: A group of physicians, hospitals, or both formed to treat a large number of persons in the same way so that new treatment can be evaluated quickly. Clinical trials of new cancer treatments often require many more people than a single physician or hospital can care for. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a
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myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [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] 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] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Crossing-over: The exchange of corresponding segments between chromatids of homologous chromosomes during meiosia, forming a chiasma. [NIH] Cryosurgery: The use of freezing as a special surgical technique to destroy or excise tissue. [NIH]
Crystallization: The formation of crystals; conversion to a crystalline form. [EU] 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] Cyproterone: An anti-androgen that, in the form of its acetate, also has progestational properties. It is used in the treatment of hypersexuality in males, as a palliative in prostatic carcinoma, and, in combination with estrogen, for the therapy of severe acne and hirsutism in females. [NIH] Cyproterone Acetate: An agent with anti-androgen and progestational properties. It shows competitive binding with dihydrotestosterone at androgen receptor sites. [NIH] Cystoscopy: Endoscopic examination, therapy or surgery of the urinary bladder. [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] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [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] Cytostatic: An agent that suppresses cell growth and multiplication. [EU] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of
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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] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [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] 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] Dermal: Pertaining to or coming from the skin. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Desogestrel: A synthetic progestational hormone used often as the progestogenic component of combined oral contraceptive agents. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dicyclomine: A muscarinic antagonist used as an antispasmodic and in urinary incontinence. It has little effect on glandular secretion or the cardiovascular system. It does have some local anesthetic properties and is used in gastrointestinal, biliary, and urinary tract spasms. [NIH] Diethylcarbamazine: An anthelmintic used primarily as the citrate in the treatment of filariasis, particularly infestations with Wucheria bancrofti or Loa loa. [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] Digital rectal examination: DRE. An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities. [NIH] Dihydroprogesterone: 20 alpha-Hydroxypregn-4-en-3-one. progesterone derivative with progestational activity. [NIH]
A
naturally
occurring
Dihydrotestosterone: Anabolic agent. [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] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU]
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Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] 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]
Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Doxazosin: A selective alpha-1-adrenergic blocker that lowers serum cholesterol. It is also effective in the treatment of hypertension. [NIH] Drinking Behavior: Behaviors associated with the ingesting of water and other liquids; includes rhythmic patterns of drinking (time intervals - onset and duration), frequency and satiety. [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] Duct: A tube through which body fluids pass. [NIH] Dyspareunia: Painful sexual intercourse. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [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] Ejaculation: The release of semen through the penis during orgasm. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH]
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Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [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] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] 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] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Erythrocyte Volume: Volume of circulating erythrocytes. It is usually measured by radioisotope dilution technique. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [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]
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Estrogen Replacement Therapy: The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, dyspareunia, and progressive development of osteoporosis. This may also include the use of progestational agents in combination therapy. [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] Ethinyl Estradiol: A semisynthetic estrogen with high oral estrogenic potency. It is often used as the estrogenic component in oral contraceptives. [NIH] Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] 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] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fetal Development: Morphologic and physiologic growth and development of the mammalian embryo or fetus. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibroblast Growth Factor: Peptide isolated from the pituitary gland and from the brain. It is a potent mitogen which stimulates growth of a variety of mesodermal cells including chondrocytes, granulosa, and endothelial cells. The peptide may be active in wound healing and animal limb regeneration. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ,
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usually as a consequence of inflammation or other injury. [NIH] Finasteride: An orally active testosterone 5-alpha-reductase inhibitor. It is used as a surgical alternative for treatment of benign prostatic hyperplasia. [NIH] Fine-needle aspiration: The removal of tissue or fluid with a needle for examination under a microscope. Also called needle biopsy. [NIH] Fistulas: An abnormal passage from one hollow structure of the body to another, or from a hollow structure to the surface, formed by an abscess, disease process, incomplete closure of a wound, or by a congenital anomaly. [NIH] Flavoxate: A drug that has been used in various urinary syndromes and as an antispasmodic. Its therapeutic usefulness and its mechanism of action are not clear. It may have local anesthetic activity and direct relaxing effects on smooth muscle as well as some activity as a muscarinic antagonist. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Flutamide: An antiandrogen with about the same potency as cyproterone in rodent and canine species. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Follicles: Shafts through which hair grows. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Frostbite: Damage to tissues as the result of low environmental temperatures. [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] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body
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through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gemcitabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [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] Genetic Markers: A phenotypically recognizable genetic trait which can be used to identify a genetic locus, a linkage group, or a recombination event. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [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] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [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] Glutathione Peroxidase: An enzyme catalyzing the oxidation of 2 moles of glutathione in the presence of hydrogen peroxide to yield oxidized glutathione and water. EC 1.11.1.9. [NIH]
Glycosidic: Formed by elimination of water between the anomeric hydroxyl of one sugar and a hydroxyl of another sugar molecule. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [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] Gonadorelin: A decapeptide hormone released by the hypothalamus. It stimulates the synthesis and secretion of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to
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supplement the action of estrogens. [NIH] Goserelin: 6-(O-(1,1-Dimethylethyl)-D-serine)-10-deglycinamideluteinizing hormonereleasing factor (pig) 2-(aminocarbonyl)hydrazide. A long-acting gonadorelin agonist. It is used in the treatment of malignant neoplasms of the prostate, uterine fibromas, and metastatic breast cancer. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] 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] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]
Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] 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] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Gynaecomastia: Excessive development of the male mammary glands, even to the functional state. [EU] Haematuria: Blood in the urine. [EU] Hair Color: Color of hair or fur. [NIH] Hair Dyes: Dyes used as cosmetics to change hair color either permanently or temporarily. [NIH]
Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [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 failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hematologic malignancies: Cancers of the blood or bone marrow, including leukemia and lymphoma. Also called hematologic cancers. [NIH] Hematuria: Presence of blood in the urine. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the
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prosthetic group in many hemeproteins. [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] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers 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] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Hidradenitis: The inflammation of a sweat gland (usually of the apocrine type). The condition can be idiopathic or occur as a result of or in association with another underlying condition. Neutrophilic eccrine hidradenitis is a relatively rare variant that has been reported in patients undergoing chemotherapy, usually for non-Hodgkin lymphomas or leukemic conditions. [NIH] Hidradenitis Suppurativa: A chronic suppurative and cicatricial disease of the apocrine glands occurring chiefly in the axillae in women and in the groin and anal regions in men. It is characterized by poral occlusion with secondary bacterial infection, evolving into abscesses which eventually rupture. As the disease becomes chronic, ulcers appear, sinus tracts enlarge, fistulas develop, and fibrosis and scarring become evident. Hormonal mechanisms are expected in its pathogenesis. [NIH] Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]
Histology: The study of tissues and cells under a microscope. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormonal therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called hormone therapy or endocrine therapy. [NIH] 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 called endocrine therapy. [NIH] Hospital Administrators: Managerial personnel responsible for implementing policy and directing the activities of hospitals. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH]
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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] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hyperandrogenism: A state characterized or caused by an excessive secretion of androgens by the adrenal cortex, ovaries, or testes. The clinical significance in males is negligible, so the term is used most commonly with reference to the female. The common manifestations in women are hirsutism and virilism. It is often caused by ovarian disease (particularly the polycystic ovary syndrome) and by adrenal diseases (particularly adrenal gland hyperfunction). [NIH] Hyperhidrosis: Excessive sweating. In the localized type, the most frequent sites are the palms, soles, axillae, inguinal folds, and the perineal area. Its chief cause is thought to be emotional. Generalized hyperhidrosis may be induced by a hot, humid environment, by fever, or by vigorous exercise. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hyperstimulation: Excessive stimulation. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypertrichosis: Localized or generalized excess hair. The concept does not include hirsutism, which is excess hair in females and children with an adult male pattern of distribution. [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] Hypophyseal: Hypophysial. [EU] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [EU] 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] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]
Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH]
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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] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [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] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In Situ Hybridization: A technique that localizes specific nucleic acid sequences within intact chromosomes, eukaryotic cells, or bacterial cells through the use of specific nucleic acid-labeled probes. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indoramin: A hypotensive agent with some anti-arrhythmic effects. [NIH] 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] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the
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microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] 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] Inguinal: Pertaining to the inguen, or groin. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] 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] 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] Insulin-like: Muscular growth factor. [NIH] Insulin-Like Growth Factor Binding Protein 3: One of the six homologous soluble proteins that bind insulin-like growth factors (somatomedins) and modulate their mitogenic and metabolic actions at the cellular level. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]
Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] 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] Intrahepatic: Within the liver. [NIH] Intravenous: IV. Into a vein. [NIH] Intravenous pyelogram: IVP. A series of x-rays of the kidneys, ureters, and bladder. The xrays are taken after a dye is injected into a blood vessel. The dye is concentrated in the urine, which outlines the kidneys, ureters, and bladder on the x-rays. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU]
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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]
Involution: 1. A rolling or turning inward. 2. One of the movements involved in the gastrulation of many animals. 3. A retrograde change of the entire body or in a particular organ, as the retrograde changes in the female genital organs that result in normal size after delivery. 4. The progressive degeneration occurring naturally with advancing age, resulting in shrivelling of organs or tissues. [EU] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] 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 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] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isopropyl: A gene mutation inducer. [NIH] Isozymes: The multiple forms of a single enzyme. [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] Keratin: A class of fibrous proteins or scleroproteins important both as structural proteins and as keys to the study of protein conformation. The family represents the principal constituent of epidermis, hair, nails, horny tissues, and the organic matrix of tooth enamel. Two major conformational groups have been characterized, alpha-keratin, whose peptide backbone forms an alpha-helix, and beta-keratin, whose backbone forms a zigzag or pleated sheet structure. [NIH] Ketoconazole: Broad spectrum antifungal agent used for long periods at high doses, especially in immunosuppressed patients. [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] 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] Laser Surgery: The use of a laser either to vaporize surface lesions or to make bloodless cuts in tissue. It does not include the coagulation of tissue by laser. [NIH] Laser therapy: The use of an intensely powerful beam of light to kill cancer cells. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]
Leucovorin: The active metabolite of folic acid. Leucovorin is used principally as its calcium salt as an antidote to folic acid antagonists which block the conversion of folic acid to folinic acid. [NIH] 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] Levamisole: An antiparasitic drug that is also being studied in cancer therapy with fluorouracil. [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]
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] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [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] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]
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Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] 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] 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] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] 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] 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] Manic: Affected with mania. [EU] Mannans: Polysaccharides consisting of mannose units. [NIH] 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 oncologist: A doctor who specializes in diagnosing and treating cancer using
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chemotherapy, hormonal therapy, and biological therapy. A medical oncologist often serves as the main caretaker of someone who has cancer and coordinates treatment provided by other specialists. [NIH] Medical Oncology: A subspecialty of internal medicine concerned with the study of neoplasms. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] 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] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] 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] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] 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 Health: The state wherein the person is well adjusted. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [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] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] 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] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] 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]
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Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microtomy: The technique of using a microtome to cut thin or ultrathin sections of tissues embedded in a supporting substance. The microtome is an instrument that hold a steel, glass or diamond knife in clamps at an angle to the blocks of prepared tissues, which it cuts in sections of equal thickness. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Micturition: The passage of urine; urination. [EU] Milligram: A measure of weight. A milligram is approximately 450,000-times smaller than a pound and 28,000-times smaller than an ounce. [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] Minocycline: A semisynthetic staphylococcus infections. [NIH]
antibiotic
effective
against
tetracycline-resistant
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] 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] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]
Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucositis: A complication of some cancer therapies in which the lining of the digestive system becomes inflamed. Often seen as sores in the mouth. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]
Multidrug resistance: Adaptation of tumor cells to anticancer drugs in ways that make the
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drugs less effective. [NIH] Myelodysplastic syndrome: Disease in which the bone marrow does not function normally. Also called preleukemia or smoldering leukemia. [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] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [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 biopsy: The removal of tissue or fluid with a needle for examination under a microscope. Also called fine-needle aspiration. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] 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] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU]
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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] Neuropeptides: Peptides released by neurons as intercellular messengers. Many neuropeptides are also hormones released by non-neuronal cells. [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] Nicergoline: An ergot derivative that has been used as a cerebral vasodilator and in peripheral vascular disease. It has been suggested to ameliorate cognitive deficits in cerebrovascular disease. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]
Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nocturia: Excessive urination at night. [EU] 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] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleic Acid Hybridization: The process whereby two single-stranded polynucleotides form a double-stranded molecule, with hydrogen bonding between the complementary bases in the two strains. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The
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prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Oestradiol: Growth hormone. [NIH] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oligomenorrhea: Abnormally infrequent menstruation. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oncologist: A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. [NIH] Oncology: The study of cancer. [NIH] Oncology nurse: A nurse who specializes in treating and caring for people who have cancer. [NIH]
Opacity: Degree of density (area most dense taken for reading). [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [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] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [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] 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 metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, cell respiration, or aerobic metabolism. [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] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU]
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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] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Paraffin: A mixture of solid hydrocarbons obtained from petroleum. It has a wide range of uses including as a stiffening agent in ointments, as a lubricant, and as a topical antiinflammatory. It is also commonly used as an embedding material in histology. [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] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] 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
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multiple sets of these or other symbols such as geometric figures. [NIH] Perineal: Pertaining to the perineum. [EU] Perineum: The area between the anus and the sex organs. [NIH] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral blood: Blood circulating throughout the body. [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] 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] Pharmacists: Those persons legally qualified by education and training to engage in the practice of pharmacy. [NIH] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] 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] Phenoxybenzamine: An alpha-adrenergic anatagonist with long duration of action. It has been used to treat hypertension and as a peripheral vasodilator. [NIH] Phentolamine: A nonselective alpha-adrenergic antagonist. It is used in the treatment of hypertension and hypertensive emergencies, pheochromocytoma, vasospasm of Raynaud's disease and frostbite, clonidine withdrawal syndrome, impotence, and peripheral vascular disease. [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylpropanolamine: A sympathomimetic that acts mainly by causing release of norepinephrine but also has direct agonist activity at some adrenergic receptors. It is most commonly used as a nasal vasoconstrictor and an appetite depressant. [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
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teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] 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] Pilot study: The initial study examining a new method or treatment. [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] 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] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [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]
Pneumonia: Inflammation of the lungs. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [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] Polycystic Ovary Syndrome: Clinical symptom complex characterized by oligomenorrhea or amenorrhea, anovulation, and regularly associated with bilateral polycystic ovaries. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH]
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Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] 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] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Prazosin: A selective adrenergic alpha-1 antagonist used in the treatment of heart failure, hypertension, pheochromocytoma, Raynaud's syndrome, prostatic hypertrophy, and urinary retention. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] 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] Preleukemia: Conditions in which the abnormalities in the peripheral blood or bone marrow represent the early manifestations of acute leukemia, but in which the changes are not of sufficient magnitude or specificity to permit a diagnosis of acute leukemia by the usual clinical criteria. [NIH] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Pressoreceptors: Receptors in the vascular system, particularly the aorta and carotid sinus, which are sensitive to stretch of the vessel walls. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] 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] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection,
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as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Propantheline: A muscarinic antagonist used as an antispasmodic, in rhinitis, in urinary incontinence, and in the treatment of ulcers. At high doses it has nicotinic effects resulting in neuromuscular blocking. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Prostate-Specific Antigen: Kallikrein-like serine proteinase produced by epithelial cells of both benign and malignant prostate tissue. It is an important marker for the diagnosis of prostate cancer. EC 3.4.21.77. [NIH] Prostatic Hyperplasia: Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells. [NIH] Prostatic Intraepithelial Neoplasia: A premalignant change arising in the prostatic epithelium, regarded as the most important and most likely precursor of prostatic adenocarcinoma. The neoplasia takes the form of an intra-acinar or ductal proliferation of secretory cells with unequivocal nuclear anaplasia, which corresponds to nuclear grade 2 and 3 invasive prostate cancer. [NIH] Prostatism: A symptom complex resulting from compression or obstruction of the urethra, due most commonly to hyperplasia of the prostate; symptoms include diminution in the calibre and force of the urinary stream, hesitancy in initiating voiding, inability to terminate micturition abruptly (with postvoiding dribbling), a sensation of incomplete bladder emptying, and, occasionally, urinary retention. [EU] Prostatitis: Inflammation of the prostate. [EU] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU]
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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] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] 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] Proto-Oncogene Proteins: Products of proto-oncogenes. Normally they do not have oncogenic or transforming properties, but are involved in the regulation or differentiation of cell growth. They often have protein kinase activity. [NIH] Proto-Oncogene Proteins c-mos: Cellular proteins encoded by the c-mos genes. They function in the cell cycle to maintain maturation promoting factor in the active state and have protein-serine/threonine kinase activity. Oncogenic transformation can take place when c-mos proteins are expressed at the wrong time. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is
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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 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 Oncology: A subspecialty of medical oncology and radiology concerned with the radiotherapy of cancer. [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] Radical prostatectomy: Surgery to remove the entire prostate. The two types of radical prostatectomy are retropubic prostatectomy and perineal prostatectomy. [NIH] Radioactive: Giving off radiation. [NIH] 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] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [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]
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Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [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] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH] Relaxin: Hormone produced by the ovaries during pregnancy that loosens ligaments that hold the hip bones together. [NIH] 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]
Renal capsule: The fibrous connective tissue that surrounds each kidney. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme, and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Reproductive system: In women, this system includes the ovaries, the fallopian tubes, the uterus (womb), the cervix, and the vagina (birth canal). The reproductive system in men includes the prostate, the testes, and the penis. [NIH]
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Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Response rate: The percentage of patients whose cancer shrinks or disappears after treatment. [NIH] Retinas: A membrane at the back of the eye which is sensitive to light stimuli and composed of the photoreceptors proper, i. e. the cones and rods, and the nerve cells which transmit to the optic nerve the stimulation of the receptor elements. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retreatment: The therapy of the same disease in a patient, with the same agent or procedure repeated after initial treatment, or with an additional or alternate measure or follow-up. It does not include therapy which requires more than one administration of a therapeutic agent or regimen. Retreatment is often used with reference to a different modality when the original one was inadequate, harmful, or unsuccessful. [NIH] 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] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Retropubic prostatectomy: Surgery to remove the prostate through an incision made in the abdominal wall. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Salvage Therapy: A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases. [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] 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,
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depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Sebaceous gland: Gland that secretes sebum. [NIH] Seborrhea: Hypersecretion of sebum with excessive oily secretion from the sweat glands. [NIH]
Sebum: The oily substance secreted by sebaceous glands. It is composed of keratin, fat, and cellular debris. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [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] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [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] Selenium: An element with the atomic symbol Se, atomic number 34, and atomic weight 78.96. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of glutathione peroxidase. [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] Seminal vesicles: Glands that help produce semen. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [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] Shedding: Release of infectious particles (e. g., bacteria, viruses) into the environment, for
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example by sneezing, by fecal excretion, or from an open lesion. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin test: A test for an immune response to a compound by placing it on or under the skin. [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] Smoldering leukemia: Disease in which the bone marrow does not function normally. Also called preleukemia or myelodysplastic syndrome. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [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 Security: Government sponsored social insurance programs. [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] Somatomedins: Insulin-like polypeptides made by the liver and some fibroblasts and released into the blood when stimulated by somatotropin. They cause sulfate incorporation into collagen, RNA, and DNA synthesis, which are prerequisites to cell division and growth of the organism. [NIH] Sonogram: A computer picture of areas inside the body created by bouncing sound waves off organs and other tissues. Also called ultrasonogram or ultrasound. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle
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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] 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] Spermatogenesis: Process of formation and development of spermatozoa, including spermatocytogenesis and spermiogenesis. [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] Spirochete: Lyme disease. [NIH] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] 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]
Standardize: To compare with or conform to a standard; to establish standards. [EU] 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] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent
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carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stent: A device placed in a body structure (such as a blood vessel or the gastrointestinal tract) to provide support and keep the structure open. [NIH] 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] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Streptozocin: An antibiotic that is produced by Stretomyces achromogenes. It is used as an antineoplastic agent and to induce diabetes in experimental animals. [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 urinary: Leakage of urine caused by actions--such as coughing, laughing, sneezing, running, or lifting--that place pressure on the bladder from inside the body. Stress urinary incontinence can result from either a fallen bladder or weak sphincter muscles. [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] Stroma: The middle, thickest layer of tissue in the cornea. [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] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Submaxillary: Four to six lymph glands, located between the lower jaw and the submandibular salivary gland. [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]
Sulfates: Inorganic salts of sulfuric acid. [NIH] Sulfuric acid: A strong acid that, when concentrated is extemely corrosive to the skin and mucous membranes. It is used in making fertilizers, dyes, electroplating, and industrial explosives. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in
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which the process of exclusion is not conscious. [NIH] Suramin: A polyanionic compound with an unknown mechanism of action. It is used parenterally in the treatment of African trypanosomiasis and it has been used clinically with diethylcarbamazine to kill the adult Onchocerca. (From AMA Drug Evaluations Annual, 1992, p1643) It has also been shown to have potent antineoplastic properties. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [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] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Syphilis: A contagious venereal disease caused by the spirochete Treponema pallidum. [NIH]
Systemic: Affecting the entire body. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [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] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [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] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone,
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which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [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] 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] 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] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [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, between individuals of the same species, or between individuals of different species. [NIH] Transrectal ultrasound: A procedure used to examine the prostate. An instrument is inserted into the rectum, and sound waves bounce off the prostate. These sound waves create echoes, which a computer uses to create a picture called a sonogram. [NIH] Transurethral: Performed through the urethra. [EU] Transurethral resection: Surgery performed with a special instrument inserted through the urethra. Also called TUR. [NIH] Transurethral Resection of Prostate: Resection of the prostate using a cystoscope passed through the urethra. [NIH] Transurethral resection of the prostate: Surgical procedure to remove tissue from the
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prostate using an instrument inserted through the urethra. Also called TURP. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Trichotillomania: Compulsion to pull out one's hair. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Trypanosomiasis: Infection with protozoa of the genus Trypanosoma. [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] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]
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]
Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]
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Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urodynamic: Measures of the bladder's ability to hold and release urine. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] Urogenital System: All the organs involved in reproduction and the formation and release of urine. It includes the kidneys, ureters, bladder, urethra, and the organs of reproduction ovaries, uterus, fallopian tubes, vagina, and clitoris in women and the testes, seminal vesicles, prostate, seminal ducts, and penis in men. [NIH] Urology: A surgical specialty concerned with the study, diagnosis, and treatment of diseases of the urinary tract in both sexes and the genital tract in the male. It includes the specialty of andrology which addresses both male genital diseases and male infertility. [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] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Valves: Flap-like structures that control the direction of blood flow through the heart. [NIH] Varices: Stretched veins such as those that form in the esophagus from cirrhosis. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [NIH] 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] Vasculitis: Inflammation of a blood vessel. [NIH] Vasectomy: An operation to cut or tie off the two tubes that carry sperm out of the testicles. [NIH]
Vasodilator: An agent that widens blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venereal: Pertaining or related to or transmitted by sexual contact. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virilism: Development of masculine traits in the female. [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] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation
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occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Void: To urinate, empty the bladder. [NIH] Watchful waiting: Closely monitoring a patient's condition but withholding treatment until symptoms appear or change. Also called observation. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]
Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] 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]
191
INDEX 5 5-alpha, 19, 27, 40, 48, 50, 67, 93, 99, 100, 104, 111, 141, 158 A Abdomen, 125, 141, 147, 160, 164, 167, 173, 181, 185, 186 Abdominal, 141, 173, 181 Ablation, 35, 80, 125, 128, 141, 143 Academic Medical Centers, 7, 141 Acetylcholine, 141, 171 Acne, 93, 95, 96, 98, 100, 141, 153 Acne Vulgaris, 93, 98, 100, 141 Acute leukemia, 10, 141, 176 Acute myelogenous leukemia, 141 Acute myeloid leukemia, 141 Acute nonlymphocytic leukemia, 13, 141 Acyl, 94, 141 Adaptability, 141, 149 Adenocarcinoma, 51, 141, 171, 177 Adjuvant, 8, 9, 22, 28, 29, 141 Adjuvant Therapy, 8, 141 Adrenal Cortex, 141, 144, 156, 162, 177, 180 Adrenal Glands, 94, 142 Adrenergic, 4, 23, 27, 125, 142, 155, 156, 174, 176, 186 Adverse Effect, 3, 4, 84, 142, 183 Aerobic, 142, 172 Aerobic Metabolism, 142, 172 Aerobic Respiration, 142, 172 Aetiology, 85, 142 Afferent, 25, 142 Affinity, 13, 95, 142, 183 Age Groups, 5, 142 Aged, 80 and Over, 142 Agonist, 31, 80, 142, 160, 170, 174, 186 Agoraphobia, 142, 162, 173 Algorithms, 142, 147 Alkaline, 48, 64, 142, 143, 148 Alkaline Phosphatase, 48, 64, 142 Allylamine, 142, 143 Alpha Particles, 142, 179 Alpha-1, 19, 23, 34, 143, 155, 176 Alternative medicine, 109, 143 Amenorrhea, 143, 175 Amine, 95, 143 Amino acid, 143, 144, 145, 173, 178, 182, 185, 188
Aminocamptothecin, 12, 143 Ammonia, 143, 186, 188 Amplification, 23, 143 Anaesthesia, 143, 163 Anal, 50, 63, 94, 143, 161, 167 Analog, 92, 143, 158 Anaplasia, 143, 177 Anatomical, 143, 163 Androgen suppression, 14, 143 Androgenic, 3, 25, 34, 92, 93, 99, 100, 102, 143 Androgens, 18, 19, 25, 31, 48, 57, 73, 75, 80, 81, 87, 88, 92, 93, 94, 100, 142, 143, 145, 162 Androstenedione, 59, 143 Anesthesia, 28, 144 Angiotensinogen, 144, 180 Animal model, 16, 17, 144 Anovulation, 144, 175 Anthracyclines, 13, 144 Antiandrogens, 93, 100, 144 Antibiotic, 144, 169, 184, 185, 186 Antibodies, 144, 160, 163, 167, 179 Antibody, 12, 142, 144, 151, 160, 161, 163, 167, 169, 179, 184 Antidepressant, 103, 144, 162 Antidote, 144, 166 Antiemetics, 13, 144 Antifungal, 144, 165 Antigen, 59, 71, 103, 111, 125, 128, 142, 144, 151, 161, 163, 167 Anti-inflammatory, 46, 68, 80, 144, 173 Anti-Inflammatory Agents, 46, 68, 80, 144 Antimetabolite, 144, 158 Antineoplastic, 28, 144, 148, 158, 172, 175, 185, 186 Antioxidant, 85, 145, 172 Antispasmodic, 103, 145, 154, 158, 177 Anuria, 145, 165 Anus, 143, 145, 151, 174, 180 Apocrine Glands, 145, 161 Apolipoproteins, 145, 166 Apoptosis, 13, 28, 39, 47, 51, 145 Applicability, 23, 145 Approximate, 15, 25, 145 Aqueous, 145, 146, 153 Arginine, 145, 171 Aromatase, 104, 145
192
Finasteride
Aromatase inhibition, 104, 145 Aromatic, 94, 96, 145 Arterial, 24, 142, 145, 150, 162, 178 Arteries, 145, 147, 152, 167, 168, 170 Arteriolar, 145, 148, 180 Artery, 97, 145, 152, 178 Asymptomatic, 23, 145, 173 Atrophy, 51, 92, 145 Attenuation, 24, 145 Autodigestion, 145, 173 Autologous, 13, 146 Axilla, 94, 146 Azasteroids, 3, 146 B Bacteria, 94, 141, 144, 146, 168, 182, 184, 188, 189 Bactericidal, 146, 157 Bacteriuria, 146, 188 Balloon Dilatation, 52, 125, 146 Balloon dilation, 106, 126, 146 Baroreflex, 24, 146 Base, 10, 11, 13, 18, 29, 30, 146, 154, 165, 166, 188 Bilateral, 146, 175 Bile, 146, 167, 185 Biliary, 146, 148, 154, 173 Biliary Tract, 146, 148, 173 Biochemical, 16, 20, 35, 80, 144, 146, 165, 174 Biological response modifier, 146, 147, 164 Biological therapy, 146, 160, 168 Biomarkers, 18, 20, 24, 85, 147 Biopsy, 24, 67, 75, 81, 88, 126, 147 Biotechnology, 30, 31, 109, 119, 147 Blood Coagulation, 147, 148 Blood Platelets, 147, 186 Blood pressure, 24, 146, 147, 162, 169, 174, 183 Blood vessel, 146, 147, 148, 149, 155, 159, 164, 165, 167, 168, 174, 183, 185, 186, 189 Blood Volume, 24, 147 Body Composition, 47, 147 Body Fluids, 147, 155, 183, 188 Body Mass Index, 47, 147 Bone Density, 66, 81, 147 Bone Marrow, 9, 10, 30, 141, 147, 160, 163, 167, 170, 176, 183, 185 Bone Marrow Transplantation, 10, 30, 147 Bowel, 143, 147, 154, 164, 185 Bradykinin, 148, 171 Branch, 137, 148, 153, 167, 173, 184, 186 Bronchial, 146, 148
Buffers, 146, 148 Burns, 92, 148 Burns, Electric, 148 C Cachexia, 29, 148 Calcium, 94, 148, 151, 166 Calculi, 146, 148 Camptothecin, 148, 165 Carbohydrates, 142, 148, 172 Carboplatin, 12, 29, 148 Carcinogenesis, 80, 148, 149 Carcinogenic, 148, 177, 185 Carcinoma, 10, 18, 34, 38, 42, 52, 55, 80, 99, 110, 148, 153, 171, 184 Cardiac, 24, 142, 146, 148, 156, 170, 185 Cardiac Output, 24, 146, 148 Cardiovascular, 5, 24, 148, 154 Cardiovascular System, 148, 154 Carotenoids, 84, 148 Case report, 36, 148, 149, 150 Case series, 149, 150 Case-Control Studies, 16, 149 Castration, 51, 149 Catheter, 146, 149 Catheterization, 146, 149 Cell Death, 30, 145, 149, 157 Cell Division, 146, 149, 153, 157, 160, 169, 175, 182, 183 Cell proliferation, 39, 149 Cell Respiration, 142, 149, 172, 181 Cell Survival, 149, 160 Cellulose, 148, 149, 158, 175 Central Nervous System, 24, 141, 146, 149, 155, 158 Cerebral, 149, 156, 171 Cerebrovascular, 149, 171 Chemoprevention, 37, 74, 80, 84, 85, 87, 149 Chemopreventive, 29, 85, 149 Chemotherapeutic agent, 93, 100, 149 Chemotherapy, 11, 13, 21, 29, 141, 149, 161, 168, 181 Chlorophyll, 149, 158 Cholesterol, 36, 146, 150, 155, 166, 167, 185, 186 Cholesterol Esters, 150, 166 Chondrocytes, 150, 157 Chromatin, 145, 150 Chromosomal, 34, 143, 150 Chromosome, 16, 150, 160, 166, 182 Chronic Disease, 148, 150 Chronic renal, 150, 175, 188
Index 193
Chylomicrons, 150, 166 Cicatricial, 150, 161 Cisplatin, 12, 150 Clamp, 128, 150 Clinical study, 48, 69, 150, 152 Clitoral, 25, 150 Cloning, 38, 147, 150 Coagulation, 147, 150, 166 Cohort Studies, 16, 150 Collagen, 143, 151, 157, 175, 183 Colon, 151, 166 Colorectal, 21, 151 Colorectal Cancer, 21, 151 Combination Therapy, 49, 74, 94, 102, 151, 157 Combined Modality Therapy, 29, 151 Complement, 151, 152 Complementary and alternative medicine, 83, 84, 90, 151 Complementary medicine, 84, 151 Computational Biology, 119, 152 Conception, 152, 157 Conflict of Interest, 30, 152 Conjugated, 152, 153 Connective Tissue, 147, 151, 152, 154, 157, 158, 168, 180, 185 Consultation, 20, 22, 152 Contraceptive Agents, 152, 154 Contraindications, ii, 152 Control group, 15, 39, 83, 85, 152, 176, 179 Controlled clinical trial, 7, 76, 152, 180 Controlled study, 36, 47, 63, 67, 152 Cooperative group, 6, 12, 21, 152 Coordination, 9, 152 Cornea, 152, 185 Coronary, 97, 152, 168, 170 Coronary Thrombosis, 152, 168, 170 Corpus, 153, 173, 177 Corpus Luteum, 153, 177 Cortex, 153 Cortical, 153, 157 Cortisone, 129, 153 Creatinine, 105, 153, 165, 188 Crossing-over, 153, 180 Cryosurgery, 92, 153 Crystallization, 95, 96, 153 Curative, 153, 186 Cutaneous, 47, 56, 153 Cyclic, 153, 160, 171 Cyproterone, 32, 40, 47, 77, 92, 153, 158 Cyproterone Acetate, 32, 40, 47, 77, 92, 153 Cystoscopy, 111, 128, 153
Cytochrome, 58, 145, 153 Cytogenetics, 10, 11, 153 Cytoplasm, 145, 153 Cytostatic, 12, 153 Cytotoxicity, 142, 150, 153 D Dairy Products, 130, 154 Data Collection, 20, 22, 154 Deletion, 16, 145, 154 Dendrites, 154, 171 Density, 43, 60, 72, 74, 147, 154, 166, 172, 184 Depressive Disorder, 154, 166 Dermal, 54, 74, 154 Dermis, 154, 186 Desogestrel, 70, 81, 154 Diagnostic procedure, 91, 109, 154 Dicyclomine, 103, 154 Diethylcarbamazine, 154, 186 Digestion, 146, 147, 154, 164, 167, 185 Digestive system, 154, 169 Digital rectal examination, 125, 154 Dihydroprogesterone, 24, 154 Dihydrotestosterone, 5, 19, 27, 32, 46, 60, 72, 93, 94, 96, 111, 130, 141, 153, 154, 180 Dilation, 148, 154 Diploid, 154, 175 Direct, iii, 19, 43, 57, 113, 154, 158, 174, 180, 186 Disinfectant, 154, 157 Dissociation, 142, 155, 165 Dizziness, 128, 155, 173 Docetaxel, 12, 86, 155 Double-blind, 22, 26, 31, 47, 52, 61, 63, 67, 75, 76, 155 Doxazosin, 19, 20, 21, 23, 43, 44, 49, 64, 74, 103, 104, 108, 128, 155 Drinking Behavior, 17, 155 Drive, ii, vi, 79, 102, 103, 125, 128, 155, 166 Drug Interactions, 5, 114, 155 Duct, 149, 155, 186 Dyspareunia, 155, 157 E Efferent, 25, 155 Ejaculation, 106, 129, 155, 182 Electrolyte, 155, 166, 176, 183, 188 Embryo, 155, 157, 163 Empirical, 99, 155 Endogenous, 16, 24, 71, 155 Endothelial cell, 155, 157 Endothelium, 155, 156, 171 Endothelium-derived, 156, 171
194
Finasteride
End-stage renal, 150, 156, 175 Environmental Exposure, 126, 156 Environmental Health, 118, 120, 156 Enzymatic, 69, 143, 148, 151, 156 Enzyme, 5, 16, 27, 87, 95, 96, 99, 141, 142, 145, 148, 156, 159, 160, 165, 177, 178, 180, 189 Epidermal, 65, 87, 156, 168 Epidermal Growth Factor, 65, 87, 156 Epidermis, 154, 156, 165, 178 Epinephrine, 142, 156, 171 Epithelial, 18, 45, 141, 156, 177 Epithelial Cells, 156, 177 Epithelium, 18, 59, 155, 156, 177 Erectile, 40, 84, 156, 173 Erection, 156 Ergot, 156, 171 Erythrocyte Volume, 147, 156 Erythrocytes, 147, 156 Estradiol, 145, 156 Estrogen, 19, 32, 92, 103, 145, 153, 156, 157, 182, 186 Estrogen Replacement Therapy, 103, 157 Ethanol, 16, 157 Ethinyl Estradiol, 40, 157 Etoposide, 12, 157 Eukaryotic Cells, 157, 163 Excitatory, 24, 157 Excrete, 145, 157, 165 Exogenous, 24, 155, 157 Extracellular, 152, 157, 183 Extracellular Matrix, 152, 157 Extraction, 43, 53, 157 F Fallopian tube, 157, 180, 189 Family Planning, 119, 157 Fat, 147, 157, 166, 182, 183 Fatty acids, 29, 157 Fetal Development, 48, 157 Fetus, 93, 100, 157, 175, 189 Fibroblast Growth Factor, 51, 157 Fibroblasts, 48, 49, 64, 73, 157, 183 Fibrosis, 142, 157, 161 Fine-needle aspiration, 158, 170 Fistulas, 158, 161 Flavoxate, 103, 158 Fluorouracil, 12, 158, 166 Flutamide, 19, 25, 32, 33, 34, 35, 38, 39, 40, 41, 51, 52, 55, 65, 70, 76, 80, 92, 94, 99, 108, 127, 158 Folate, 13, 158 Folic Acid, 158, 166
Follicles, 92, 158 Forearm, 147, 158 Free Radicals, 145, 155, 158 Frostbite, 158, 174 Fungi, 144, 158, 168, 190 Fungus, 127, 156, 158 G Ganglia, 141, 158, 170 Gas, 143, 158, 162, 171, 189 Gastric, 145, 146, 156, 159 Gastrin, 159, 161 Gastrointestinal, 8, 10, 11, 148, 154, 156, 157, 159, 185, 188 Gastrointestinal tract, 157, 159, 185, 188 Gemcitabine, 12, 29, 159 Gene, 10, 13, 16, 18, 19, 23, 34, 42, 44, 145, 147, 159, 165, 182 Gene Expression, 16, 18, 23, 42, 159 Genetic Markers, 24, 159 Genetics, 10, 13, 18, 23, 92, 153, 159 Genital, 25, 94, 159, 165, 189 Genitourinary, 159, 189 Genotype, 159, 174 Gland, 94, 110, 111, 128, 141, 153, 159, 161, 162, 173, 175, 177, 182, 185, 186 Glomerular, 18, 159, 165 Glomerulus, 159 Glucose, 19, 149, 159, 164, 181 Glutathione Peroxidase, 159, 182 Glycosidic, 144, 159 Goats, 154, 159 Gonad, 159 Gonadal, 18, 25, 48, 94, 159, 185 Gonadorelin, 159, 160 Gonadotropin, 31, 48, 80, 159 Goserelin, 52, 80, 160 Governing Board, 160, 176 Grade, 107, 160, 177 Graft, 160, 161, 163 Graft Rejection, 160, 163 Groin, 160, 161, 164 Growth, 10, 14, 15, 18, 25, 26, 27, 31, 39, 57, 67, 74, 81, 86, 92, 93, 94, 100, 101, 111, 127, 143, 144, 145, 149, 153, 156, 157, 160, 164, 167, 170, 172, 175, 178, 182, 183, 187 Growth factors, 15, 25, 160, 164 Guanylate Cyclase, 160, 171 Gynaecomastia, 69, 160 H Haematuria, 57, 160 Hair Color, 160
Index 195
Hair Dyes, 92, 160 Hair follicles, 54, 92, 154, 160 Haploid, 160, 175 Haptens, 142, 160 Health Status, 27, 160 Heart failure, 160, 176 Hematologic malignancies, 10, 160 Hematuria, 32, 38, 47, 56, 67, 68, 69, 73, 75, 108, 160 Heme, 153, 160 Hemodialysis, 161, 165, 166 Hemorrhage, 161, 185 Hepatic, 21, 161 Hereditary, 127, 129, 161 Heredity, 141, 159, 161 Heterogeneity, 142, 161 Hidradenitis, 51, 161 Hidradenitis Suppurativa, 51, 161 Histology, 161, 173 Homologous, 153, 161, 164, 182 Hormonal, 15, 19, 37, 52, 57, 63, 80, 93, 99, 100, 102, 106, 125, 129, 130, 145, 157, 161, 168 Hormonal therapy, 52, 80, 102, 161, 168 Hormone therapy, 86, 141, 145, 161 Hospital Administrators, 29, 161 Host, 27, 93, 100, 161, 163, 189 Hybrid, 161 Hybridization, 22, 161 Hydrogen, 143, 146, 148, 159, 162, 166, 169, 171, 172, 174, 178 Hydrolysis, 150, 162, 178 Hydrophobic, 162, 166 Hyperandrogenism, 57, 162 Hyperhidrosis, 94, 162 Hyperplasia, 18, 22, 38, 41, 63, 73, 81, 86, 111, 162, 177 Hyperstimulation, 93, 100, 162 Hypertension, 155, 162, 174, 176, 188 Hyperthermia, 106, 162 Hypertrichosis, 161, 162 Hypertrophy, 18, 51, 53, 75, 97, 98, 128, 146, 162, 176 Hypophyseal, 48, 162 Hypotensive, 162, 163 I Id, 82, 88, 131, 136, 138, 162 Idiopathic, 31, 37, 40, 41, 45, 63, 71, 77, 80, 109, 161, 162 Imipramine, 103, 162 Immune response, 141, 144, 153, 160, 162, 163, 183, 185
Immune system, 146, 162, 163, 167, 189, 190 Immunization, 163, 177 Immunoglobulin, 144, 163, 169 Immunohistochemistry, 18, 23, 163 Immunology, 10, 11, 141, 142, 163 Immunosuppressant, 158, 163 Immunosuppressive, 163 Immunosuppressive therapy, 163 Immunotherapy, 10, 147, 163 Impairment, 23, 163, 168 Impotence, 156, 163, 174 In situ, 18, 75, 81, 88, 163 In Situ Hybridization, 18, 163 In vitro, 19, 25, 27, 58, 59, 163 In vivo, 18, 59, 69, 163 Incision, 111, 125, 163, 165, 177, 181 Incontinence, 20, 21, 103, 128, 154, 163, 177, 185 Indicative, 101, 163, 173, 189 Indoramin, 104, 163 Induction, 19, 87, 143, 163 Infant, Newborn, 142, 163 Infarction, 163 Infection, 89, 92, 111, 125, 126, 127, 146, 147, 161, 163, 166, 167, 185, 188, 190 Infertility, 164, 189 Inflammation, 125, 141, 144, 158, 161, 164, 173, 175, 177, 181, 189 Inguinal, 162, 164 Inorganic, 150, 164, 185 Insight, 125, 164 Insulin, 15, 67, 74, 164, 183 Insulin-dependent diabetes mellitus, 164 Insulin-like, 15, 67, 74, 164, 183 Insulin-Like Growth Factor Binding Protein 3, 15, 164 Intensive Care, 58, 164 Interferon, 12, 164 Interferon-alpha, 164 Intestinal, 103, 164 Intestine, 147, 151, 164, 166 Intoxication, 164, 190 Intracellular, 163, 164, 171, 176, 182 Intrahepatic, 21, 164 Intravenous, 128, 164 Intravenous pyelogram, 128, 164 Intrinsic, 142, 164 Invasive, 4, 8, 22, 28, 61, 102, 106, 111, 165, 177 Involution, 67, 165 Ionization, 64, 165
196
Finasteride
Ionizing, 143, 156, 165, 179 Ions, 146, 148, 155, 162, 165 Irinotecan, 12, 165 Ischemia, 145, 165 Isopropyl, 96, 165 Isozymes, 58, 165 K Kb, 118, 165 Keratin, 165, 182 Ketoconazole, 32, 165 Kidney Disease, 19, 22, 118, 128, 165 Kidney Failure, 19, 156, 165 Kidney Failure, Acute, 165 Kidney Failure, Chronic, 165 L Large Intestine, 151, 154, 164, 166, 180, 183 Laser Surgery, 92, 127, 128, 166 Laser therapy, 111, 166 Leprosy, 92, 166 Leucocyte, 143, 166 Leucovorin, 12, 166 Leukemia, 6, 8, 9, 10, 11, 12, 13, 21, 28, 160, 166, 176 Leukocytes, 147, 164, 166 Levamisole, 48, 64, 166 Libido, 3, 59, 143, 166 Library Services, 136, 166 Ligament, 157, 166, 177 Ligands, 18, 166 Linkage, 144, 159, 166 Lipid, 145, 164, 166, 172 Lipid Peroxidation, 166, 172 Lipoprotein, 36, 166, 167 Lithium, 96, 98, 166 Liver, 94, 141, 146, 154, 158, 161, 164, 167, 180, 183, 188 Localization, 15, 18, 163, 167 Localized, 86, 161, 162, 163, 167, 175 Locomotion, 167, 175 Longitudinal study, 17, 167 Loop, 65, 167 Low-density lipoprotein, 166, 167 Lymphatic, 155, 164, 167, 168, 183 Lymphatic system, 167, 183 Lymphocyte, 144, 167 Lymphoid, 144, 166, 167 Lymphoma, 8, 10, 11, 13, 22, 160, 167 M Malignant, 11, 14, 22, 96, 141, 144, 160, 167, 170, 177, 179 Malnutrition, 145, 148, 167 Mammary, 160, 167, 186
Manic, 166, 167 Mannans, 158, 167 Mediator, 93, 99, 167 Medical oncologist, 6, 167 Medical Oncology, 21, 168, 179 MEDLINE, 119, 168 Medullary, 144, 168 Melanocytes, 168 Melanoma, 27, 168 Membrane, 151, 157, 168, 169, 174, 175, 181, 187 Meninges, 149, 168 Menopause, 168, 176 Menstrual Cycle, 168, 177 Mental, iv, 5, 118, 120, 155, 168, 176, 178, 181, 188 Mental Disorders, 168, 176 Mental Health, iv, 5, 118, 120, 168, 176 Mesenchymal, 156, 168 Meta-Analysis, 67, 168 Metabolite, 24, 36, 166, 168 Metastasis, 26, 85, 168 Metastatic, 160, 168, 182 MI, 47, 54, 56, 69, 73, 139, 168 Microbe, 168, 187 Microorganism, 168, 190 Microscopy, 23, 169 Microtomy, 23, 169 Microtubules, 169, 172 Micturition, 169, 177 Milligram, 5, 111, 169 Milliliter, 62, 147, 169 Minocycline, 48, 73, 169 Mitosis, 145, 169 Mitotic, 155, 157, 169 Modeling, 26, 45, 64, 169 Modification, 27, 143, 169, 178 Modulator, 16, 24, 169 Molecular, 8, 10, 16, 20, 23, 37, 38, 59, 81, 86, 119, 121, 147, 152, 153, 169, 185, 188 Molecule, 144, 146, 151, 155, 156, 159, 162, 169, 171, 172, 179, 180 Monitor, 10, 13, 130, 153, 169, 171 Monoclonal, 12, 169, 179 Morphological, 155, 158, 168, 169 Morphology, 25, 169 Mucosa, 169, 185 Mucositis, 12, 169 Multicenter study, 52, 61, 169 Multidrug resistance, 30, 169 Myelodysplastic syndrome, 11, 29, 170, 183
Index 197
Myocardial infarction, 97, 153, 168, 170 Myocardium, 168, 170 Myopathy, 69, 170 N Naloxone, 170 Naltrexone, 17, 170 Narcotic, 170 Nausea, 144, 170, 173, 188 NCI, 1, 6, 13, 27, 29, 117, 125, 170 Need, 3, 27, 55, 72, 93, 100, 102, 105, 108, 110, 111, 126, 132, 142, 150, 170 Needle biopsy, 44, 158, 170 Neoplasia, 170, 177 Neoplasm, 14, 102, 124, 170 Neoplastic, 6, 28, 143, 167, 170, 181 Nephropathy, 18, 165, 170 Nerve, 25, 69, 142, 144, 154, 155, 167, 170, 181, 185, 187 Nervous System, 24, 142, 149, 167, 170, 171, 185, 186 Neural, 142, 170 Neurogenic, 170, 188 Neuromuscular, 141, 170, 177, 188 Neuronal, 25, 170, 171 Neurons, 24, 154, 157, 158, 170, 171, 186 Neuropeptides, 25, 171 Neutrons, 142, 171, 179 Nicergoline, 104, 171 Nitric Oxide, 19, 171 Nitrogen, 94, 143, 146, 165, 171 Nocturia, 83, 128, 171 Non-small cell lung cancer, 29, 171 Norepinephrine, 142, 171, 174 Nuclear, 18, 148, 157, 171, 177 Nucleic acid, 161, 163, 171 Nucleic Acid Hybridization, 161, 171 Nucleus, 94, 145, 150, 153, 157, 171, 178 O Odds Ratio, 16, 171, 180 Odour, 145, 172, 188 Oestradiol, 49, 172 Ointments, 172, 173 Oligomenorrhea, 172, 175 Oliguria, 165, 172 Oncologist, 168, 172 Oncology, 6, 7, 9, 10, 11, 13, 21, 29, 85, 86, 172 Oncology nurse, 7, 172 Opacity, 154, 172 Orgasm, 129, 155, 172 Osteoporosis, 157, 172 Outpatient, 13, 172
Ovaries, 25, 145, 162, 172, 175, 180, 182, 189 Ovary, 143, 153, 156, 159, 172, 185 Ovum, 153, 172, 177 Oxidation, 145, 153, 159, 166, 172 Oxidative metabolism, 58, 142, 172 Oxidative Stress, 19, 172 P Paclitaxel, 12, 172 Palliative, 22, 153, 172, 186 Pancreas, 141, 147, 154, 164, 173, 188 Pancreatic, 173 Pancreatitis, 33, 173 Panic, 162, 173 Panic Disorder, 162, 173 Paraffin, 23, 173 Pathogenesis, 35, 161, 173 Pathologic, 14, 145, 147, 152, 173 Pathologic Processes, 145, 173 Patient Education, 105, 124, 125, 134, 136, 139, 173 Patient Selection, 110, 173 Pelvic, 32, 47, 84, 85, 173, 177 Pelvis, 141, 172, 173, 189 Penis, 25, 155, 173, 180, 189 Peptide, 143, 157, 165, 173, 177, 178 Perception, 152, 173, 181 Perineal, 162, 174, 179 Perineum, 94, 174 Perioperative, 8, 65, 174 Peripheral blood, 29, 164, 174, 176 Peripheral Vascular Disease, 97, 171, 174 Petroleum, 173, 174 Pharmacists, 6, 7, 54, 174 Pharmacodynamics, 8, 12, 38, 174 Pharmacokinetic, 34, 64, 174 Pharmacologic, 14, 17, 144, 174, 187, 188 Phenotype, 25, 174 Phenoxybenzamine, 104, 174 Phentolamine, 104, 174 Phenyl, 99, 174 Phenylpropanolamine, 103, 174 Phospholipids, 157, 166, 174 Phosphorus, 148, 174 Physical Examination, 105, 175 Physiologic, 129, 142, 157, 168, 175, 180 Physiology, 125, 126, 129, 175 Pilot study, 20, 31, 32, 47, 61, 175 Pituitary Gland, 157, 159, 175 Placenta, 145, 156, 175, 177 Plants, 102, 159, 169, 171, 175, 181, 187
198
Finasteride
Plasma, 15, 19, 35, 43, 57, 62, 64, 144, 147, 150, 165, 175, 180, 182 Platelet Aggregation, 171, 175 Platelets, 171, 175 Platinum, 150, 167, 175 Pneumonia, 58, 152, 175 Podophyllotoxin, 157, 175 Polycystic, 71, 76, 162, 175 Polycystic Ovary Syndrome, 71, 76, 162, 175 Polymorphic, 95, 96, 150, 175 Polyposis, 151, 175 Polysaccharide, 144, 149, 176 Posterior, 143, 173, 176 Postmenopausal, 60, 63, 108, 145, 157, 172, 176 Postnatal, 25, 176 Postoperative, 128, 176 Potassium, 94, 176 Practicability, 176, 188 Practice Guidelines, 105, 120, 176 Prazosin, 104, 176 Precancerous, 149, 176 Precursor, 144, 156, 171, 176, 177 Preleukemia, 170, 176, 183 Premalignant, 176, 177 Pressoreceptors, 146, 176 Prevalence, 18, 125, 172, 176 Primary endpoint, 15, 176 Primary Prevention, 15, 26, 27, 176 Progesterone, 24, 48, 154, 177, 185 Progression, 14, 18, 19, 20, 21, 23, 24, 74, 103, 108, 144, 177 Progressive, 150, 157, 160, 165, 177 Promoter, 44, 177 Propantheline, 103, 177 Prospective study, 32, 67, 167, 177 Prostate gland, 3, 52, 72, 80, 102, 111, 128, 177 Prostatectomy, 34, 106, 111, 125, 177, 179 Prostate-Specific Antigen, 3, 26, 35, 37, 41, 44, 46, 60, 70, 72, 76, 80, 105, 126, 130, 177 Prostatic Hyperplasia, 3, 4, 5, 14, 15, 19, 21, 22, 23, 26, 27, 28, 31, 32, 33, 34, 35, 36, 38, 39, 41, 42, 43, 44, 45, 46, 47, 49, 50, 51, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 64, 65, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 80, 83, 84, 85, 86, 87, 88, 89, 93, 95, 96, 98, 99, 100, 101, 102, 103, 104, 105, 109, 110, 111, 124, 125, 126, 128, 129, 146, 158, 177
Prostatic Intraepithelial Neoplasia, 50, 108, 177 Prostatism, 72, 105, 124, 177 Prostatitis, 32, 84, 85, 89, 125, 177 Protease, 151, 177 Protein C, 145, 165, 166, 178, 188 Protein S, 147, 178, 186 Proteins, 13, 19, 67, 143, 144, 145, 150, 151, 161, 164, 165, 169, 171, 173, 175, 178, 182, 187 Proteolytic, 143, 151, 178 Protocol, 8, 13, 14, 20, 22, 178 Protons, 142, 162, 165, 178, 179 Proto-Oncogene Proteins, 172, 178 Proto-Oncogene Proteins c-mos, 172, 178 Psychic, 166, 168, 178 Psychoactive, 178, 190 Psychogenic, 178, 188 Puberty, 18, 94, 178 Public Policy, 119, 178 Pulmonary, 147, 165, 178 Pulmonary Artery, 147, 178 Pulmonary Edema, 165, 178 Pulse, 169, 178 Pustular, 141, 178 Q Quality of Life, 7, 8, 15, 20, 23, 26, 45, 47, 50, 178 R Race, 12, 125, 178 Radiation, 8, 9, 10, 29, 125, 141, 156, 158, 162, 165, 172, 179, 181, 190 Radiation Oncology, 8, 9, 29, 179 Radiation therapy, 141, 179, 181 Radical prostatectomy, 76, 179 Radioactive, 162, 165, 171, 179 Radioimmunotherapy, 151, 179 Radiology, 10, 179 Radiotherapy, 179 Random Allocation, 179 Randomization, 20, 22, 179 Randomized clinical trial, 26, 27, 28, 63, 67, 179 Randomized Controlled Trials, 83, 180 Receptor, 18, 19, 23, 25, 34, 44, 68, 93, 95, 100, 144, 153, 180, 181 Recombination, 18, 159, 180 Rectal, 27, 110, 111, 128, 146, 180 Rectum, 145, 151, 154, 159, 163, 166, 177, 180, 187 Recurrence, 149, 180 Refer, 1, 151, 155, 158, 167, 171, 179, 180
Index 199
Regeneration, 157, 180 Regimen, 155, 180, 181 Relative risk, 5, 180 Relaxin, 92, 180 Reliability, 23, 180 Renal capsule, 18, 25, 180 Renin, 19, 144, 180 Renin-Angiotensin System, 19, 180 Reproductive system, 177, 180 Resection, 75, 108, 181, 187 Respiration, 169, 181 Response rate, 103, 181 Retinas, 146, 181 Retinoid, 10, 58, 181 Retreatment, 65, 181 Retrograde, 106, 165, 181 Retroperitoneal, 142, 181 Retropubic, 177, 179, 181 Retropubic prostatectomy, 179, 181 Retrospective, 27, 181 Rhinitis, 177, 181 Rigidity, 175, 181 Risk factor, 15, 27, 40, 125, 177, 180, 181 Rod, 150, 181 S Salvage Therapy, 151, 181 Saponins, 181, 185 Schizoid, 181, 190 Schizophrenia, 181, 182, 190 Schizotypal Personality Disorder, 181, 190 Screening, 18, 21, 26, 125, 150, 182, 188 Sebaceous, 154, 182 Sebaceous gland, 154, 182 Seborrhea, 93, 98, 100, 182 Sebum, 94, 141, 182 Secondary tumor, 168, 182 Secretion, 48, 141, 154, 156, 159, 162, 164, 182 Secretory, 63, 177, 182 Sedative, 162, 182 Sediment, 182, 188 Segregation, 146, 180, 182 Selective estrogen receptor modulator, 182, 186 Selenium, 26, 182 Semen, 37, 64, 68, 155, 177, 182 Seminal vesicles, 182, 189 Semisynthetic, 148, 157, 169, 182 Serine, 160, 177, 178, 182 Serum, 15, 23, 24, 45, 46, 47, 48, 59, 67, 70, 72, 73, 103, 105, 151, 155, 159, 165, 167, 182
Sex Characteristics, 143, 178, 182, 186 Shedding, 111, 182 Shock, 183, 188 Side effect, 27, 38, 102, 103, 110, 113, 130, 142, 147, 183, 187 Skeletal, 25, 143, 150, 183, 184 Skeleton, 183 Skin test, 72, 183 Small cell lung cancer, 29, 183 Small intestine, 150, 161, 164, 183 Smoldering leukemia, 170, 183 Smooth muscle, 4, 142, 158, 180, 183, 184, 185 Sneezing, 183, 185 Social Environment, 178, 183 Social Security, 180, 183 Sodium, 94, 183, 186 Soft tissue, 147, 183 Solid tumor, 10, 183 Solvent, 95, 98, 157, 183 Somatomedins, 164, 183 Sonogram, 183, 187 Sound wave, 183, 187 Spasm, 145, 184 Spatial disorientation, 155, 184 Specialist, 131, 154, 184 Species, 156, 158, 161, 169, 178, 184, 187, 189, 190 Specificity, 142, 176, 184 Spectrum, 165, 184 Sperm, 143, 150, 184, 186, 189 Spermatogenesis, 37, 56, 68, 70, 81, 184 Sphincter, 103, 184, 185 Spinal cord, 149, 150, 168, 170, 184 Spirochete, 184, 186 Squamous, 171, 184 Squamous cell carcinoma, 171, 184 Staging, 13, 126, 184 Standardize, 8, 184 Staphylococcus, 169, 184 Steel, 150, 169, 184 Stent, 31, 32, 108, 185 Steroid, 15, 16, 25, 38, 39, 42, 44, 56, 59, 96, 98, 111, 129, 143, 145, 146, 153, 181, 185 Stimulus, 155, 185 Stomach, 141, 145, 154, 159, 161, 170, 183, 185 Stool, 151, 163, 166, 185 Streptozocin, 18, 185 Stress, 19, 103, 129, 170, 172, 185 Stress urinary, 103, 185 Stroke, 97, 118, 148, 185
200
Finasteride
Stroma, 18, 59, 185 Stromal, 18, 45, 185 Stromal Cells, 45, 185 Subacute, 163, 185 Subclinical, 163, 185 Submaxillary, 156, 185 Substance P, 168, 182, 185 Sulfates, 64, 185 Sulfuric acid, 185 Superoxide, 19, 185 Suppression, 14, 70, 81, 143, 185 Suramin, 12, 186 Sweat, 93, 94, 145, 154, 161, 182, 186 Sweat Glands, 94, 145, 154, 182, 186 Sympathomimetic, 156, 171, 174, 186 Symphysis, 177, 186 Synapse, 142, 186, 187 Synergistic, 6, 186 Syphilis, 92, 186 Systemic, 114, 147, 156, 163, 179, 186, 189 T Tachycardia, 24, 186 Tamoxifen, 12, 70, 182, 186 Testicles, 143, 186, 189 Testicular, 35, 46, 80, 145, 186 Testis, 143, 156, 186 Tetracycline, 169, 186 Therapeutics, 8, 9, 12, 18, 32, 36, 45, 49, 50, 64, 114, 186 Thermal, 22, 28, 106, 127, 155, 171, 186 Thorax, 141, 186 Thrombocytopenia, 56, 186 Thrombosis, 178, 185, 186 Thyroid, 127, 186 Tomography, 147, 187 Tone, 103, 187 Tonus, 187 Topical, 58, 60, 75, 92, 157, 173, 187 Topoisomerase inhibitors, 143, 165, 187 Toxic, iv, 153, 156, 175, 182, 187 Toxicity, 6, 12, 13, 96, 155, 187 Toxicology, 33, 120, 187 Toxins, 144, 163, 179, 187 Trachea, 186, 187 Traction, 129, 150, 187 Transfection, 147, 187 Translational, 7, 10, 187 Transmitter, 141, 167, 171, 187 Transplantation, 8, 11, 25, 127, 150, 163, 166, 187 Transrectal ultrasound, 125, 187
Transurethral, 22, 28, 36, 45, 65, 75, 108, 111, 125, 127, 128, 130, 177, 187 Transurethral resection, 22, 36, 45, 65, 111, 125, 127, 130, 177, 187 Transurethral Resection of Prostate, 177, 187 Transurethral resection of the prostate, 22, 36, 45, 65, 111, 125, 127, 130, 187 Trauma, 92, 173, 188 Treatment Outcome, 124, 188 Trichotillomania, 129, 188 Tricyclic, 162, 188 Trigger zone, 144, 188 Trypanosomiasis, 186, 188 Tumor marker, 10, 147, 188 U Unconscious, 162, 188 Uraemia, 173, 188 Urea, 165, 186, 188 Uremia, 165, 188 Ureters, 164, 188, 189 Urethra, 103, 111, 127, 128, 146, 173, 177, 187, 188, 189 Urinalysis, 105, 188 Urinary, 3, 4, 5, 15, 20, 21, 23, 27, 31, 32, 42, 43, 55, 71, 72, 77, 83, 102, 103, 108, 127, 146, 148, 153, 154, 158, 159, 163, 172, 176, 177, 181, 185, 188, 189 Urinary Retention, 5, 20, 21, 23, 31, 32, 55, 72, 102, 108, 176, 177, 188 Urinary tract, 15, 20, 21, 42, 43, 83, 127, 146, 154, 188, 189 Urinary tract infection, 20, 21, 146, 188 Urinate, 5, 25, 84, 111, 125, 128, 188, 189, 190 Urine, 27, 83, 111, 125, 128, 145, 146, 147, 153, 156, 160, 163, 164, 165, 169, 172, 185, 188, 189 Urodynamic, 61, 77, 80, 104, 189 Urogenital, 25, 159, 189 Urogenital System, 25, 189 Uterus, 153, 172, 177, 180, 189 V Vaccine, 141, 178, 189 Vagina, 25, 180, 189 Valves, 146, 189 Varices, 146, 189 Vascular, 48, 72, 142, 146, 154, 155, 163, 164, 171, 175, 176, 189 Vascular endothelial growth factor, 48, 72, 189 Vascular Resistance, 146, 189
Index 201
Vasculitis, 173, 189 Vasectomy, 125, 189 Vasodilator, 148, 171, 174, 189 Vasomotor, 157, 189 VE, 58, 75, 85, 88, 189 Vein, 25, 164, 171, 189 Venereal, 186, 189 Veterinary Medicine, 119, 189 Virilism, 162, 189 Virulence, 187, 189 Viruses, 168, 182, 189 Vitro, 19, 189 Vivo, 190
Void, 27, 190 W Watchful waiting, 27, 41, 105, 125, 126, 127, 128, 190 White blood cell, 144, 166, 167, 190 Windpipe, 186, 190 Withdrawal, 16, 55, 84, 174, 190 Wound Healing, 157, 190 X Xenograft, 144, 190 X-ray, 96, 147, 164, 171, 179, 190 Y Yeasts, 158, 174, 190
202
Finasteride
Index 203
204
Finasteride