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

MYALGIA A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. P ...

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MYALGIA 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., 1960Myalgia: 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: 0-597-84509-3 1. Myalgia-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on myalgia. 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 MYALGIA .................................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Myalgia ......................................................................................... 4 E-Journals: PubMed Central ......................................................................................................... 9 The National Library of Medicine: PubMed .................................................................................. 9 CHAPTER 2. NUTRITION AND MYALGIA ........................................................................................ 53 Overview...................................................................................................................................... 53 Finding Nutrition Studies on Myalgia........................................................................................ 53 Federal Resources on Nutrition ................................................................................................... 55 Additional Web Resources ........................................................................................................... 56 CHAPTER 3. CLINICAL TRIALS AND MYALGIA ............................................................................... 59 Overview...................................................................................................................................... 59 Recent Trials on Myalgia............................................................................................................. 59 Keeping Current on Clinical Trials ............................................................................................. 61 CHAPTER 4. PATENTS ON MYALGIA ............................................................................................... 63 Overview...................................................................................................................................... 63 Patents on Myalgia ...................................................................................................................... 63 Patent Applications on Myalgia .................................................................................................. 66 Keeping Current .......................................................................................................................... 67 CHAPTER 5. BOOKS ON MYALGIA................................................................................................... 69 Overview...................................................................................................................................... 69 Book Summaries: Federal Agencies.............................................................................................. 69 Book Summaries: Online Booksellers........................................................................................... 70 Chapters on Myalgia.................................................................................................................... 71 CHAPTER 6. PERIODICALS AND NEWS ON MYALGIA ..................................................................... 73 Overview...................................................................................................................................... 73 News Services and Press Releases................................................................................................ 73 Newsletter Articles ...................................................................................................................... 74 Academic Periodicals covering Myalgia ...................................................................................... 75 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 77 Overview...................................................................................................................................... 77 U.S. Pharmacopeia....................................................................................................................... 77 Commercial Databases ................................................................................................................. 78 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 83 Overview...................................................................................................................................... 83 NIH Guidelines............................................................................................................................ 83 NIH Databases............................................................................................................................. 85 Other Commercial Databases....................................................................................................... 87 APPENDIX B. PATIENT RESOURCES ................................................................................................. 89 Overview...................................................................................................................................... 89 Patient Guideline Sources............................................................................................................ 89 Finding Associations.................................................................................................................. 110 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 113 Overview.................................................................................................................................... 113 Preparation................................................................................................................................. 113 Finding a Local Medical Library................................................................................................ 113 Medical Libraries in the U.S. and Canada ................................................................................. 113 ONLINE GLOSSARIES................................................................................................................ 119

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Online Dictionary Directories ................................................................................................... 121 MYALGIA DICTIONARY ........................................................................................................... 123 INDEX .............................................................................................................................................. 173

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

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

Differential Diagnosis of Masticatory Muscle Pain and Dysfunction Source: Oral and Maxillofacial Surgery Clinics of North America. 7(1): 29-49. February 1995. Summary: This article on the differential diagnosis of masticatory muscle pain and dysfunction is from an issue of Oral and Maxillofacial Clinics on the medical management of temporomandibular disorders (TMD). The author notes that there are many local and systemic conditions besides TMD that can cause similar signs and symptoms and that need to be considered in the differential diagnosis. The author describes many of these conditions, their causes, and their distinguishing characteristics. Conditions discussed include masticatory myalgia; myositis; fibromyalgia syndrome (FS); direct muscle injury; acute cervical strain (whiplash); tendonitis; secondary pains of dental origin; complications of middle ear infections; maxillary sinus disease; paranasal

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sinus neoplasia; salivary gland disease; lymphadenitis; skeletal disease; neurogenic disturbances; vascular disturbances; psychogenic disturbances; and systemic disorders. 3 tables. 72 references. (AA-M). •

Fibromyalgia and Chronic Fatigue Syndrome: Similarities and Differences Source: Rheumatic Disease Clinics of North America. 22(2):219-243; May 1996. Summary: This journal article for health professionals examines the similarities and differences between fibromyalgia (FM) and chronic fatigue syndrome (CFS). CFS and FM are clinical conditions characterized by a variety of nonspecific symptoms, including prominent fatigue, myalgia, and sleep disturbances. There are no diagnostic studies or widely accepted, pathogenic explanatory models for either illness. Despite remarkably different diagnostic criteria, CFS and FM have many demographic and clinical similarities. Similarities and differences in the epidemiologic, clinical, laboratory, and psychiatric features of FM ad CFS are discussed, as are the prognosis and treatment of these conditions. This discussion reveals that few differences exist in the domains of symptoms, examination findings, laboratory tests, functional status, psychosocial features, and psychiatric disorders. FM appears to represent an additional burden of suffering among those with CFS. Further clarification of the similarities and differences between CFS and FM may be useful in studies of the prognosis and help define subsets of patients who may benefit from specific therapeutic interventions. 178 references and 5 tables. (AA-M).

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Eosinophilia-myalgia Syndrome: Review and Reappraisal of Clinical, Epidemiologic and Animal Studies Symposium Source: Journal of Rheumatology. 23(Supp. 46):1-110; October 1996. Summary: This journal for health professionals includes papers that were presented at a conference on eosinophilia myalgia syndrome (EMS) in December 1994. Papers presented the criteria for the definition of EMS, a diagnostic algorithm for differentiating EMS from fibromyalgia and chronic myofascial pain, a study on the clinical status of EMS patients 2 to 4 years after onset, a critique of epidemiologic studies on the association of L-tryptophan (LT) with EMS, a review of epidemiologic studies that assessed the association between LT and EMS, and an analysis of Centers for Disease Control and Prevention criteria for EMS in a geographically defined population, animal models of EMS, and the results of a comparative histopathologic evaluation of animal studies of EMS. Other topics included the pathophysiology of EMS, the way in which fibromyalgia and psychiatric disorders may complicate the assessment of patients with possible EMS, and the causal relationship between tryptophan produced by Showa Denko and epidemic EMS. Discussions follow many of the papers. Appendices list conference participants and data collection variables used in the development of a diagnostic algorithm for EMS. Numerous references, 25 figures, and 30 tables.

Federally Funded Research on Myalgia The U.S. Government supports a variety of research studies relating to myalgia. 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 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

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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 myalgia. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore myalgia. The following is typical of the type of information found when searching the CRISP database for myalgia: •

Project Title: HANTAVIRUS: HEMORRHAGIC FEVER IMMUNOPATHOGENESIS Principal Investigator & Institution: Libraty, Daniel H.; Assistant Professor; Univ of Massachusetts Med Sch Worcester Office of Research Funding Worcester, Ma 01655 Timing: Fiscal Year 2003; Project Start 01-OCT-2003; Project End 30-SEP-2008 Summary: Hantaviruses are RNA viruses that cause hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS). HPS and HFRS are characterized by fever, myalgia, rapid onset of a vascular leak syndrome, hemoconcentration, and thrombocytopenia. In HPS, the lung is the prominent target organ; while, in HFRS, the kidney is the prominent target organ. Hantaviruses are NIAID category A priority pathogens with regards to biodefense, as they can produce severe, potentially fatal, diseases, are transmitted by aerosol, and do not have effective vaccines or specific therapeutics. The goal of this project is to understand the immunologic mechanisms that lead to HFRS. Several lines of evidence suggest that HFRS is not caused by direct cytopathic effects of hantaviruses, but rather by exuberant host immunopathological responses. This project will rely on samples provided from a prospective cohort study of Puumala (PUU) virus infections, a HFRS-associated hantavirus in Finland. The first aim will be to characterize dendritic cell functions and humoral immune responses that affect the PUU virus burden, using flow cytometry, antibody detection assays, and quantitative viral RT-PCR. The second aim will be to analyze the patterns and temporal regulation of cellular immune responses throughout acute PUU virus infection. ELISAs, multiplex immunoassays, quantitative RT-PCR, and genomic screening techniques will be used to examine immune response mediators in a comprehensive fashion, along with virus levels and disease severity. The third aim will be to characterize the antigen specificity and behavior of T lymphocyte responses during and after PUU virus infection. CD8+ and CD4+ T cell epitopes from PUU virus proteins will be identified using cell cloning techniques, ELISPOTs, cytotoxic T lymphocyte (CTL) assays, and mapping with overlapping synthetic peptides. Effector mechanisms of vascular leakage will be studied by examining interactions between endothelial cells and PUU virus-specific T cell clones. Peptide stimulation with intracellular cytokine staining and peptide-HLA Class I and II tetramers will be used to identify and quantify antigen-specific T cell responses across a spectrum of PUU virus disease. Elucidation of the immunopathogenetic mechanisms in PUU virus infection will contribute to the development of effective vaccine strategies and immune-based therapies of HFRS and HPS. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

(FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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Project Title: MECHANISMS MICROTUBLES

OF

PAIN

CAUSED

BY

DISRUPTION

OF

Principal Investigator & Institution: Levine, Jon D.; Professor of Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002 Summary: The chemotherapeutic agent paclitaxel (Taxol) is widely used for the treatment of many different types of carcinomas. At present, the dose of paclitaxel that can be tolerated by patients is limited primarily by the development of a painful peripheral neuropathy characterized by paresthesias, myalgia and arthralgia. Similar dose-limiting painful neuropathies are produced by other microtubule-disrupting chemotherapeutic drugs, dose-limiting painful neuropathies are produced by other microtubule-disrupting chemotherapeutic drugs, including vincristine therapy, but also increase the effectiveness of their treatment by permitting the use of higher doses of the drugs. We propose a series of experiments to elucidate the cellular mechanisms of paclitaxel- and vincristine-induced painful neuropathy. Specifically, we will establish a model of paclitaxel-induced painful peripheral neuropathy in the rat, and then analyze paclitaxel-induced changes in the excitability of nociceptive nerve fibers in this model. Our interpretation of those data will be greatly enhanced by our extensive knowledge of the effects of vincristine on nerve fiber excitability. Because taxol stabilizes microtubules while vincristine stimulates microtubule depolymerization, comparison of similarities and differences in the effects of the two agents may provide valuable insights into the mechanisms by which microtuble disruption causes nociceptor hyperexcitability. Guided by these in vivo electrophysiological analyses, we will employ patch clamp recording of cultured sensory neurons to study the effects of both drugs on specific transduction molecules and ion channels. Finally, we will investigate intracellular second messenger pathways that participate in the production of hyperalgesia and nociceptor hyperexcitability induced by paclitaxel and vincristine. The proposed in vitro studies may identify specific molecules to be targeted by new pharmacological strategies to treat chemotherapy-induced neuropathic pain caused by chemotherapy. By improving our understanding of the cellular mechanisms of neuropathic pain, these studies can potentially provide important insights into the pathophysiology and treatment of orofacial neuropathies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR ETIOLOGY OF FAMILIAL MEDITERRANEAN FEVER Principal Investigator & Institution: Gumucio, Deborah L.; Associate Professor; Cell and Developmental Biology; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Patients with the autosomal recessive disease, Familial Mediterranean fever (FMF), suffer periodic, unpredictable attacks of fever associated with severe pain; the pain is localized most commonly in joints (arthritis), abdomen (peritonitis) or chest (pleuritis). Occasionally, this disease presents with skin manifestations (erysipeloid erythema), pericarditis, vasculitis, or myalgia. In many patients, amyloidosis is a complication, and if untreated, this can be life-threatening. FMF is caused by missense mutations in pyrin, a protein of unknown function expressed in neutrophils, monocytes, eosinophils, dendritic cells, synovial cells and skin and peritoneal fibroblasts. Pyrin expression in these cells is induced by proinflammatory cytokines and by LPS. Thus, it has been speculated that pyrin modulates

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the inflammatory response. Evolutionary studies of the pyrin molecule indicate that it has been under positive Darwinian selection during evolution of the primates. Moreover, the high frequency of mutant pyrin alleles in several human ethnic groups supports a heterozygote (selective) advantage for the mutant allele. Mutant forms of pyrin may enhance the body's ability to clear important pathogen(s). Indeed, acute phase reactants, important agents of innate immunity, are up-regulated not only in patients but in carriers of mutant alleles. Structural analysis of the pyrin molecule revealed that exon 1 encodes a death-domain related structural motif (known as the pyrin domain or PyD) that is found in a growing family of proteins involved in inflammation and innate immunity. Identification of pyrin-interacting proteins as well as additional functional studies reveal that pyrin is linked directly to apoptotic and cytoskeletal signaling cascades, and that it modulates cytokine secretion. Experiments described in this proposal are designed to further explore these functions of pyrin and determine the effects of pyrin mutations on apoptosis (Aim 1); cytoskeletal signaling (Aim 2); and cytokine production (Aim 3). Recently identified pyrin isoforms will also be examined in these functional assays, since preliminary studies indicate that the various isoforms may function differently. Such studies could provide clues to understanding of the molecular pathogenesis of FMF, and may reveal new information about inflammatory pathways in general. In fact, pyrin-interacting proteins and pyrin domain-containing family members have already been connected to several human diseases, including inflammatory bowel disease, PAPA syndrome, Muckle-Wells syndrome, familial cold urticaria, Blau syndrome and Bechet's disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NON-TOXIC HUMAN INTERFERON-ALPHA ANALOG Principal Investigator & Institution: Villarete, Lorelie H.; Pepgen Corporation 1255 Harbor Bay Pky, Ste B Alameda, Ca 94502 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): The clinically available forms of human interferon (IFN) alpha-IFNalpha2alpha (Roferon-A), IFNalpha2b (Intron). Consensus IFN and pegylated IFNs (PEG Intron and Pegasys) - are useful in the treatment of several viral diseases and cancers. However, when used at therapeutic doses they produce frequent and sometimes serious side effects, including fever, myalgia, CNS effects and leukopenia, which limit their use. IFNinterferon, a structurally related interferon in ruminants, has similar antiviral and antitumor properties as the IFNalpha's but little or no toxicity. However, as a xenoprotein IFNinterferon is not a suitable candidate for development as a parenteral drug for humans. We have synthesized an analog of human IFNalpha2b, NLVgalpha2b, which contains five amino acid substitutions at positions19, 20, 22, 24 and 27 using residues from the corresponding positions in the IFNinterferon molecule. The in vitro and in vivo data from our SBIR phase I study demonstrated that these substitutions conferred markedly reduced cellular toxicity on the resulting molecule without diminishing its antiviral and antitumor activities. In this phase II project we will advance NLVgalpha2b into preclinical development by optimizing expression of this recombinant IFN in yeast, producing pegylated as well as unpegylated preparations and subjecting them to rigorous evaluation in well established animal models. The antiviral, anticancer, immunogenicity and toxicity profiles of NLVgalpha2b will be compared with those of commercially available IFNalpha2b. If this project is successful, it should be possible to administer NLVgalpha2b to patients in higher doses than can be achieved with current IFNalpha's, resulting in improved clinical outcomes.

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

Project Title: PILOT--DNA AND LIPID INDUCE TH1 MEDIATED PULMONARY INFLAMMATION Principal Investigator & Institution: Van Ginkel, Frits; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002 Summary: Description (adapted from the application): This pilot project deals with elucidation of mechanisms involved in the DNA/lipid complex-induced toxicity in CF patient during cationic liposome-mediated gene therapy. The symptoms observed include fever, myalgia and arthralgia, occurring at six hours with full recovery between 24-48 hours after the administration of DNA/lipid 67 complexes. The applicant believes that the toxic effects of DNA/lipid complexes are caused by unmethylated CpG motif in plasmid DNA. It is hypothesized that CpG motif activates T lymphocytes and macrophages to release inflammatory cytokines (TNF-a and IL-1), Th1-inducing cytokines (IL-12 and IL-18), Th-1 cytokine (IFN-r), leading to fever, myalgia, arthralgia and activation of NK and B cells. The applicant has proposed two Specific Aims to test his hypothesis. Aim 1 is to explore the effect of methylated and unmethylated CpG motifs of plasmid DNA in the presence or absence of lipid 67 on the production of specific cytokines in human peripheral blood cells (PBMCs) in vitro, and to test the effect of anti-inflammatory cytokines IL-10 and IL-4 on the production of the specific cytokines. Aim 2 deals with similar experiments in vivo using IL-12 or IFN-r knock out mice. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RECOMBINANT & LIVE ORAL SALMONELLA TYPHI HYBRID VACCINES Principal Investigator & Institution: Levine, Myron Max.; Director; Medicine; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2004; Project Start 01-APR-1990; Project End 28-FEB-2009 Summary: (provided by applicant): In November 2002 in China, an outbreak of atypical pneumonia occurred in which a proportion of cases were very severe or fatal, and a high lethality was seen among elderly patients. The clinical syndrome began with fever, dry cough, myalgia and sore throat and progressed to atypical pneumonia. Outbreaks followed thereafter in 2003 in Vietnam, Hong Kong, Singapore, Canada, and Taiwan. Extraordinary characteristics of this global epidemic of "Severe Acute Respiratory Syndrome" (SARS) include the rapid isolation of the etiologic agent (a novel coronavirus; SARS-CoV), elucidation of the complete sequence of the viral genome, accelerated development of diagnostic tests, and rapid global exchange of clinical, epidemiologic and microbiologic information via the Internet by scientists and health officials in many countries. Investigators in the USA and Hong Kong were first to isolate from patients the novel coronavirus that is distinct from previously recognized groups of coronavirus. The underlying hypothesis of this research plan is that by appropriate manipulation of attenuated Salmonella enterica serovar Typhi (S. Typhi) and Shigella live vectors it will be possible to develop a mucosally-administered "prime-boost" vaccination strategy to prevent SARS. We will utilize attenuated S. Typhi or Shigella flexneri 2a live vector vaccine strains to deliver (via mucosal immunization) a Sindbis eukaryotic DNA replicon encoding the S (spike) and M (membrane) glycoproteins and the N nucleocapsid protein of the Urbani strain of the SARS-CoV to prime the immune

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system to recognize these coronavirus antigens. We will then boost the immune response by mucosally administering proteosomes (meningococcal outer membrane protein vesicles) to which the same SARS proteins are adsorbed (along with a lipopolysaccharide adjuvant). Virus-like Particles and attenuated S. Typhi expressing SARS peptide epitopes will serve as back-up boosting strategies. We will study whether these constructs can elicit the relevant immune responses, first in mice, then in cynomolgus monkeys, and finally in clinical trials in humans (the latter under separate funding). The induction of B and T cell memory pools will also be examined in monkeys. This approach aims to mimic the strong and broad immunity elicited by live virus vaccines with the inherent safety factor of not having to use putative attenuated live SARS virus derivatives. If the proposed vaccination strategy can indeed elicit broad, balanced and long-lasting immune responses in cynomolgus monkeys, these studies can be followed by a challenge (under respiratory pathogen biosafety level 3 containment) to assess the efficacy of the vaccine against wild type SARS-CoV. 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 “myalgia” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for myalgia in the PubMed Central database: •

Hypodense eosinophils and interleukin 5 activity in the blood of patients with the eosinophilia-myalgia syndrome. by Owen WF Jr, Petersen J, Sheff DM, Folkerth RD, Anderson RJ, Corson JM, Sheffer AL, Austen KF.; 1990 Nov; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=55014

•

Severe myalgia from an interaction between treatments with pantoprazole and methotrexate. by Troger U.; 2002 Jun 22; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=116448

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

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

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

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

A 38 year old military pilot referred with complaints of profound malaise, fever, rigors, myalgia, intermittent headaches and nausea of 2 days duration. Author(s): Murdock MC. Source: Aviation, Space, and Environmental Medicine. 1991 February; 62(2): 185-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2001222

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A 59-year-old female with increasing dyspnoea, an unusual rash and myalgia. Diagnosis: dermatomyositis with associated interstitial lung disease. Author(s): Botha JA, Carney IK. Source: Respiration; International Review of Thoracic Diseases. 1999; 66(4): 377-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10461091

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A Belgian case of the eosinophilia-myalgia syndrome. Author(s): Naeyaert JM, Cuelenaere C, De Bersaques J, Platevoet D, Kint A. Source: The British Journal of Dermatology. 1991 March; 124(3): 303-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2018743

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A case of L-tryptophan-induced eosinophilia-myalgia resulting in death. Author(s): Marks DR. Source: Conn Med. 1990 October; 54(10): 552-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2265542

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A case of Zieve's syndrome presenting with myalgia: not to be confused with polymyalgia rheumatica. Author(s): Martin JC, Ross A, Watson D, O'Sullivan MM. Source: British Journal of Rheumatology. 1996 May; 35(5): 495-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8646447

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.

Studies

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A comparative study of tissue distribution and excretion among three substances implicated in eosinophilia-myalgia syndrome. Author(s): Adachi J, Ueno Y, Tatsuno Y, Gomez M, Smith CC, Sternberg EM. Source: Advances in Experimental Medicine and Biology. 1996; 398: 365-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8906290

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A comparative study on antibodies to nucleoli and 5-hydroxytryptamine in patients with fibromyalgia syndrome and tryptophan-induced eosinophilia-myalgia syndrome. Author(s): Klein R, Berg PA. Source: Clin Investig. 1994 July; 72(7): 541-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7981584

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A comparison of behavioral and educational interventions for fibromyalgia. Author(s): Nicassio PM, Radojevic V, Weisman MH, Schuman C, Kim J, SchoenfeldSmith K, Krall T. Source: The Journal of Rheumatology. 1997 October; 24(10): 2000-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9330945

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A comparison of rocuronium and lidocaine for the prevention of postoperative myalgia after succinylcholine administration. Author(s): Spence D, Domen-Herbert R, Boulette E, Olson RL, Vacchiano C, Maye J. Source: Aana Journal. 2002 October; 70(5): 367-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12425125

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A comparison of the effect of propofol or thiopentone on the incidence and severity of suxamethonium-induced myalgia. Author(s): McClymont C. Source: Anaesthesia and Intensive Care. 1994 April; 22(2): 147-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8210016

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A diagnostic algorithm for distinguishing the eosinophilia-myalgia syndrome from fibromyalgia and chronic myofascial pain. Author(s): Taylor RM, Gabriel SE, O'Fallon WM, Bowles CA, Duffy J. Source: J Rheumatol Suppl. 1996 October; 46: 13-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895177

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A histopathologic comparison of Shulman's syndrome (diffuse fasciitis with eosinophilia) and the fasciitis associated with the eosinophilia-myalgia syndrome. Author(s): Feldman SR, Silver RM, Maize JC. Source: Journal of the American Academy of Dermatology. 1992 January; 26(1): 95-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1732344

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A Japanese boy with myalgia and cramps has a novel in-frame deletion of the dystrophin gene. Author(s): Ishigaki C, Patria SY, Nishio H, Yabe M, Matsuo M. Source: Neurology. 1996 May; 46(5): 1347-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8628480

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A limited form of the eosinophilia-myalgia syndrome. Author(s): Martinez-Osuna P, Espinoza LR. Source: Clin Exp Rheumatol. 1991 May-June; 9(3): 307-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1879093

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A prospective study of 287 patients with polymyalgia rheumatica and temporal arteritis: clinical and laboratory manifestations at onset of disease and at the time of diagnosis. Author(s): Myklebust G, Gran JT. Source: British Journal of Rheumatology. 1996 November; 35(11): 1161-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8948307

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A rare case of recurrent post-streptococcal myalgia. Author(s): Subramanian S, Carty JE, Gaywood I. Source: Rheumatology (Oxford, England). 2002 July; 41(7): 827-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12096237

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Absent neutrophil alkaline phosphatase in the eosinophilia myalgia syndrome associated with L-tryptophan use. Author(s): Jaffe JP, Gertner E, Miller W. Source: American Journal of Hematology. 1991 April; 36(4): 280-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2012075

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Acute encephalopathy associated with the eosinophilia-myalgia syndrome. Author(s): Adair JC, Rose JW, Digre KB, Balbierz JM. Source: Neurology. 1992 February; 42(2): 461-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1736188

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Alpha sleep and information processing, perception of sleep, pain, and arousability in fibromyalgia. Author(s): Perlis ML, Giles DE, Bootzin RR, Dikman ZV, Fleming GM, Drummond SP, Rose MW. Source: The International Journal of Neuroscience. 1997 February; 89(3-4): 265-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9134461

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Alterations in tryptophan metabolism in the toxic oil syndrome and in the eosinophilia-myalgia syndrome. Author(s): Silver RM, Sutherland SE, Carreira P, Heyes MP. Source: The Journal of Rheumatology. 1992 January; 19(1): 69-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1532618

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An eosinophilia-myalgia syndrome associated with an L-tryptophan containing product. Author(s): Saag KG, Goldschmidt R, Vernof H, Golbus J. Source: The Journal of Rheumatology. 1990 November; 17(11): 1551-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2273501

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An eosinophilia-myalgia syndrome related disorder associated with exposure to L-5hydroxytryptophan. Author(s): Michelson D, Page SW, Casey R, Trucksess MW, Love LA, Milstien S, Wilson C, Massaquoi SG, Crofford LJ, Hallett M, et al. Source: The Journal of Rheumatology. 1994 December; 21(12): 2261-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7699627

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Analysis of Centers for Disease Control and Prevention criteria for the eosinophiliamyalgia syndrome in a geographically defined population. Author(s): Spitzer WO, Haggerty JL, Berkson L, Davis W, Palmer W, Tamblyn R, Laprise R, Mulder LJ. Source: J Rheumatol Suppl. 1996 October; 46: 73-9; Discussion 79-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895183

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Antineutrophil cytoplasmic antibodies and the eosinophilia myalgia syndrome. Author(s): Schnabel A, Gross WL, Berg PA, Klein R, Lehnert H. Source: Annals of the Rheumatic Diseases. 1995 March; 54(3): 233. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7748023

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Antiphospholipid antibodies in patients with eosinophilia myalgia and toxic oil syndrome. Author(s): Carreira PE, Montalvo MG, Kaufman LD, Silver RM, Izquierdo M, GomezReino JJ. Source: The Journal of Rheumatology. 1997 January; 24(1): 69-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9002013

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Autoantibodies in sera from patients with L-tryptophan-associated eosinophiliamyalgia syndrome. Demonstration of unique antigen-antibody specificities. Author(s): Kaufman LD, Varga J, Gomez-Reino JJ, Jimenez S, Targoff IN. Source: Clinical Immunology and Immunopathology. 1995 August; 76(2): 115-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7542184

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Autoantibodies to nuclear lamin C in the eosinophilia-myalgia syndrome associated with L-tryptophan ingestion. Author(s): Varga J, Maul GG, Jimenez SA. Source: Arthritis and Rheumatism. 1992 January; 35(1): 106-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1290474

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Axonal neuropathy in eosinophilia-myalgia syndrome. Author(s): Burns SM, Lange DJ, Jaffe I, Hays AP. Source: Muscle & Nerve. 1994 March; 17(3): 293-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8107705

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Bacterial endocarditis and septic arthritis presenting as polymyalgia rheumatica. Author(s): Spomer A, Ho G Jr. Source: R I Med. 1994 January; 77(1): 5-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8118070

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Bias or biology: evaluating the epidemiologic studies of L-tryptophan and the eosinophilia-myalgia syndrome. Author(s): Horwitz RI, Daniels SR. Source: J Rheumatol Suppl. 1996 October; 46: 60-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895182

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Biotransformation of 3-(phenylamino)-1,2-propanediol to 3-(phenylamino)alanine: a chemical link between toxic oil syndrome and eosinophilia-myalgia syndrome. Author(s): Mayeno AN, Benson LM, Naylor S, Colberg-Beers M, Puchalski JT, Gleich GJ. Source: Chemical Research in Toxicology. 1995 October-November; 8(7): 911-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8555405

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Bladder training biofeedback and pelvic floor myalgia. Author(s): Nadler RB. Source: Urology. 2002 December; 60(6 Suppl): 42-3; Discussion 44. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12521595

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Bryostatin 1, a novel antineoplastic agent and protein kinase C activator, induces human myalgia and muscle metabolic defects: a 31P magnetic resonance spectroscopic study. Author(s): Hickman PF, Kemp GJ, Thompson CH, Salisbury AJ, Wade K, Harris AL, Radda GK. Source: British Journal of Cancer. 1995 October; 72(4): 998-1003. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7547256

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Can lidocaine reduce succinylcholine induced postoperative myalgia? Author(s): Amornyotin S, Santawat U, Rachatamukayanant P, Nilsuwankosit P, Pipatnaraphong H. Source: J Med Assoc Thai. 2002 September; 85 Suppl 3: S969-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12452237

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Cardiac abnormalities in the toxic oil syndrome, with comparative observations on the eosinophilia-myalgia syndrome. Author(s): James TN, Gomez-Sanchez MA, Martinez-Tello FJ, Posada-de la Paz M, Abaitua-Borda I, Soldevilla LB. Source: Journal of the American College of Cardiology. 1991 November 1; 18(5): 1367-79. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1918715

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Central and peripheral nervous system involvement in the L-tryptophan associated eosinophilia myalgia syndrome. Author(s): Tolander LM, Bamford CR. Source: The International Journal of Neuroscience. 1991 November; 61(1-2): 69-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1809736

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Central nervous system inflammation in the eosinophilia-myalgia syndrome. Author(s): Pixley JS, Eaton JM, Zweig RM. Source: British Journal of Rheumatology. 1993 February; 32(2): 174. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8428238

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Central nervous system involvement in the eosinophilia-myalgia syndrome. Author(s): Lynn J, Rammohan KW, Bornstein RA, Kissel JT. Source: Archives of Neurology. 1992 October; 49(10): 1082-5. Erratum In: Arch Neurol 1993 March; 50(3): 323. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1417516

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Changes in muscle morphology in chronic trapezius myalgia. Author(s): Lindman R, Hagberg M, Angqvist KA, Soderlund K, Hultman E, Thornell LE. Source: Scand J Work Environ Health. 1991 October; 17(5): 347-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1947920

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Changes of trapezius muscle blood flow and electromyography in chronic neck pain due to trapezius myalgia. Author(s): Larsson R, Oberg PA, Larsson SE. Source: Pain. 1999 January; 79(1): 45-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9928775

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Characterization of “peak E,” a novel amino acid associated with eosinophiliamyalgia syndrome. Author(s): Mayeno AN, Lin F, Foote CS, Loegering DA, Ames MM, Hedberg CW, Gleich GJ. Source: Science. 1990 December 21; 250(4988): 1707-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2270484

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Chlamydia pneumoniae antibodies in myalgia of unknown cause (including fibromyalgia) Author(s): Machtey I. Source: British Journal of Rheumatology. 1997 October; 36(10): 1134. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9374940

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Chronic demyelinating polyneuropathy associated with eosinophilia-myalgia syndrome. Author(s): Freimer ML, Glass JD, Chaudhry V, Tyor WR, Cornblath DR, Griffin JW, Kuncl RW. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1992 May; 55(5): 352-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1534836

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Chronic eosinophilic perimyositis with persistent myalgias. Author(s): Zivkovic SA, Lacomis D, Clemens PR. Source: Muscle & Nerve. 2002 March; 25(3): 461-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11870728

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Chronic fatigue: a peculiar evolution of eosinophilia myalgia syndrome following treatment with L-tryptophan in four Italian adolescents. Author(s): Priori R, Conti F, Luan FL, Arpino C, Valesini G. Source: European Journal of Pediatrics. 1994 May; 153(5): 344-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8033924

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Chronic immune activation in the eosinophilia-myalgia syndrome. Author(s): McKinley KL, Harati Y, Schneider LW. Source: Muscle & Nerve. 1993 September; 16(9): 947-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8355725

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Chronic progressive external ophthalmoplegia and myalgia associated with tubular aggregates. Author(s): Beyenburg S, Zierz S. Source: Acta Neurologica Scandinavica. 1993 May; 87(5): 397-402. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8333245

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Chronic trapezius myalgia. Morphology and blood flow studied in 17 patients. Author(s): Larsson SE, Bodegard L, Henriksson KG, Oberg PA. Source: Acta Orthopaedica Scandinavica. 1990 October; 61(5): 394-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2239160

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Chronicity of the eosinophilia-myalgia syndrome. A reassessment after three years. Author(s): Kaufman LD. Source: Arthritis and Rheumatism. 1994 January; 37(1): 84-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8129767

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Clinical features of eosinophilia myalgia syndrome and related disorders. Author(s): Clauw DJ. Source: Advances in Experimental Medicine and Biology. 1996; 398: 331-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8906285

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Clinical follow-up and immunogenetic studies of 32 patients with eosinophiliamyalgia syndrome. Author(s): Kaufman LD, Gruber BL, Gregersen PK. Source: Lancet. 1991 May 4; 337(8749): 1071-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1673503

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Clinical improvement of the myopathy in eosinophilia-myalgia syndrome with steroids and rehabilitative therapy. Author(s): Esper JJ, Nigro MA, Wishnow R, Barnett T, Perrotta AL, Richardson W. Source: J Am Osteopath Assoc. 1992 August; 92(8): 1056-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1429067

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Cognitive performance and muscle activation in workers with chronic shoulder myalgia. Author(s): Roe C, Bjorklund RA, Knardahl S, Waersted M, Vollestad NK. Source: Ergonomics. 2001 January 15; 44(1): 1-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11214895

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Comparison of rocuronium and d-tubocurarine for prevention of succinylcholineinduced fasciculations and myalgia. Author(s): Demers-Pelletier J, Drolet P, Girard M, Donati F. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1997 November; 44(11): 1144-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9398951

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Comparison of rocuronium and vecuronium pretreatment for prevention of fasciculations, myalgia and biochemical changes following succinylcholine administration. Author(s): Kim JH, Cho H, Lee HW, Lim HJ, Chang SH, Yoon SM. Source: Acta Anaesthesiol Sin. 1999 December; 37(4): 173-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10670114

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Comparison of the pathology of fascia in eosinophilic myalgia syndrome patients and idiopathic eosinophilic fasciitis. Author(s): Umbert I, Winkelmann RK, Wegener L. Source: Dermatology (Basel, Switzerland). 1993; 186(1): 18-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8435512

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Contaminants in L-tryptophan associated with eosinophilia myalgia syndrome. Author(s): Hill RH Jr, Caudill SP, Philen RM, Bailey SL, Flanders WD, Driskell WJ, Kamb ML, Needham LL, Sampson EJ. Source: Archives of Environmental Contamination and Toxicology. 1993 July; 25(1): 13442. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8346973

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Continuing occurrence of eosinophilia myalgia syndrome in Canada. Author(s): Spitzer WO, Haggerty JL, Berkson L, Davis W, Palmer W, Tamblyn R, Laprise R, Faith JM, Elmore JG, Horwitz RI. Source: British Journal of Rheumatology. 1995 March; 34(3): 246-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7728400

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Continuous propofol administration for suxamethonium-induced postoperative myalgia. Author(s): Manataki AD, Arnaoutoglou HM, Tefa LK, Glatzounis GK, Papadopoulos GS. Source: Anaesthesia. 1999 May; 54(5): 419-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10995136

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Criteria for the definition of the eosinophilia-myalgia syndrome. Author(s): Hertzman PA. Source: J Rheumatol Suppl. 1996 October; 46: 7-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895176

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Cutaneous manifestations of the eosinophilia-myalgia syndrome. Author(s): Oursler JR, Farmer ER, Roubenoff R, Mogavero HS, Watson RM. Source: The British Journal of Dermatology. 1992 August; 127(2): 138-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1390142

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Cutaneous manifestations of the L-tryptophan-associated eosinophilia-myalgia syndrome: a spectrum of sclerodermatous skin disease. Author(s): Kaufman LD, Seidman RJ, Phillips ME, Gruber BL. Source: Journal of the American Academy of Dermatology. 1990 December; 23(6 Pt 1): 1063-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2273104

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Cutaneous mucinosis in a patient with eosinophilia-myalgia syndrome associated with L-tryptophan ingestion. Author(s): Dubin DB, Kwan TH, Morse MO, Case DC. Source: Archives of Dermatology. 1990 November; 126(11): 1517-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2241210

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Delayed onset of skin fibrosis after the ingestion of eosinophilia-myalgia syndromeassociated L-tryptophan. Author(s): Greenberg AS, Takagi H, Hill RH, Hasan A, Murata H, Falanga V. Source: Journal of the American Academy of Dermatology. 1996 August; 35(2 Pt 1): 2646. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8708033

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Demyelinating polyneuropathy in eosinophilia-myalgia syndrome. Author(s): Donofrio PD, Stanton C, Miller VS, Oestreich L, Lefkowitz DS, Walker FO, Ely EW. Source: Muscle & Nerve. 1992 July; 15(7): 796-805. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1323757

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Dermal mucinosis in the eosinophilia-myalgia syndrome. Author(s): Farmer KL, Hebert AA, Rapini RP, Jordan RE. Source: Archives of Dermatology. 1990 November; 126(11): 1518-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2241211

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Detection of antineutrophil cytoplasmic antibody in a patient with L-tryptophan induced eosinophilia-myalgia syndrome. Author(s): Cilursu AM, Goeken J, Olson RR. Source: Annals of the Rheumatic Diseases. 1991 November; 50(11): 817-9. Erratum In: Ann Rheum Dis 1992 July; 51(7): 928. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1772299

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Detection of Borrelia burgdorferi DNA in muscle of patients with chronic myalgia related to Lyme disease. Author(s): Frey M, Jaulhac B, Piemont Y, Marcellin L, Boohs PM, Vautravers P, Jesel M, Kuntz JL, Monteil H, Sibilia J. Source: The American Journal of Medicine. 1998 June; 104(6): 591-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9674723

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Development of trapezius myalgia among female workers performing light manual work. Author(s): Veiersted KB, Westgaard RH. Source: Scand J Work Environ Health. 1993 August; 19(4): 277-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8235517

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Diagnostic bias in clinical decision making: an example of L-tryptophan and the diagnosis of eosinophilia-myalgia syndrome. Author(s): Wagner KR, Elmore JG, Horwitz RI. Source: The Journal of Rheumatology. 1996 December; 23(12): 2079-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8970044

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Diffuse arthralgia and myalgia as the first manifestation of benign myeloradiculopathy due to cytomegalovirus infection in an immunocompetent patient. Author(s): Etaouil N, Benyahya E, Janani S, el Fatimi A, Bennis R, Mkinsi O. Source: Rev Rhum Engl Ed. 1997 January; 64(1): 57-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9051861

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Drug points: Severe myalgia from an interaction between treatments with pantoprazole and methotrexate. Author(s): Troger U, Stotzel B, Martens-Lobenhoffer J, Gollnick H, Meyer FP. Source: Bmj (Clinical Research Ed.). 2002 June 22; 324(7352): 1497. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12077038

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Dyspnea and pulmonary function in the L-tryptophan-associated eosinophiliamyalgia syndrome. Author(s): Read CA, Clauw D, Weir C, Da Silva AT, Katz P. Source: Chest. 1992 May; 101(5): 1282-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1582285

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Effect of local glucocorticoid injection on masseter muscle level of serotonin in patients with chronic myalgia. Author(s): Ernberg M, Hedenberg-Magnusson B, Alstergren P, Kopp S. Source: Acta Odontologica Scandinavica. 1998 June; 56(3): 129-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9688220

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Effect of preoperative i.m. administration of diclofenac on suxamethonium-induced myalgia. Author(s): Kahraman S, Ercan S, Aypar U, Erdem K. Source: British Journal of Anaesthesia. 1993 August; 71(2): 238-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8123399

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Effect on prostaglandin E2 and leukotriene B4 levels by local administration of glucocorticoid in human masseter muscle myalgia. Author(s): Hedenberg-Magnusson B, Ernberg M, Alstergren P, Kopp S. Source: Acta Odontologica Scandinavica. 2002 January; 60(1): 29-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11902610

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Effects of high-dose propofol on succinylcholine-induced fasciculations and myalgia. Author(s): Kararmaz A, Kaya S, Turhanoglu S, Ozyilmaz MA. Source: Acta Anaesthesiologica Scandinavica. 2003 February; 47(2): 180-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12631047

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Effects of pretreatment with cisatracurium, rocuronium, and d-tubocurarine on succinylcholine-induced fasciculations and myalgia: a comparison with placebo. Author(s): Joshi GP, Hailey A, Cross S, Thompson-Bell G, Whitten CC. Source: Journal of Clinical Anesthesia. 1999 December; 11(8): 641-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10680105

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Effects of training on female trapezius Myalgia: An intervention study with a 3-year follow-up period. Author(s): Waling K, Jarvholm B, Sundelin G. Source: Spine. 2002 April 15; 27(8): 789-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11935098

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Effects on physical performance and pain from three dynamic training programs for women with work-related trapezius myalgia. Author(s): Ahlgren C, Waling K, Kadi F, Djupsjobacka M, Thornell LE, Sundelin G. Source: Journal of Rehabilitation Medicine : Official Journal of the Uems European Board of Physical and Rehabilitation Medicine. 2001 July; 33(4): 162-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11506214

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Electromyographic evaluation of muscular work pattern as a predictor of trapezius myalgia. Author(s): Veiersted KB, Westgaard RH, Andersen P. Source: Scand J Work Environ Health. 1993 August; 19(4): 284-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8235518

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Elevated expression of the genes for transforming growth factor-beta 1 and type VI collagen in diffuse fasciitis associated with the eosinophilia-myalgia syndrome. Author(s): Peltonen J, Varga J, Sollberg S, Uitto J, Jimenez SA. Source: The Journal of Investigative Dermatology. 1991 January; 96(1): 20-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1702819

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Elevated L-kynurenine level and its normalization by prednisolone in a patient with eosinophilia-myalgia syndrome. Author(s): Hisatomi A, Kubota A, Ohashi M, Umeda F, Nawata H, Imamura T, Nagata T. Source: Fukuoka Igaku Zasshi. 1997 January; 88(1): 11-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9037890

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Empiric parenteral antibiotic treatment of patients with fibromyalgia and fatigue and a positive serologic result for Lyme disease. A cost-effectiveness analysis. Author(s): Lightfoot RW Jr, Luft BJ, Rahn DW, Steere AC, Sigal LH, Zoschke DC, Gardner P, Britton MC, Kaufman RL. Source: Annals of Internal Medicine. 1993 September 15; 119(6): 503-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8357117

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Endogenous formation of 1-methyl-1,2,3,4-tetrahydro-beta-carboline-3- carboxylic acid in man as the possible causative substance of eosinophilia-myalgia syndrome associated with ingestion of L-tryptophan. Author(s): Adachi J, Yamamoto K, Ogawa Y, Ueno Y, Mizoi Y, Tatsuno Y. Source: Archives of Toxicology. 1991; 65(6): 505-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1929872

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Eosinophilia myalgia syndrome. Author(s): Blackburn WD Jr. Source: Seminars in Arthritis and Rheumatism. 1997 June; 26(6): 788-93. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9213377

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Eosinophilia myalgia syndrome: I. Immunocytochemical evidence for a T-cellmediated immune effector response. Author(s): Emslie-Smith AM, Engel AG, Duffy J, Bowles CA. Source: Annals of Neurology. 1991 May; 29(5): 524-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1859182

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Eosinophilia-myalgia syndrome and giant cell myocarditis: a case report and therapeutic approach. Author(s): Amidon TM, Baldwin JL, George E. Source: Heart Disease. 1999 May-June; 1(2): 66-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11720607

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Eosinophilia-myalgia syndrome associated with ingestion of L-tryptophan: muscle biopsy findings in 4 patients. Author(s): Hollander D, Adelman LS. Source: Neurology. 1991 February; 41(2 ( Pt 1)): 319-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1992385

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Eosinophilia-myalgia syndrome associated with L-tryptophan use. Author(s): Firestone A. Source: The Medical Journal of Australia. 1991 January 7; 154(1): 71-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1984598

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Eosinophilia-myalgia syndrome associated with L-tryptophan use. Author(s): Pervan Z. Source: The Medical Journal of Australia. 1991 April 15; 154(8): 565-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2017099

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Eosinophilia-myalgia syndrome associated with L-tryptophan use. Author(s): Boyd I. Source: The Medical Journal of Australia. 1991 February 18; 154(4): 295. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1994219

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Eosinophilia-myalgia syndrome case-associated contaminants in commercially available 5-hydroxytryptophan. Author(s): Klarskov K, Johnson KL, Benson LM, Gleich GJ, Naylor S. Source: Advances in Experimental Medicine and Biology. 1999; 467: 461-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10721089

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Eosinophilia-myalgia syndrome, eosinophilic fasciitis, and related fibrosing disorders. Author(s): Varga J, Kahari VM. Source: Current Opinion in Rheumatology. 1997 November; 9(6): 562-70. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9375286

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Eosinophilia-myalgia syndrome. Author(s): Kazura JW. Source: Cleve Clin J Med. 1991 May-June; 58(3): 267-70. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1893558

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Eosinophilia-myalgia syndrome. Author(s): Broide DH. Source: The Western Journal of Medicine. 1991 April; 154(4): 459. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1877190

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Eosinophilia-myalgia syndrome. A clinical case series of 21 patients. New Mexico Eosinophilia-Myalgia Syndrome Study Group. Author(s): Philen RM, Eidson M, Kilbourne EM, Sewell CM, Voorhees R. Source: Archives of Internal Medicine. 1991 March; 151(3): 533-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2001136

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Eosinophilia-myalgia syndrome. Status of patients at onset and after four years of disease. Author(s): Criswell LA, Pincus T. Source: Advances in Experimental Medicine and Biology. 1996; 398: 371-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8906291

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Eosinophilia-myalgia syndrome: CDC update. Author(s): Auerbach SB, Falk H. Source: Cleve Clin J Med. 1991 May-June; 58(3): 215-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1654229

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Eosinophilia-myalgia syndrome: description of an unusual case. Author(s): Giordano N, Senesi M, Monaco R, Palumbo F, Battisti E, Nardi P, Mattii G, Gennari C. Source: Clin Exp Rheumatol. 1997 March-April; 15(2): 222-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9196880

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Eosinophilia-myalgia syndrome: how well prepared is Australian public health? Author(s): Smith W, Leeder SR. Source: The Medical Journal of Australia. 1993 January 4; 158(1): 8-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8380219

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Eosinophilia-myalgia syndrome: lessons for public health researchers. Author(s): Taylor R, McNeil JJ. Source: The Medical Journal of Australia. 1993 January 4; 158(1): 51-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8380218

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Eosinophilia-myalgia syndrome: opportunities realized and missed. Author(s): Hess EV. Source: The Journal of Rheumatology. 1997 June; 24(6): 1239-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9195545

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Eosinophilia-myalgia syndrome: selective cognitive impairment, longitudinal effects, and neuroimaging findings. Author(s): Armstrong C, Lewis T, D'Esposito M, Freundlich B. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1997 November; 63(5): 633-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9408106

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Eosinophilia-myalgia. Author(s): Kirkpatrick JB. Source: Human Pathology. 1991 January; 22(1): 1-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1985072

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Eosinophilic cholecystitis as a possible late manifestation of the eosinophilia-myalgia syndrome. Author(s): Hepburn A, Coady A, Livingstone J, Pandit N. Source: Clinical Rheumatology. 2000; 19(6): 470-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11147758

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Eosinophilic fasciitis associated with tryptophan ingestion. A manifestation of eosinophilia-myalgia syndrome. Author(s): Gordon ML, Lebwohl MG, Phelps RG, Cohen SR, Fleischmajer R. Source: Archives of Dermatology. 1991 February; 127(2): 217-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1990986

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Eosinophilic fasciitis is clinically distinguishable from the eosinophilia-myalgia syndrome and is not associated with L-tryptophan use. Author(s): Varga J, Griffin R, Newman JH, Jimenez SA. Source: The Journal of Rheumatology. 1991 February; 18(2): 259-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2023221

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Epidemiologic studies of the association of L-tryptophan with the eosinophiliamyalgia syndrome: a critique. Author(s): Shapiro S. Source: J Rheumatol Suppl. 1996 October; 46: 44-58; Discussion 58-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895181

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Episodic myalgia, weakness, and dark urine. Author(s): Young JJ, Mazzaferri EL. Source: Hosp Pract (Off Ed). 2000 January 15; 35(1): 140-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10645995

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Ethics and suxamethonium-induced myalgia. Author(s): Walpole R. Source: Anaesthesia. 1999 October; 54(10): 1017. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10541696

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EULAR response criteria for polymyalgia rheumatica: results of an initiative of the European Collaborating Polymyalgia Rheumatica Group (subcommittee of ESCISIT). Author(s): Leeb BF, Bird HA, Nesher G, Andel I, Hueber W, Logar D, Montecucco CM, Rovensky J, Sautner J, Sonnenblick M. Source: Annals of the Rheumatic Diseases. 2003 December; 62(12): 1189-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14644857

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Exertional myalgia syndrome associated with diminished serum ammonia elevation in ischemic exercise testing. Author(s): Riggs JE, Schochet SS Jr, Webb RW. Source: Military Medicine. 1999 September; 164(9): 663-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10495640

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Facial arthralgia and myalgia: can they be differentiated by trigeminal sensory assessment? Author(s): Eliav E, Teich S, Nitzan D, El Raziq DA, Nahlieli O, Tal M, Gracely RH, Benoliel R. Source: Pain. 2003 August; 104(3): 481-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12927620

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Fasciculations, myalgia and biochemical changes following succinylcholine with atracurium and lidocaine pretreatment. Author(s): Raman SK, San WM. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1997 May; 44(5 Pt 1): 498-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9161744

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Fatal eosinophilia myalgia syndrome in a marrow transplant patient attributed to total parenteral nutrition with a solution containing tryptophan. Author(s): de Oliveira JS, Auerbach SB, Sullivan KM, Sale GE. Source: Bone Marrow Transplantation. 1993 February; 11(2): 163-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8435665

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Fatal skin rashes and myalgia in a leukaemic patient. Author(s): Tse E, Lie A, Ng IO, Kwong YL. Source: Haematologica. 2003 February; 88(2): Eim02. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12604430

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Fatigue and myalgia in AIDS patients. Author(s): Miller RG, Carson PJ, Moussavi RS, Green AT, Baker AJ, Weiner MW. Source: Neurology. 1991 October; 41(10): 1603-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1922802

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Fibre type proportion and fibre size in trapezius muscle biopsies from cleaners with and without myalgia and its correlation with ragged red fibres, cytochrome-c-oxidasenegative fibres, biomechanical output, perception of fatigue, and surface electromyography during repetitive forward flexions. Author(s): Larsson B, Bjork J, Elert J, Lindman R, Gerdle B. Source: European Journal of Applied Physiology. 2001 June; 84(6): 492-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11482543

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Fibrogenic growth factors in the eosinophilia-myalgia syndrome and the toxic oil syndrome. Author(s): Kaufman LD, Gruber BL, Gomez-Reino JJ, Miller F. Source: Archives of Dermatology. 1994 January; 130(1): 41-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8285738

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Fibromyalgia and chronic fatigue syndrome: similarities and differences. Author(s): Buchwald D. Source: Rheumatic Diseases Clinics of North America. 1996 May; 22(2): 219-43. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9157484

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Fibromyalgia and the rheumatisms. Common sense and sensibility. Author(s): Block SR. Source: Rheumatic Diseases Clinics of North America. 1993 February; 19(1): 61-78. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8356261

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Fibromyalgia and the serotonin pathway. Author(s): Juhl JH. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 1998 October; 3(5): 367-75. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9802912

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Fibromyalgia, psychiatric disorders, and assessment of the longterm outcome of eosinophilia-myalgia syndrome. Author(s): Hudson JI, Pope HG Jr, Carter WP, Daniels SR. Source: J Rheumatol Suppl. 1996 October; 46: 37-42; Discussion 42-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895180

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Fibromyalgia, sleep disorder and chronic fatigue syndrome. Author(s): Moldofsky H. Source: Ciba Found Symp. 1993; 173: 262-71; Discussion 272-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8491102

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Function of beta 2-adrenergic receptors in chronic localized myalgia. Author(s): Maekawa K, Kuboki T, Inoue E, Inoue-Minakuchi M, Suzuki K, Yatani H, Clark GT. Source: J Orofac Pain. 2003 Spring; 17(2): 140-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12836502

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Gallium uptake in eosinophilia myalgia syndrome. Author(s): Rao MG, Chauhan D, Mengel CE. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1991 October; 32(10): 2026-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1919750

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Gastrointestinal involvement in L-tryptophan (L-Trp) associated eosinophiliamyalgia syndrome (EMS). Author(s): De Schryver-Kecskemeti K, Bennert KW, Cooper GS, Yang P. Source: Digestive Diseases and Sciences. 1992 May; 37(5): 697-701. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1563309

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Gemfibrozil-lovastatin-associated myalgia. Author(s): Rosenson RS. Source: The American Journal of Cardiology. 1993 February 15; 71(5): 497. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8498994

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Head and neck manifestations of eosinophilia-myalgia syndrome. Author(s): Levine B, Lanza DC, Ficco A, Freundlich B. Source: The Annals of Otology, Rhinology, and Laryngology. 1995 February; 104(2): 909. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7857025

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Histopathologic features of the L-tryptophan-related eosinophilia-myalgia (fasciitis) syndrome. Author(s): Winkelmann RK, Connolly SM, Quimby SR, Griffing WL, Lie JT. Source: Mayo Clinic Proceedings. 1991 May; 66(5): 457-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1709432

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Hypodense eosinophils and interleukin 5 activity in the blood of patients with the eosinophilia-myalgia syndrome. Author(s): Owen WF Jr, Petersen J, Sheff DM, Folkerth RD, Anderson RJ, Corson JM, Sheffer AL, Austen KF. Source: Proceedings of the National Academy of Sciences of the United States of America. 1990 November; 87(21): 8647-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2236076

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Immune-mediated mechanisms and immune activation of fibroblasts in the pathogenesis of eosinophilia-myalgia syndrome induced by L-tryptophan. Author(s): Illa I, Dinsmore S, Dalakas MC. Source: Human Pathology. 1993 July; 24(7): 702-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8100551

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Immunohistochemical analysis of lymphocytes in postmortem study of the heart from fatal cases of the eosinophilia myalgia syndrome and of the toxic oil syndrome. Author(s): Hayashi T, James TN. Source: American Heart Journal. 1994 May; 127(5): 1298-308. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8172059

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Increased activity of the alpha 1(I) procollagen promoter in skin fibroblasts from patients with chronic eosinophilia-myalgia syndrome. Author(s): Hitraya EG, Jimenez SA, Ludwicka A, Silver RM, Varga J. Source: The International Journal of Biochemistry & Cell Biology. 1997 January; 29(1): 135-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9076948

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Increased pain sensitivity of the upper extremities of TMD patients with myalgia to experimentally-evoked noxious stimulation: possibility of worsened endogenous opioid systems. Author(s): Kashima K, Rahman OI, Sakoda S, Shiba R. Source: Cranio. 1999 October; 17(4): 241-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10650395

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Increased type I collagen gene expression in L-tryptophan associated eosinophiliamyalgia syndrome skin fibroblasts. Author(s): Varga J, Li L, Jimenez SA. Source: The Journal of Rheumatology. 1993 August; 20(8): 1303-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8230009

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Intensive rehabilitative approach to eosinophilia myalgia syndrome associated with severe polyneuropathy. Author(s): Draznin E, Rosenberg NL. Source: Archives of Physical Medicine and Rehabilitation. 1993 July; 74(7): 774-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8328904

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Interleukin-4 levels in the eosinophilia-myalgia syndrome. Author(s): Kaufman LD, Gruber BL, Needleman BW. Source: The American Journal of Medicine. 1991 December; 91(6): 664-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1750440

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Internalised capillaries, neuromyopathy and myalgia. Author(s): Isaacs H, Badenhorst ME. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1992 October; 55(10): 9214. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1331336

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Intubation conditions and postoperative myalgia in outpatient dental surgery: a comparison of succinylcholine with mivacurium. Author(s): Deehan S, Henderson D, Stewart K. Source: Anaesthesia and Intensive Care. 2000 April; 28(2): 146-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10788964

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Investigation of fluoroquinolone-induced myalgia using (31)P magnetic resonance spectroscopy and in vitro contracture tests. Author(s): Guis S, Bendahan D, Kozak-Ribbens G, Mattei JP, Le Fur Y, Confort-Gouny S, Figarella-Branger D, Jouglard J, Cozzone PJ. Source: Arthritis and Rheumatism. 2002 March; 46(3): 774-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11920414

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Is fibromyalgia a distinct clinical entity? Historical and epidemiological evidence. Author(s): Wessely S, Hotopf M. Source: Bailliere's Best Practice & Research. Clinical Rheumatology. 1999 September; 13(3): 427-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10562373

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Is there any relationship between eosinophilia myalgia syndrome (EMS) and fibromyalgia syndrome (FMS)? An analysis of clinical and immunological data. Author(s): Barth H, Berg PA, Klein R. Source: Advances in Experimental Medicine and Biology. 1999; 467: 487-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10721092

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Kegel dyspareunia: levator ani myalgia caused by overexertion. Author(s): DeLancey JO, Sampselle CM, Punch MR. Source: Obstetrics and Gynecology. 1993 October; 82(4 Pt 2 Suppl): 658-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8378003

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L-tryptophan and eosinophilia-myalgia syndrome. Author(s): Shapiro S. Source: Lancet. 1994 April 23; 343(8904): 1035-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7909063

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L-tryptophan and eosinophilia-myalgia syndrome. Author(s): Mitchell N. Source: The Medical Journal of Australia. 1993 March 1; 158(5): 363-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8329035

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L-tryptophan and eosinophilia-myalgia syndrome. Author(s): Shapiro S. Source: Lancet. 1994 September 17; 344(8925): 817-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7916094

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L-tryptophan and the eosinophilia-myalgia syndrome: a clinical and laboratory study. Author(s): McKeon P, Swanwick G, Manley P. Source: Acta Psychiatrica Scandinavica. 1994 December; 90(6): 451-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7892779

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L-tryptophan and the eosinophilia-myalgia syndrome: current understanding of the etiology and pathogenesis. Author(s): Varga J, Jimenez SA, Uitto J. Source: The Journal of Investigative Dermatology. 1993 January; 100(1): 97S-105S. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8423409

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L-tryptophan and the eosinophilia-myalgia syndrome: pathologic findings in eight patients. Author(s): Herrick MK, Chang Y, Horoupian DS, Lombard CM, Adornato BT. Source: Human Pathology. 1991 January; 22(1): 12-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1985073

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L-tryptophan associated eosinophilia-myalgia syndrome. Author(s): Katz JD, Wakem CJ, Parke AL. Source: The Journal of Rheumatology. 1990 November; 17(11): 1559-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2273504

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L-tryptophan implicated in human eosinophilia-myalgia syndrome causes fasciitis and perimyositis in the Lewis rat. Author(s): Crofford LJ, Rader JI, Dalakas MC, Hill RH Jr, Page SW, Needham LL, Brady LS, Heyes MP, Wilder RL, Gold PW, et al. Source: The Journal of Clinical Investigation. 1990 November; 86(5): 1757-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2243145

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L-tryptophan induced cough and pleural effusions associated with the eosinophiliamyalgia syndrome. Author(s): Shore ET. Source: Chest. 1990 December; 98(6): 1540. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2245712

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L-tryptophan induced eosinophilia-myalgia syndrome. Author(s): Lindgren CE, Walker LA, Bolton P. Source: J R Soc Health. 1991 February; 111(1): 29-30. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2005606

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L-tryptophan induced eosinophilia-myalgia syndrome. Author(s): Chartash EK, Given WP, Vishnubhakat SM, Susin M, Coffey EL Jr, Farmer PM, Albanese JM, Kaplan MH, Furie RA. Source: The Journal of Rheumatology. 1990 November; 17(11): 1527-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2273498

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L-tryptophan: eosinophilia-myalgia syndrome. Author(s): D'Arcy PF. Source: Adverse Drug Reactions and Toxicological Reviews. 1995 Spring; 14(1): 37-43. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7612781

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L-tryptophan-associated eosinophilia-myalgia syndrome: perspective of a new illness. Author(s): Kaufman LD, Seidman RJ. Source: Rheumatic Diseases Clinics of North America. 1991 May; 17(2): 427-41. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1862249

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L-tryptophan-associated eosinophilic fasciitis prior to the 1989 eosinophilia-myalgia syndrome outbreak. Author(s): Hibbs JR, Mittleman B, Hill P, Medsger TA Jr. Source: Arthritis and Rheumatism. 1992 March; 35(3): 299-303. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1536667

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L-tryptophan-induced eosinophilia without myalgia. Author(s): Adamson DJ, Legge JS. Source: Lancet. 1991 June 15; 337(8755): 1474-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1675335

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L-tryptophan-induced eosinophilia-myalgia syndrome and myopathy. Author(s): Sagman DL, Melamed JC. Source: Neurology. 1990 October; 40(10): 1629-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2215960

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L-tryptophan-induced eosinophilia-myalgia syndrome associated with primary cutaneous malignant fibrous histiocytoma and extraabdominal desmoid tumor. Author(s): Mainetti C, Masouye I, Salomon D, Chavaz P, Saurat JH. Source: Cancer. 1993 November 1; 72(9): 2712-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8402494

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L-tryptophan-induced eosinophilia-myalgia syndrome. Author(s): Arnouts PJ, Colemont LJ, Van Outryve MJ, Van Moer EM. Source: Journal of Internal Medicine. 1991 July; 230(1): 83-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1829754

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L-tryptophan-induced eosinophilia-myalgia syndrome. I. Report of two cases with pseudoxanthoma-elasticum-like skin changes. Author(s): Mainetti C, Schmied E, Masouye I, Chavaz P, Saurat JH. Source: Dermatologica. 1991; 183(1): 57-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1769422

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L-tryptophan-induced eosinophilia-myalgia syndrome. II. Partial correction of abnormal tryptophan metabolism by pyridoxine. Author(s): Mainetti C, Fathi M, Saurat JH. Source: Dermatologica. 1991; 183(1): 62-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1722762

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L-tryptophan-related eosinophilia-myalgia syndrome possibly associated with a chronic B-lymphocytic leukemia. Author(s): Bohme A, Wolter M, Hoelzer D. Source: Annals of Hematology. 1998 November; 77(5): 235-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9858150

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Magnesium deficiency in the eosinophilia-myalgia syndrome. Report of clinical and biochemical improvement with repletion. Author(s): Clauw DJ, Ward K, Wilson B, Katz P, Rajan SS. Source: Arthritis and Rheumatism. 1994 September; 37(9): 1331-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7945497

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Malignant hyperthermia susceptibility revealed by myalgia and rhabdomyolysis during fluoroquinolone treatment. Author(s): Guis S, Jouglard J, Kozak-Ribbens G, Figarella-Branger D, Vanuxem D, Pellissier JF, Cozzone PJ. Source: The Journal of Rheumatology. 2001 June; 28(6): 1405-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11409139

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Mechanical performance and electromyography during repeated maximal isokinetic shoulder forward flexions in female cleaners with and without myalgia of the trapezius muscle and in healthy controls. Author(s): Larsson B, Bjork J, Elert J, Gerdle B. Source: European Journal of Applied Physiology. 2000 November; 83(4 -5): 257-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11138562

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Microangiopathy in the eosinophilia-myalgia syndrome. Author(s): Smith SA, Roelofs RI, Gertner E. Source: The Journal of Rheumatology. 1990 November; 17(11): 1544-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2273500

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Mononeuropathy multiplex in tryptophan-associated eosinophilia-myalgia syndrome. Author(s): Selwa JF, Feldman EL, Blaivas M. Source: Neurology. 1990 October; 40(10): 1632-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2215962

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Mosaic expression of dystrophin in carriers of Becker's muscular dystrophy and the X-linked syndrome of myalgia and cramps. Author(s): Minetti C, Bonilla E. Source: The New England Journal of Medicine. 1992 October 8; 327(15): 1100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1522852

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Movement disorders in the eosinophilia-myalgia syndrome: tremor, myoclonus, and myokymia. Author(s): Kaufman LD, Kaufman MA, Krupp LB. Source: The Journal of Rheumatology. 1995 January; 22(1): 157-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7699663

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Muscle performance, electromyography and fibre type composition in fibromyalgia and work-related myalgia. Author(s): Elert JE, Rantapaa-Dahlqvist SB, Henriksson-Larsen K, Lorentzon R, Gerdle BU. Source: Scandinavian Journal of Rheumatology. 1992; 21(1): 28-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1570484

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Muscle ultrasound evaluation of patients with familial Mediterranean fever complicated by myalgia. Author(s): Saatci U, Topaloglu R, Bakkaloglu A, Topaloglu H. Source: British Journal of Rheumatology. 1994 October; 33(10): 995-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7921772

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Muscle weakness and myalgia. MR imaging investigation. Author(s): Fleckenstein JL. Source: Magn Reson Imaging Clin N Am. 1995 November; 3(4): 773-803. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8564695

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Muscles, mitochondria and myalgia. Author(s): Behan WM. Source: The Journal of Pathology. 1992 March; 166(3): 213-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1517878

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Myalgia and arthralgia associated with enalapril and ramipril. Author(s): Peppers MP. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 1995 January 15; 52(2): 203-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12879551

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Myalgia and biochemical changes following suxamethonium after induction of anaesthesia with thiopentone or propofol. Author(s): Maddineni VR, Mirakhur RK, Cooper AR. Source: Anaesthesia. 1993 July; 48(7): 626-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8346781

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Myalgia and cramps: dystrophinopathy with wide-ranging laboratory findings. Author(s): Samaha FJ, Quinlan JG. Source: Journal of Child Neurology. 1996 January; 11(1): 21-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8745380

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Myalgia and elevated creatine kinase activity associated with subcutaneous injections of diluent. Author(s): Bach MA, Blum DM, Rose SR, Charnas LR. Source: The Journal of Pediatrics. 1992 October; 121(4): 650-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1403405

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Myalgia and eosinophilia associated with ingestion of tryptophan. An intriguing new syndrome. Author(s): Lewkonia RM. Source: Archives of Internal Medicine. 1990 October; 150(10): 2005-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2171445

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Myalgia as the major symptom in systemic panniculitis (Weber-Christian disease). Author(s): Ohara S, Koh CS, Yanagisawa N. Source: European Neurology. 1992; 32(6): 321-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1490498

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Myalgia as the revealing symptom of multicore disease and fibre type disproportion myopathy. Author(s): Sobreira C, Marques W Jr, Barreira AA. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2003 September; 74(9): 1317-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12933945

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Myalgia with lymphadenopathy. Author(s): Haq I, Moss K, Morris VH. Source: Journal of the Royal Society of Medicine. 2001 October; 94(10): 521-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11581347

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Myalgia, fever, abnormal muscle enzymes and blue urine in a farmworker from Thailand. Author(s): Levy Y, Rimbrot S, Raz R. Source: Isr Med Assoc J. 2001 September; 3(9): 704. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11574993

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Myalgia, neuromyopathy and internalized capillaries: a steroid responsive syndrome. Author(s): Yamout BI, Kyriakides T, Tamim W, Drousiotov A. Source: Acta Neurologica Scandinavica. 1995 April; 91(4): 294-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7625157

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Natural history of the eosinophilia-myalgia syndrome. Author(s): Culpepper RC, Williams RG, Mease PJ, Koepsell TD, Kobayashi JM. Source: Annals of Internal Medicine. 1991 September 15; 115(6): 437-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1651673

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Neurocognitive dysfunction in the eosinophilia-myalgia syndrome. Author(s): Krupp LB, Masur DM, Kaufman LD. Source: Neurology. 1993 May; 43(5): 931-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8492948

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Neurologic complications of the tryptophan-associated eosinophilia-myalgia syndrome. Author(s): Tolander LM, Bamford CR, Yoshino MT, Downing S, Bryan G. Source: Archives of Neurology. 1991 April; 48(4): 436-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2012522

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Neurologic, MR imaging, and MR spectroscopic findings in eosinophilia myalgia syndrome. Author(s): Haseler LJ, Sibbitt WL Jr, Sibbitt RR, Hart BL. Source: Ajnr. American Journal of Neuroradiology. 1998 October; 19(9): 1687-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9802492

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Neuromuscular manifestations of L-tryptophan-associated eosinophilia-myalgia syndrome: a histomorphologic analysis of 14 patients. Author(s): Verity MA, Bulpitt KJ, Paulus HE. Source: Human Pathology. 1991 January; 22(1): 3-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1985074

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Neuromuscular manifestations of the L-tryptophan-associated eosinophilia-myalgia syndrome. Author(s): Kaufman LD. Source: Current Opinion in Rheumatology. 1990 December; 2(6): 896-900. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2083154

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Neuropsychological and emotional sequelae of eosinophilia-myalgia syndrome. Author(s): Hartlage LC, Horton AM. Source: The International Journal of Neuroscience. 1993 October; 72(3-4): 251-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8138379

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Non-L-tryptophan related eosinophilia-myalgia syndrome with hypoproteinemia and hypoalbuminemia. Author(s): Margolin L. Source: The Journal of Rheumatology. 2003 March; 30(3): 628-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12610828

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Nontropical pyomyositis as a cause of subacute, multifocal myalgia in the acquired immunodeficiency syndrome. Author(s): Wolf RF, Sprenger HG, Mooyaart EL, Tamsma JT, Kengen RA, Weits J. Source: Arthritis and Rheumatism. 1990 November; 33(11): 1728-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2242070

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Novel mutation in the CPT II gene in a child with periodic febrile myalgia and myoglobinuria. Author(s): Bruno C, Bado M, Minetti C, Cordone G, DiMauro S. Source: Journal of Child Neurology. 2000 June; 15(6): 390-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10868782

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On the treatment of the eosinophilia-myalgia syndrome. Author(s): Martinez-Osuna P, Espinoza LR. Source: Archives of Internal Medicine. 1991 June; 151(6): 1239. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2043034

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On the use of vecuronium 0.01 mg/kg to prevent suxamethonium-induced myalgia. Author(s): Sosis M. Source: Acta Anaesthesiologica Scandinavica. 1991 January; 35(1): 92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1672480

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On-line HPLC-tandem mass spectrometry structural characterization of caseassociated contaminants of L-tryptophan implicated with the onset of eosinophilia myalgia syndrome. Author(s): Williamson BL, Johnson KL, Tomlinson AJ, Gleich GJ, Naylor S. Source: Toxicology Letters. 1998 October 15; 99(2): 139-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9817085

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Overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder. Author(s): Aaron LA, Burke MM, Buchwald D. Source: Archives of Internal Medicine. 2000 January 24; 160(2): 221-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10647761

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P-31 magnetic resonance spectroscopy of skeletal muscle in the eosinophilia-myalgia syndrome: a preliminary study. Author(s): Clauw DJ, Hewes B, Nelson M, Katz P, Rajan S. Source: The Journal of Rheumatology. 1994 April; 21(4): 654-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8035389

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Pain due to tissue acidosis: a mechanism for inflammatory and ischemic myalgia? Author(s): Issberner U, Reeh PW, Steen KH. Source: Neuroscience Letters. 1996 April 26; 208(3): 191-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8733302

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Pain, fatigue, and sleep in eosinophilia-myalgia syndrome: relationship to neuropsychological performance. Author(s): Pollina DA, Kaufman LD, Masur DM, Krupp LB. Source: The Journal of Neuropsychiatry and Clinical Neurosciences. 1998 Summer; 10(3): 338-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9706542

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Pathogenesis of L-tryptophan eosinophilia myalgia syndrome. Author(s): Sternberg EM. Source: Advances in Experimental Medicine and Biology. 1996; 398: 325-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8906284

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Pathologic manifestations of the eosinophilia myalgia syndrome: analysis of 11 cases. Author(s): Lin JD, Phelps RG, Gordon ML, Hilfer JB, Wolfe DE, Venkataseshan VS, Fleischmajer R. Source: Human Pathology. 1992 April; 23(4): 429-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1563745

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Pathological mechanisms implicated in localized female trapezius myalgia. Author(s): Kadi F, Waling K, Ahlgren C, Sundelin G, Holmner S, Butler-Browne GS, Thornell LE. Source: Pain. 1998 December; 78(3): 191-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9870572

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Pathophysiology of the eosinophilia-myalgia syndrome. Author(s): Silver RM. Source: J Rheumatol Suppl. 1996 October; 46: 26-36. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895179

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Pectoral girdle myalgia in women: a 5-year study in a clinical setting. Author(s): Ryan EL. Source: The Clinical Journal of Pain. 2000 December; 16(4): 298-303. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11153784

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Perceived pain before and after three exercise programs--a controlled clinical trial of women with work-related trapezius myalgia. Author(s): Waling K, Sundelin G, Ahlgren C, Jarvholm B. Source: Pain. 2000 March; 85(1-2): 201-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10692619

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Perimyositis with perineuritis and myofiber type grouping in the eosinophilia myalgia syndrome associated with tryptophan ingestion. Author(s): Talpos DC, Carstens SA, Silverman J, Gladson CL. Source: The American Journal of Surgical Pathology. 1991 March; 15(3): 222-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1996728

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Persian Gulf War myalgia syndrome. Author(s): Alloway JA, Older SA, Battafarano DF, Carpenter MT. Source: The Journal of Rheumatology. 1998 February; 25(2): 388-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9489841

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Persian Gulf War myalgia syndrome. Author(s): Schlesinger N, Baker DG, Schumacher HR Jr. Source: The Journal of Rheumatology. 1997 May; 24(5): 1018-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9150108

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Persistent eosinophilia in 2 patients with eosinophilia-myalgia syndrome. Author(s): Wallace DJ. Source: Arthritis and Rheumatism. 1993 October; 36(10): 1488. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8216410

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Persistent microvasculopathy in chronic eosinophilia-myalgia syndrome. Author(s): Smith SA. Source: Advances in Experimental Medicine and Biology. 1996; 398: 359-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8906289

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Persistent unilateral tibialis anterior muscle hypertrophy with complex repetitive discharges and myalgia: report of two unique cases and response to botulinum toxin. Author(s): Nix WA, Butler IJ, Roontga S, Gutmann L, Hopf HC. Source: Neurology. 1992 March; 42(3 Pt 1): 602-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1549222

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Pharmacogenetic characteristics of the eosinophilia-myalgia syndrome. Author(s): Flockhart DA, Clauw DJ, Sale EB, Hewett J, Woosley RL. Source: Clinical Pharmacology and Therapeutics. 1994 October; 56(4): 398-405. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7955801

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Phenytoin reduces suxamethonium-induced myalgia. Author(s): Hatta V, Saxena A, Kaul HL. Source: Anaesthesia. 1992 August; 47(8): 664-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1519714

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Post suxamethonium myalgia--will we never learn? Author(s): van den Berg AA, Iqbal S. Source: Anaesthesia and Intensive Care. 1996 February; 24(1): 116-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8669631

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Postoperative myalgia after succinylcholine: no evidence for an inflammatory origin. Author(s): Schreiber JU, Mencke T, Biedler A, Furst O, Kleinschmidt S, Buchinger H, Fuchs-Buder T. Source: Anesthesia and Analgesia. 2003 June; 96(6): 1640-4, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12760988

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Post-streptococcal reactive myalgia: a novel syndrome secondary to infection with group A or G streptococci. Author(s): Jansen TL, Janssen M, Macfarlane JD, de Jong AJ. Source: British Journal of Rheumatology. 1998 December; 37(12): 1343-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9973162

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Presence of peak X and related compounds: the reported contaminant in case related 5-hydroxy-L-tryptophan associated with eosinophilia-myalgia syndrome. Author(s): Johnson KL, Klarskov K, Benson LM, Williamson BL, Gleich GJ, Naylor S. Source: The Journal of Rheumatology. 1999 December; 26(12): 2714-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10606395

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Pressure pain threshold in pain-free subjects, in patients with chronic regional pain syndromes, and in patients with fibromyalgia syndrome. Author(s): Granges G, Littlejohn G. Source: Arthritis and Rheumatism. 1993 May; 36(5): 642-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8489541

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Pressure-pain threshold variation in temporomandibular disorder myalgia over the course of the menstrual cycle. Author(s): Isselee H, De Laat A, De Mot B, Lysens R. Source: J Orofac Pain. 2002 Spring; 16(2): 105-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12043517

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Protracted febrile myalgia in patients with familial Mediterranean fever. Author(s): Langevitz P, Zemer D, Livneh A, Shemer J, Pras M. Source: The Journal of Rheumatology. 1994 September; 21(9): 1708-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7799354

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Protracted febrile myalgia of familial Mediterranean fever. Mutation analysis and clinical correlations. Author(s): Sidi G, Shinar Y, Livneh A, Langevitz P, Pras M, Pras E. Source: Scandinavian Journal of Rheumatology. 2000; 29(3): 174-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10898070

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Pseudoxanthoma elasticum-like lesions in the L-tryptophan-induced eosinophiliamyalgia syndrome. Author(s): Mainetti C, Masouye I, Saurat JH. Source: Journal of the American Academy of Dermatology. 1991 April; 24(4): 657-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2033151

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Psychiatric aspects of the eosinophilia-myalgia syndrome. Author(s): Epstein SA, Krahn L, Clauw DJ, Gomes AP, Weigert S, Goldberg RL. Source: Psychosomatics. 1995 January-February; 36(1): 22-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7871130

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Pulmonary hypertension in a patient with tryptophan-induced eosinophilia-myalgia syndrome. Author(s): Yakovlevitch M, Siegel M, Hoch DH, Rutlen DL. Source: The American Journal of Medicine. 1991 February; 90(2): 272-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1996600

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Pulmonary hypertension in patients with eosinophilia-myalgia syndrome or toxic oil syndrome. Author(s): Cheng TO. Source: Mayo Clinic Proceedings. 1993 August; 68(8): 823-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8331987

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Pulmonary involvement in the eosinophilia-myalgia syndrome. Author(s): Catton CK, Elmer JC, Whitehouse AC, Clode JB, Hustrulid RI. Source: Chest. 1991 February; 99(2): 327-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1989790

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Pulmonary manifestations of the eosinophilia-myalgia syndrome associated with tryptophan ingestion. Author(s): Campagna AC, Blanc PD, Criswell LA, Clarke D, Sack KE, Gold WM, Golden JA. Source: Chest. 1992 May; 101(5): 1274-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1582284

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Rapid HPLC screening method for contaminants found in implicated L-tryptophan associated with eosinophilia myalgia syndrome and adulterated rapeseed oil associated with toxic oil syndrome. Author(s): Williamson BL, Tomlinson AJ, Hurth KM, Posada de la Paz M, Gleich GJ, Naylor S. Source: Biomedical Chromatography : Bmc. 1998 September-October; 12(5): 255-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9787895

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Reduced severity of eosinophilia-myalgia syndrome associated with the consumption of vitamin-containing supplements before illness. Author(s): Hatch DL, Goldman LR. Source: Archives of Internal Medicine. 1993 October 25; 153(20): 2368-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8215741

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Repeated coronary artery spasm in a young woman with the eosinophilia-myalgia syndrome. Author(s): Hertzman PA, Maddoux GL, Sternberg EM, Heyes MP, Mefford IN, Kephart GM, Gleich GJ. Source: Jama : the Journal of the American Medical Association. 1992 June 3; 267(21): 2932-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1583764

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Restrictive cardiomyopathy associated with the eosinophilia-myalgia syndrome. Author(s): Berger PB, Duffy J, Reeder GS, Karon BL, Edwards WD. Source: Mayo Clinic Proceedings. 1994 February; 69(2): 162-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8309268

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Review of L-tryptophan and eosinophilia-myalgia syndrome. Author(s): Roufs JB. Source: Journal of the American Dietetic Association. 1992 July; 92(7): 844-50. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1624654

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Rhabdomyolysis and myalgia associated with anticholesterolemic treatment as potential signs of malignant hyperthermia susceptibility. Author(s): Guis S, Bendahan D, Kozak-Ribbens G, Figarella-Branger D, Mattei JP, Pellissier JF, Treffouret S, Bernard V, Lando A, Cozzone PJ. Source: Arthritis and Rheumatism. 2003 April 15; 49(2): 237-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12687516

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Rigorous new approach to constructing a gold standard for validating new diagnostic criteria, as exemplified by the eosinophilia-myalgia syndrome. Author(s): Hertzman PA, Clauw DJ, Duffy J, Medsger TA Jr, Feinstein AR. Source: Archives of Internal Medicine. 2001 October 22; 161(19): 2301-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11606145

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Risk factors for developing eosinophilia myalgia syndrome among L-tryptophan users in New York. Author(s): Back EE, Henning KJ, Kallenbach LR, Brix KA, Gunn RA, Melius JM. Source: The Journal of Rheumatology. 1993 April; 20(4): 666-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8496862

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Rocuronium is the best non-depolarizing relaxant to prevent succinylcholine fasciculations and myalgia. Author(s): Martin R, Carrier J, Pirlet M, Claprood Y, Tetrault JP. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1998 June; 45(6): 521-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9669004

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Rocuronium pretreatment reduces suxamethonium-induced myalgia: comparison with vecuronium. Author(s): Findlay GP, Spittal MJ. Source: British Journal of Anaesthesia. 1996 April; 76(4): 526-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8652325

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Serum aldolase and lactate dehydrogenase levels in the eosinophilia myalgia syndrome. Author(s): Clauw DJ, Siegel LB, Whalen G, Katz P. Source: Clin Exp Rheumatol. 1993 January-February; 11(1): 97-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8453808

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Serum cytokines and the eosinophilia myalgia syndrome. Author(s): Clauw DJ, Zackrison LH, Katz P. Source: Annals of Internal Medicine. 1992 August 15; 117(4): 344-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1463513

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Severe and prolonged febrile myalgia in familial Mediterranean fever. Author(s): Odabas AR, Cetinkaya R, Selcuk Y, Kaya H. Source: Scandinavian Journal of Rheumatology. 2000; 29(6): 394-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11132210

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Severe arthralgia and myalgia due to high-dose methylprednisolone pulse therapy cured by potassium infusion in a patient with diffuse proliferative lupus nephritis. Author(s): Odabas AR, Cetinkaya R, Selcuk Y, Kaya H. Source: Nephron. 2001 January; 87(1): 95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11174035

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Severe periodic febrile myalgia in infancy due to carnitine palmitoyltransferase deficiency. Author(s): Schiffmann R, Lahat E, Schechter A. Source: Neuromuscular Disorders : Nmd. 1992; 2(4): 285-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1483055

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Severe sclerodermalike manifestations of the eosinophilia-myalgia syndrome despite concomitant colchicine therapy. Author(s): Lacour JP, Perrin C, Bodokh I, Ortonne JP. Source: Archives of Dermatology. 1991 November; 127(11): 1732-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1952988

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Short-term effect of glucocorticoid injection into the superficial masseter muscle of patients with chronic myalgia: a comparison between fibromyalgia and localized myalgia. Author(s): Ernberg M, Hedenberg-Magnusson B, Alstergren P, Kopp S. Source: J Orofac Pain. 1997 Summer; 11(3): 249-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9610315

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Simultaneous development of two cases of eosinophilia-myalgia syndrome with the same lot of L-tryptophan in Japan. Author(s): Mizutani T, Mizutani H, Hashimoto K, Nakamura Y, Kishida M, Taniguchi H, Murata M, Kuzuhara S, Shimizu M. Source: Journal of the American Academy of Dermatology. 1991 September; 25(3): 512-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1918490

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Somatosensory perception in a remote pain-free area and function of diffuse noxious inhibitory controls (DNIC) in patients suffering from long-term trapezius myalgia. Author(s): Ann Intern Med. 2002 Mar 19;136(6):I24 Source: European Journal of Pain (London, England). 2002; 6(2): 149-59. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11900513

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Somatosensory perception in patients suffering from long-term trapezius myalgia at the site overlying the most painful part of the muscle and in an area of pain referral. Author(s): Leffler AS, Hansson P, Kosek E. Source: European Journal of Pain (London, England). 2003; 7(3): 267-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12725850

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Sporadic lower limb hypertrophy and exercise induced myalgia in a woman with dystrophin gene deletion. Author(s): Malapert D, Recan D, Leturcq F, Degos JD, Gherardi RK. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1995 November; 59(5): 552-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8530947

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Steroid-responsive myalgia in a patient with Becker muscular dystrophy. Author(s): Higuchi I, Nakamura K, Nakagawa M, Nakamura N, Usuki F, Inose M, Osame M. Source: Journal of the Neurological Sciences. 1993 April; 115(2): 219-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7683333

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Structural changes in male trapezius muscle with work-related myalgia. Author(s): Kadi F, Hagg G, Hakansson R, Holmner S, Butler-Browne GS, Thornell LE. Source: Acta Neuropathologica. 1998 April; 95(4): 352-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9560012

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Structural characterization of case-associated contaminants peak C and FF in Ltryptophan implicated in eosinophilia-myalgia syndrome. Author(s): Naylor S, Williamson BL, Johnson KL, Gleich GJ. Source: Advances in Experimental Medicine and Biology. 1999; 467: 453-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10721088

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Structural characterization of contaminants found in commercial preparations of melatonin: similarities to case-related compounds from L-tryptophan associated with eosinophilia-myalgia syndrome. Author(s): Williamson BL, Tomlinson AJ, Mishra PK, Gleich GJ, Naylor S. Source: Chemical Research in Toxicology. 1998 March; 11(3): 234-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9544622

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Subclinical myositis is common in primary Sjogren's syndrome and is not related to muscle pain. Author(s): Lindvall B, Bengtsson A, Ernerudh J, Eriksson P. Source: The Journal of Rheumatology. 2002 April; 29(4): 717-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11950012

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Succinylcholine-associated postoperative myalgia. Author(s): Wong SF, Chung F. Source: Anaesthesia. 2000 February; 55(2): 144-52. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10651675

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Suspected role of ofloxacin in a case of arthalgia, myalgia, and multiple tendinopathy. Author(s): Schwald N, Debray-Meignan S. Source: Rev Rhum Engl Ed. 1999 July-September; 66(7-9): 419-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10526383

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Suxamethonium myalgia: an ethnic comparison with and without pancuronium pretreatment. Author(s): Houghton IT, Aun CS, Gin T, Lau JT, Oh TE. Source: Anaesthesia. 1993 May; 48(5): 377-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8317643

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Suxamethonium-induced myalgia. Author(s): Dolenska S. Source: British Journal of Anaesthesia. 1994 July; 73(1): 118. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8093161

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Symptoms and signs of temporomandibular disorders in patients with fibromyalgia and local myalgia of the temporomandibular system. A comparative study. Author(s): Hedenberg-Magnusson B, Ernberg M, Kopp S. Source: Acta Odontologica Scandinavica. 1997 December; 55(6): 344-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9477026

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Tension myalgia versus myoadenylate deaminase deficiency: a case report. Author(s): Marin R, Connick E. Source: Archives of Physical Medicine and Rehabilitation. 1997 January; 78(1): 95-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9014967

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The cause and pathogenesis of the eosinophilia-myalgia syndrome. Author(s): Varga J, Uitto J, Jimenez SA. Source: Annals of Internal Medicine. 1992 January 15; 116(2): 140-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1727618

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The clinical patterns of myalgia in children with familial Mediterranean fever. Author(s): Majeed HA, Al-Qudah AK, Qubain H, Shahin HM. Source: Seminars in Arthritis and Rheumatism. 2000 October; 30(2): 138-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11071586

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The effects of different training programs on the trapezius muscle of women with work-related neck and shoulder myalgia. Author(s): Kadi F, Ahlgren C, Waling K, Sundelin G, Thornell LE. Source: Acta Neuropathologica. 2000 September; 100(3): 253-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10965794

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The eosinophilia myalgia syndrome: to be or not to be. Author(s): Espinoza LR. Source: Seminars in Arthritis and Rheumatism. 1997 June; 26(6): 781-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9213375

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The eosinophilia-myalgia syndrome and related disorders. Author(s): Kaufman LD. Source: Recenti Prog Med. 1991 May; 82(5): 286-90. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1887155

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The eosinophilia-myalgia syndrome and the toxic oil syndrome. Pursuing parallels. Author(s): Hertzman PA. Source: Advances in Experimental Medicine and Biology. 1996; 398: 339-42. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8906286

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The eosinophilia-myalgia syndrome revisited. Author(s): Belongia EA, Gleich GJ. Source: The Journal of Rheumatology. 1996 October; 23(10): 1682-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895139

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The eosinophilia-myalgia syndrome. Author(s): Silver RM. Source: Clinics in Dermatology. 1994 July-September; 12(3): 457-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7954203

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The eosinophilia-myalgia syndrome: lessons from Germany. Author(s): Mayeno AN, Gleich GJ. Source: Mayo Clinic Proceedings. 1994 July; 69(7): 702-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8015338

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The eosinophilia-myalgia syndrome: opportunities realized and missed. Author(s): Hertzman PA. Source: The Journal of Rheumatology. 1996 October; 23(10): 1679-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895138

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The eosinophilia-myalgia syndrome: status of 205 patients and results of treatment 2 years after onset. Author(s): Hertzman PA, Clauw DJ, Kaufman LD, Varga J, Silver RM, Thacker HL, Mease P, Espinoza LR, Pincus T. Source: Annals of Internal Medicine. 1995 June 1; 122(11): 851-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7741371

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The eosinophilia-myalgia syndrome: what we know, what we think we know, and what we need to know. Author(s): Clauw DJ, Pincus T. Source: J Rheumatol Suppl. 1996 October; 46: 2-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895175

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The eosinophilia-myalgia syndrome--guidelines for patient care. Author(s): Hertzman PA, Kaufman LD, Love LA, Mease PJ, Philen RM, Pincus T, Rosenberg NL, Silver R, Varga J, Clauw DJ. Source: The Journal of Rheumatology. 1995 January; 22(1): 161-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7699664

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The evolving spectrum of eosinophilia myalgia syndrome. Author(s): Kaufman LD. Source: Rheumatic Diseases Clinics of North America. 1994 November; 20(4): 973-94. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7855332

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The importance of activity and pretreatment in the prevention of suxamethonium myalgias. Author(s): Oxorn DC, Whatley GS, Knox JW, Hooper J. Source: British Journal of Anaesthesia. 1992 August; 69(2): 200-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1389827

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The lessons of eosinophilia-myalgia syndrome. Author(s): Duffy J. Source: Hosp Pract (Off Ed). 1992 April 30; 27(4A): 65-9, 73-80, 83-90. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1560091

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The natural history of eosinophilia-myalgia syndrome in a tryptophan-exposed cohort in South Carolina. Author(s): Sullivan EA, Kamb ML, Jones JL, Meyer P, Philen RM, Falk H, Sinks T. Source: Archives of Internal Medicine. 1996 May 13; 156(9): 973-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8624177

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The neuromuscular pathology of the Eosinophilia-Myalgia syndrome. Author(s): Seidman RJ, Kaufman LD, Sokoloff L, Miller F, Iliya A, Peress NS. Source: Journal of Neuropathology and Experimental Neurology. 1991 January; 50(1): 49-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1985153

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The prevalences of cytochrome c oxidase negative and superpositive fibres and ragged-red fibres in the trapezius muscle of female cleaners with and without myalgia and of female healthy controls. Author(s): Larsson B, Bjork J, Henriksson KG, Gerdle B, Lindman R. Source: Pain. 2000 February; 84(2-3): 379-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10666544

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The toxic oil syndrome and the eosinophilia-myalgia syndrome: pursuing clinical parallels. Author(s): Hertzman PA, Borda IA. Source: The Journal of Rheumatology. 1993 October; 20(10): 1707-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8295182

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The value of percentage of CD8+ T lymphocyte levels in distinguishing polymyalgia rheumatica from early rheumatoid arthritis. Author(s): Corrigall VM, Dolan AL, Panayi GS. Source: The Journal of Rheumatology. 1995 June; 22(6): 1020-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7674224

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Toxic oil syndrome and eosinophilia myalgia syndrome: similar, different or the same disorder? Author(s): Kaufman LD, Izquierdo Martinez M, Gomez-Reino JJ. Source: The Journal of Rheumatology. 1994 December; 21(12): 2177-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7699614

•

Toxic oil syndrome and eosinophilia-myalgia syndrome: May 8-10, 1991, World Health Organization meeting report. Author(s): Philen RM, Posada M. Source: Seminars in Arthritis and Rheumatism. 1993 October; 23(2): 104-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8266108

•

Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study. Author(s): Bennett RM, Kamin M, Karim R, Rosenthal N. Source: The American Journal of Medicine. 2003 May; 114(7): 537-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12753877

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Tryptophan and eosinophilia-myalgia syndrome. Author(s): Hertzman PA, Brown RR. Source: The Western Journal of Medicine. 1991 February; 154(2): 229-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1900976

•

Tryptophan contaminants associated with eosinophilia-myalgia syndrome. The Eosinophilia-Myalgia Studies of Oregon, New York and New Mexico. Author(s): Philen RM, Hill RH Jr, Flanders WD, Caudill SP, Needham L, Sewell L, Sampson EJ, Falk H, Kilbourne EM. Source: American Journal of Epidemiology. 1993 August 1; 138(3): 154-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8356958

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Tryptophan induced eosinophilia-myalgia syndrome: clinical and microscopic findings. Author(s): Groves RW, Simpson KJ, Koblar S, Pitzalis C, Hay RJ. Source: Journal of the Royal Society of Medicine. 1992 February; 85(2): 111-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1538375

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Tryptophan metabolism via the kynurenine pathway in patients with the eosinophilia-myalgia syndrome. Author(s): Silver RM, McKinley K, Smith EA, Quearry B, Harati Y, Sternberg EM, Heyes MP. Source: Arthritis and Rheumatism. 1992 September; 35(9): 1097-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1418026

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Tryptophan produced by Showa Denko and epidemic eosinophilia-myalgia syndrome. Author(s): Kilbourne EM, Philen RM, Kamb ML, Falk H. Source: J Rheumatol Suppl. 1996 October; 46: 81-8; Discussion 89-91. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8895184

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Unexplained myalgia in a patient with linear IgA disease. Author(s): Ossenkoppele PM, Van Vloten WA, Baart de la Faille H. Source: The British Journal of Dermatology. 1991 September; 125(3): 282-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1911327

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Unraveling the eosinophilia-myalgia syndrome. Author(s): Silver RM. Source: Archives of Dermatology. 1991 August; 127(8): 1214-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1863082

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Upper extremity contractures in a patient with eosinophilia-myalgia syndrome. Author(s): Marchman HB, Gleason CB, Shaw JC. Source: Archives of Physical Medicine and Rehabilitation. 1991 November; 72(12): 102930. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1953317

•

Use of basiliximab as a cyclosporin-sparing agent in palmoplantar pustular psoriasis with myalgia as an adverse effect. Author(s): Bell HK, Parslew RA. Source: The British Journal of Dermatology. 2002 September; 147(3): 606-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12207613

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Use of cyclosporin A in the eosinophilia myalgia syndrome. Author(s): Clauw DJ, Alloway JA, Katz P. Source: Annals of the Rheumatic Diseases. 1993 January; 52(1): 81-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8427523

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Use of ketorolac in the prevention of suxamethonium myalgia. Author(s): Leeson-Payne CG, Nicoll JM, Hobbs GJ. Source: British Journal of Anaesthesia. 1994 December; 73(6): 788-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7880667

•

Use of vecuronium to prevent suxamethonium-induced myalgia after ECT. Author(s): Herriot PM, Cowain T, McLeod D. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1996 May; 168(5): 653-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8733812

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

Finding Nutrition Studies on Myalgia 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 “myalgia” (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 “myalgia” (or a synonym): •

1,1'-Ethylidenebis(tryptophan) (Peak E) induces functional activation of human eosinophils and interleukin 5 production from T lymphocytes: association of eosinophilia-myalgia syndrome with a L-tryptophan contaminant. Author(s): U365-Institut National de la Sante et de la Recherche Medicale (INSERM), Interferons et Cytokines, Institut Curie, Paris, France. Source: Yamaoka, K A Miyasaka, N Inuo, G Saito, I Kolb, J P Fujita, K Kashiwazaki, S JClin-Immunol. 1994 January; 14(1): 50-60 0271-9142

•

1995 Bailey K. Ashford lecture. Public health lessons from two catastrophic epidemics: the toxic oil syndrome and the eosinophilia-myalgia syndrome. Author(s): University of Texas Medical Branch, Galveston 77555-0129, USA. Source: James, T N P-R-Health-Sci-J. 1996 March; 15(1): 45-8 0738-0658

•

A contaminant of L-tryptophan enhances expression of dermal collagen in a murine model of eosinophilia myalgia syndrome. Author(s): Department of Medicine, Medical University of South Carolina, Charleston, 29425-2229, USA. Source: Suzuki, S Tourkina, E Ludwicka, A Hampton, M Bolster, M Maize, J Silver, R Proc-Assoc-Am-Physicians. 1996 July; 108(4): 315-22 1081-650X

•

Abnormalities of the coronary arteries, neural structures and conduction system of the heart observed postmortem in the eosinophilia-myalgia syndrome, with a discussion of comparative findings from the toxic oil syndrome. Author(s): Department of Medicine, University of Texas Medical Branch, Galveston 77550-2774. Source: James, T N Trans-Am-Clin-Climatol-Assoc. 1990; 10252-81; discussion 81-3 00657778

•

Accumulation of 3-(phenylamino)alanine, a constituent in L-tryptophan products implicated in eosinophilia-myalgia syndrome, in blood and organs of the Lewis rats. Author(s): Department of Legal Medicine, Kobe University School of Medicine, Japan. Source: Adachi, J Gomez, M Smith, C C Sternberg, E M Arch-Toxicol. 1995; 69(4): 266-70 0340-5761

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Decreasing post-succinylcholine myalgia in outpatients. Source: Melnick, B Chalasani, J Uy, N T Phitayakorn, P Mallett, S V Rudy, T E Can-JAnaesth. 1987 May; 34(3 ( Pt 1)): 238-41 0832-610X

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Early impressions concerning actinomycetal infections that may play a role in the pathogenesis of eosinophilia-myalgia syndrome (EMS) and other 'new illnesses'. Source: Matthews, H A Med-Hypotheses. 1992 May; 38(1): 25-45 0306-9877

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Effectiveness of atracurium in preventing succinylcholine myalgia. Source: Marr, A T Sosis, M AANA-J. 1989 April; 57(2): 128-30 0094-6354

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Environmental pathology. Mast cell and eosinophil infiltration in intestinal mucosa of Lewis rats treated with L-tryptophan implicated in human eosinophilia myalgia syndrome. Author(s): Department of Pathology, Case Western Reserve University, Cleveland, Ohio. Source: DeSchryver Kecskemeti, K Gramlich, T L Crofford, L J Rader, J I Page, S W Needham, L L Hill, R H Sternberg, E M Mod-Pathol. 1991 May; 4(3): 354-7 0893-3952

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Eosinophilia myalgia syndrome secondary to contaminated tryptophan--clinical experience. Source: Jaffe, R. J-Nutr-Med. Abingdon, UK : Carfax Pub. Co. 1991. volume 2 (2) page 195-200. 0955-6664

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Eosinophilia, myalgia associated with L-tryptophan use: case report. Author(s): Department of Medicine, University of Virginia School of Medicine, Charlottesville. Source: Becker, D M Habib Hong, S Smith, S M Va-Med. 1990 February; 11768-70 01463616

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Eosinophilia-myalgia syndrome associated with ingestion of L-tryptophan. Author(s): Department of Surgery, Waikato Hospital, Hamilton. Source: Keating, J P Wardill, K Viggiano, J N-Z-Med-J. 1992 August 12; 105(939): 317 0028-8446

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Kinetics of the formation and decomposition of 1,1'-ethylidenebis[L-tryptophan], an eosinophilia myalgia syndrome-associated compound. Source: Fu, T.J. J-agric-food-chem. Washington, D.C. : American Chemical Society. May 1996. volume 44 (5) page 1224-1229. 0021-8561

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

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

•

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to myalgia; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Niacin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,892,00.html Vitamin B1 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B1 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin E Source: Healthnotes, Inc.; www.healthnotes.com

•

Minerals Calcium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,884,00.html Carnitine Source: Prima Communications, Inc.www.personalhealthzone.com Carnitine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com

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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10012,00.html Copper Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,886,00.html Creatine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10020,00.html L-carnitine Source: Healthnotes, Inc.; www.healthnotes.com Magnesium Source: Healthnotes, Inc.; www.healthnotes.com Magnesium Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: Prima Communications, Inc.www.personalhealthzone.com Magnesium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html Zinc Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10071,00.html •

Food and Diet Pain Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. CLINICAL TRIALS AND MYALGIA Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning myalgia.

Recent Trials on Myalgia The following is a list of recent trials dedicated to myalgia.8 Further information on a trial is available at the Web site indicated. •

The Efficacy of Reiki in the Treatment of Fibromyalgia Condition(s): Fibromyalgia Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: The purpose of this study is to investigate the effectiveness of Reiki in the treatment of fibromyalgia (FM), a condition characterized by widespread muscle pain and stiffness, often accompanied by sleep disturbance, headaches, irritable bowel syndrome, and psychological distress. Reiki is a form of energy medicine in which practitioners reportedly access universal life energy to heal patients, either by direct contact at specific hand positions or from a distance. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00051428

•

Efficacy of Acupuncture in the Treatment of Fibromyalgia Condition(s): Fibromyalgia Study Status: This study is no longer recruiting patients.

8

These are listed at www.ClinicalTrials.gov.

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Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM); National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: Fibromyalgia (FM), one of the most common rheumatic conditions, is a condition of unknown etiology characterized by widespread muscle pain and stiffness. Treatment is generally unsatisfactory and most randomized, controlled treatment trials have been unable to demonstrate a sustained effective intervention. A single, brief trial of electroacupuncture demonstrated remarkable improvement among patients with FM, although lasting effects were not evaluated. Nonetheless, the recently published National Institutes of Health Consensus Development Statement on Acupuncture says "musculoskeletal conditions such as fibromyalgia, myofascial pain.are conditions for which acupuncture may be beneficial". Thus, 96 patients will be recruited from a referral clinic for fatigue for a 12 week (24 treatments) trial. These patients will be randomized into 3 control groups and 1 "true" acupuncture group. The control groups will consist of a group receiving acupuncture treatment for an unrelated condition (morning sickness), a group receiving needle insertion at non-channel, nonpoint locations, and a "true" placebo group. This latter group will have acupuncture needle guides tapped on the skin, then needles tapped. Thus, the specific aims of this study are to 1) evaluate the short and long term efficacy and side effects of a 12 week randomized, controlled trial of bi-weekly acupuncture in the treatment of FM; 2) establish the most useful and scientifically sound control group for studies of acupuncture using FM as a model for conditions characterized by chronic pain; 3) use both subjective and objective measures of overall health and pain to determine the optimal time length of treatment; and 4) examine the concordance of allopathic and acupuncture-based measures of outcome. For the purposes of this study, subjects will be asked to complete a unique set of study measures at enrollment, at 4, 8, and 12 weeks, and then again at 1 and 6 months post-treatment. Our primary outcomes will be patient global assessment, subjective pain, and mean number of tender points. Secondary outcomes will be pain threshold, analgesic use, physician global assessment, functional status, sleep, psychological distress, and fatigue. Thus, this trial will have both immediate and longer term implications for the scientific study of acupuncture as well as the clinical care of the estimated 5 million patients with FM in the US. From a methodological point of view, the proposed trial will establish the most appropriate methods for choosing a control group should larger trials be conducted, suggest the optimum duration of treatment, and evaluate the utility of diverse allopathic and alternative outcome measures. Of equal importance, however, this research will test and potentially establish the effectiveness of acupuncture. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00010764 •

Behavioral Treatment of Fibromyalgia Condition(s): Fibromyalgia Study Status: This study is completed. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Purpose - Excerpt: Fibromyalgia (FM) is one of the most common rheumatic diseases (conditions or disorders that cause pain or stiffness in the joints, muscles, or bones). It

Clinical Trials 61

affects 6 million Americans and up to 20 percent of patients seen by doctors who specialize in treating rheumatic diseases. This study will evaluate the effects of two of the most promising nondrug treatments for FM: coping skills training and physical exercise training. We will randomly assign each of 180 patients diagnosed with FM to one of four groups: coping skills training (CST), physical exercise training alone, CST plus physical exercise training, or a waiting list (nontreatment group). We will look at the separate and combined effects of CST and physical exercise training and evaluate how changes in aerobic fitness, self-effectiveness (a person's belief in his or her ability to reach a goal, such as managing one's own disease), and negative pain-related thoughts relate to improvements in pain and disability. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000398 •

L-5-HTP-related EMS Condition(s): Eosinophilia-Myalgia Syndrome Study Status: This study is completed. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: In 1989 more than 1500 people who took the dietary supplement Ltryptophan for insomnia and depression developed eosinophilia myalgia syndrome (EMS)-a potentially fatal disease characterized by an excess of a type of white blood cell called eosinophils. Disease symptoms include fever, muscle aches and inflammation, and skin rashes. As many as 40 of the patients who became ill died. It is suspected that impurities in the supplements caused the disease. More recently, similar impurities have been detected in batches of a similar dietary supplement called L-5-hydroxytryptophan. This study is designed to learn more about EMS that develops in patients taking L-5hydroxytryptophan. The study is open to patients newly diagnosed with eosinophilia myalgia who have taken L-5-HTP. Patients in the study will have a physical examination and urine and blood tests. They may also have X rays, an electrocardiogram, magnetic resonance imaging (MRI), and a skin test for tuberculosis. They will have a psychiatric interview, take a memory test, and fill out questionnaires relating to sadness and depression. Patients may also undergo special tests to study conduction of nerve impulses and muscle function. Samples of patients' supplements will be taken for chemical analysis. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001918

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions.

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The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “myalgia” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 4. PATENTS ON MYALGIA Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “myalgia” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on myalgia, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Myalgia By performing a patent search focusing on myalgia, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We

9Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on myalgia: •

Arthritis, muscle pain, and dry skin remedy Inventor(s): Merich, deceased; Nick (late of Daytona Beach, FL) Assignee(s): None Reported Patent Number: 6,146,639 Date filed: July 26, 1999 Abstract: An arthritis, muscle pain, and dry skin remedy is provided containing rubbing alcohol, witch hazel, and olive oil. In the preferred embodiment, the remedy contains sixteen parts rubbing alcohol, sixteen parts witch hazel, and four parts olive oil. An alternate embodiment arthritis, muscle pain, and dry skin remedy is also disclosed which relieves symptoms of muscle pain, arthritis, and dry, scaly skin in horses. This alternate remedy uses castor oil instead of olive oil. Excerpt(s): This invention relates to arthritis remedies, and in particular to an arthritis and muscle pain remedy which also treats dry or scaly skin. Arthritis is a term which refers to a group of diseases which affect the joint. Symptoms of arthritis include pain, stiffness and swelling of the affected joints. The disease is a serious problem in that it is very widely spread. For example, in the United States alone more than 31 million individuals suffer from arthritis. The two main types of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis is also referred to as degenerative joint disease, and occurs where the joint itself wears out. This strain of arthritis is common in elderly people, and it may also occur where a joint has been injured repeatedly. The most commonly affected joints are in the hands, knees, lower back and neck. Web site: http://www.delphion.com/details?pn=US06146639__

•

Treatment of composition

refractory

Eosinophilia-Myalgia

Syndrome

with

L-tryptophan

Inventor(s): Caston; John C. (108 Cinder Ter., Spartanburg, SC 29302) Assignee(s): None Reported Patent Number: 5,185,157 Date filed: May 2, 1990 Abstract: A method of treating a human patient with refractory Eosinophilia Myalgia Syndrome via oral administration of an effective dosage range of from 1000 mg. to 3000 mg. of a pharmaceutical composition, in unit dosage form, comprising a minor amount of a solid or liquid carrier and a major amount of the amino acid, pharmaceutical grade L-tryptophan, or its acid addition salt, with both of the carriers and the amino acid to be selected to exclude the zinc, magnesium, and calcium containing salts as adjuvants. Excerpt(s): This invention relates to the treatment of human Eosinophilia-Myalgia syndrome with selected amino acids. Eosinophilias are naturally occurring components in the mammalian blood which have activities like that of other white blood cells (lymphocytes). Eosinophilia means "an increase of such eosinophils circulating in the blood. The precise function of the eosinophils is not established, but they appear to be a first line of defense against parasitic invasions of the blood stream. They could also play

Patents 65

a marked role in allergies and inflammation. Normally, a droplet of blood (e.g. a cubic millimeter) contains as many as 350 eosinophils. In patients with the ailment, EMS, there are 1,000-12,000 eosinophils per cubic millimeter. In the fall of 1989, medical investigators at the Federal Center for Disease Control reported discovery of the reason for a recent outbreak of the rare disease, EMS, apparently, it was linked to at least one source of the nutritional supplement, L-tryptophan, which had become contaminated in the manufacturing process. L-tryptophan (L-TTP) (chemically, 1-alpha-aminoindole-3propionic acid) is an essential amino acid, which is normally ingested as a constituent of dietary protein, but is not synthesized by the human body. It was first isolated from the milk protein, casein, early in this century. For many decades, L-tryptophan has been capable of laboratory synthesis by any of several routes, now well known in organic chemistry. Possibly, the once patented synthesis, starting with alpha-ketoglutaric acid phenylhydrazine, is the currently preferred mode of industrial-scale manufacture. Having a single asymmetric carbon atom, (alpha on the side chain), it is normally a mixture of two optically active antipodes. Web site: http://www.delphion.com/details?pn=US05185157__ •

Use of sympathetic blockade for treatment of chronic muscle pain Inventor(s): Hubbard; David R. (4150 Regents Park Row, Ste. 255, La Jolla, CA 920371467) Assignee(s): None Reported Patent Number: 5,513,661 Date filed: October 14, 1993 Abstract: Methods are provided for intramuscular needle diagnosis and treatment of muscle pain that is believed to be the result of sympathetically mediated spindle spasm. Two simultaneous needle EMG needle recordings are used to establish the presence of and magnitude of the "trigger points" in painful muscle. The abnormal muscle activity so identified can then be treated by blocking the sympathetic activation muscle blocker or other agent that would have the same effect of inhibiting the abnormal muscle activity. Excerpt(s): This invention relates to methods for treating chronic muscle pain using sympathetic blocking agents. The method is exemplified by injection of phenoxybenzamine directly into myofascial trigger points. Myofascial pain syndrome is a neuromuscular dysfunction of skeletal muscle fibers manifested by trigger point (TrP) phenomena of various origins and referred phenomena. The underlying pathophysiology of TrPs is unknown. However, specific criteria have been defined for identifying TrPs (Simons, D., (1990) Adv. Pain Res. Ther. 17:1-41; Travell et al. Myofascial pain and dysfunction, the trigger point manual, New York; Williams & Wilkins (1983) 5-44). These criteria include a palpable firm area of muscle, referred to as the taut band; within the taut band, a localized spot of exquisite tenderness to manual pressure, the TrP; a characteristic pattern of pain, tingling, or numbness in response to sustained pressure on the TrP within the taut band; and a local twitch of the taut band when the TrP is distorted transversely. Although the taut band may be several centimeters long, the TrP itself is reported to be only a few millimeters in diameter. The referral phenomena include referred pain, referred tenderness, or referred autonomic phenomena, such as vasoconstriction, coldness, sweating, pilomotor response, ptosis and hypersecretion. There are both active TrPs that cause clinical pain syndromes, and latent TrPs, which are painless, and not associated with clinical pain syndromes. Latent

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TrPs are, like active ones, identified by manual palpation of taut bands, tenderness, and characteristic referral pattern of pain in response to sustained manual pressure. Fifty percent of asymptomatic persons have latent TrPs on examination of the shoulder-girdle musculature. Sola et al. (1955) Am. J. Phys. Med. 34:585-90. TrPs can also be distinguished from Tender points (TePs). Tender points are areas of tenderness that may or may not be in muscle tissue, do not have palpable taut bands, and do not refer pain to adjacent areas. Travell et al. Myofascial pain and dysfunction, the trigger point manual, New York; Williams & Wilkins (1983) 5-44). Web site: http://www.delphion.com/details?pn=US05513661__

Patent Applications on Myalgia As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to myalgia: •

Cardiac glycosides for treating muscle pain and spasm Inventor(s): Davis, Matthew; (Media, PA), Laudadio, Charles; (Chadds Ford, PA) Correspondence: Connolly Bove Lodge & Hutz Llp; P.O. Box 2207; Wilmington; DE; 19899-2207; US Patent Application Number: 20030229029 Date filed: June 4, 2003 Abstract: This invention provides methods of treating muscle spasm and/or pain by treatment with a cardiac glycoside or aglycone derivative. These methods are useful in treatment of conditions associated with muscle pain. Excerpt(s): This application is based upon provisional application Serial No. 60/386,261, filed Jun. 6, 2002. The present invention relates generally to use of administering a cardiac glycoside (topically, orally, parenterally or anally) for the relief of striated muscle pain. Foxglove is the common name for plants of the Digitalis species, primarily represented by common foxglove, Digitalis purpurea L., and Grecian foxglove, Digitalis lanata J. F. Ehrh. Digitalis is poisonous, and symptoms include vomiting, headache, irregular heartbeat, and convulsions. Overdoses can be fatal. Cardiac glycosides such as digitalis have been used extensively to treat heart failure. The assumed mechanism of action is inhibition of Na.sup.+, K.sup.+-ATPase resulting in increased intracellular sodium and subsequent intracellular calcium leading to enhanced muscle contraction in cardiac tissue. This enhanced muscle contraction is thought to include increasing the contractility of the heart. Various cardiac glycosides may have cardiotonic or cardiotoxic effects. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

10

This has been a common practice outside the United States prior to December 2000.

Patents 67

•

Isoxazolone compounds useful in treating diseases associated with unwanted cytokine activity Inventor(s): Clark, Michael Philip; (Loveland, OH), De, Biswanath; (Cincinnati, OH), Djung, Jane Far-Jine; (Mason, OH), Laughlin, Steven Karl; (Taylor Mill, KY), Natchus, Michael George; (Alpharetta, GA), Tullis, Joshua Spector; (Broomfield, CO) Correspondence: The Procter & Gamble Company; Intellectual Property Division; Winton Hill Technical Center - Box 161; 6110 Center Hill Avenue; Cincinnati; OH; 45224; US Patent Application Number: 20030096814 Date filed: May 7, 2002 Abstract: Isoxazolone compounds having the generic structure: 1are used to treat disease associated with unwanted cytokine activity, including rheumatoid arthritis, osteoarthritis, diabetes, HIV/AIDS, inflammatory bowel disease, Crohn's disease, ulcerative colitis, congestive heart, hypertension, chronic obstructive pulmonary disease, septic shock syndrome, tuberculosis, adult respiratory distress, asthma, atherosclerosis, muscle degeneration, periodontal disease, cachexia, Reiter's syndrome, gout, acute synovitis, anorexia and bulimia nervosa fever, malaise, myalgia and headaches. Excerpt(s): This application claims priority under Title 35, United States Code 119(e) from Provisional Application Serial No. 60/293,889, filed May 24, 2001. The present invention is directed to certain isoxazolone compounds that inhibit the release of inflammatory cytokines such as interleukin-1 (1L-1) and tumor necrosis factor (TNF) from cells. The compounds of the invention, therefore, are useful in treating diseases involving unwanted cytokine activity. Many cytokine-mediated diseases and conditions are associated with excessive or unregulated production or activity of one or more cytokines such as interleukin 1 (IL-1), tumor necrosis factor (TNF), interleukin 6 (IL-6) and interleukin 8 (IL-8). IL-1 and TNF are important proinflammatory cytokines, which along with several other related molecules, mediate inflammatory cellular response in a wide variety of diseases and conditions. Proinflammatory cytokines such as IL-1 and TNF stimulate other inflammatory mediators such as nitric oxide, cyclooxygenase-2, matrix metalloproteinases. The inhibition of these cytokines is consequently both directly and indirectly beneficial in controlling, reducing and alleviating many of these disease states. 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 myalgia, 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 “myalgia” (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 myalgia.

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You can also use this procedure to view pending patent applications concerning myalgia. 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 MYALGIA Overview This chapter provides bibliographic book references relating to myalgia. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on myalgia include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “myalgia” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on myalgia: •

Orofacial Pain: From Basic Science to Clinical Management Source: Chicago, IL: Quintessence Publishing Co, Inc. 2001. 312 p. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $38.00 plus shipping and handling. ISBN: 0867153814. Summary: This textbook on orofacial pain focuses on the topics that would be found in an undergraduate curriculum for dentistry, emphasizing acute pain and chronic pain states other than temporomandibular disorders (TMD). Most of the chapters in the book were first presented as papers at a symposium for teachers of orofacial pain held in Vancouver, Canada, in March 1999 in conjunction with the American and Canadian Associations of Dental Schools and the International Association for Dental Research. The book offers 24 chapters in four sections: the clinical problem of pain and the

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epidemiology of pain; the neurobiology of pain; pain and behavior; and the management of orofacial pain. Specific topics include how to classify orofacial pain, peripheral mechanisms of orofacial pain, neurochemical factors in injury and inflammation of orofacial tissues, mechanisms of neuropathic pain, the measurement of pain, perception and behavioral modulation of pain, psychosocial issues, pain and gender, pain and sleep disturbances, pain and movement, diagnostic strategies, the management of persistent orofacial pain, the management of dental pain, the management of inflammatory pain, masticatory myalgia (pain on chewing), mucosal pain, the management of neuropathic pain, and science transfer in orofacial pain. One chapter offers illustrative case reports and a subject index concludes the text.

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 “myalgia” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “myalgia” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “myalgia” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

90 Seconds to Muscle Pain Relief: The Fold and Hold Method by Dale L. Anderson; ISBN: 0896382427; http://www.amazon.com/exec/obidos/ASIN/0896382427/icongroupinterna

•

Chronic Muscle Pain by Paul Davidson; ISBN: 0425130541; http://www.amazon.com/exec/obidos/ASIN/0425130541/icongroupinterna

•

Diagnosis and Treatment of Muscle Pain by Hans Kraus (Editor); ISBN: 0867151668; http://www.amazon.com/exec/obidos/ASIN/0867151668/icongroupinterna

•

Fibromyalgia: Relief from Chronic Muscle Pain by Paul Davidson (Illustrator); ISBN: 0965349322; http://www.amazon.com/exec/obidos/ASIN/0965349322/icongroupinterna

•

Healing Muscle Pain : Tools, Techniques, and Tips to Bring Your Muscles Back to Health by Elisabeth Aaslid (Author); ISBN: 0471378917; http://www.amazon.com/exec/obidos/ASIN/0471378917/icongroupinterna

•

Healthy Bones & Joints: A Natural Approach to Treating Arthritis, Osteoporosis, Tendinitis, Myalgia & Bursitis by David Hoffmann, David Hoffman; ISBN: 1580172539; http://www.amazon.com/exec/obidos/ASIN/1580172539/icongroupinterna

•

Living Life Free from Pain: Treating Arthritis, Joint Pain, Muscle Pain, and Fibromyalgia With Maharishi Vedic Medicine by Kumuda, Md Reddy, et al; ISBN: 1930051549; http://www.amazon.com/exec/obidos/ASIN/1930051549/icongroupinterna

•

Muscle Pain Relief in 90 Seconds: The Fold and Hold Method by Dale L. Anderson (Author); ISBN: 0471346896; http://www.amazon.com/exec/obidos/ASIN/0471346896/icongroupinterna

Books

71

•

Muscle Pain Syndromes and Fibromyalgia: Pressure Algometry for Quantification of Diagnosis and Treatment Outcome (Journal of Musculoskeletal Pain, V. 6, No. 1) by Andrew A. Fischer (Editor), B.C.) World Congress on Pain 1996 Vancouver; ISBN: 0789005107; http://www.amazon.com/exec/obidos/ASIN/0789005107/icongroupinterna

•

Muscle Pain, Myofascial Pain, and Fibromyalgia: Recent Advances (Journal of Musculoskeletal Pain, V. 7, No. 1/2) by Leonardo Vecchiet (Editor), et al; ISBN: 0789008289; http://www.amazon.com/exec/obidos/ASIN/0789008289/icongroupinterna

•

Muscle Pain: Understanding Its Nature, Diagnosis and Treatment by Siegfried Mense, et al; ISBN: 0683059289; http://www.amazon.com/exec/obidos/ASIN/0683059289/icongroupinterna

•

When Muscle Pain Won't Go Away: The Relief Handbook for Fibromyaliga and Chronic Muscle Pain by Gayle Backstrom, et al; ISBN: 0878339981; http://www.amazon.com/exec/obidos/ASIN/0878339981/icongroupinterna

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

Management of Masticatory Myalgia and Arthralgia Source: in Lund, J.P., et al., eds. Orofacial Pain: From Basic Science to Clinical Management. Chicago, IL: Quintessence Publishing Co, Inc. 2001. p. 235-248. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $38.00 plus shipping and handling. ISBN: 0867153814. Summary: Myalgia and arthralgia refer to muscle and joint pain, respectively. When involving the masticatory muscles, the temporomandibular joint structures, or both, they are collectively called temporomandibular disorders (TMD). This chapter on the management of masticatory (chewing) myalgia and arthralgia is from a textbook that focuses on the topics that would be found in an undergraduate curriculum for dentistry. Most of the chapters in the book were first presented as papers at a symposium for teachers of orofacial pain held in Vancouver, Canada, in March 1999 in conjunction with the American and Canadian Associations of Dental Schools and the International Association for Dental Research. In this chapter, the authors discuss differential diagnosis, including that of masticatory myalgia which should include postexercise myalgia, myofascial pain, fibromyalgia, tension type headache, myositis, muscle contracture, muscle spasm, dyskinesias and dystonias; and that of temporomandibular joint arthralgia, which includes TMJ disc displacement, TMJ subluxation or dislocation, osteoarthritis, TMJ synovitis or capsulitis, rheumatic diseases, fracture and contusion,

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ankylosis, and tumors or growths. The authors then focus on management strategies, including pharmacotherapy (drugs), physical medicine, intraoral splints, behavioral management including self management, and surgery. The chapter concludes with a brief section discussing referrals to other specialists. 2 tables. 21 references.

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

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

Prednisone reduces severity of paclitaxel-induced arthralgias and myalgias uncontrolled with NSAIDs Source: Reuters Medical News Date: January 26, 1999

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “myalgia” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “myalgia” (or synonyms). If you know the name of a company that is relevant to myalgia, 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 “myalgia” (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

Periodicals and News

75

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 “myalgia” (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 myalgia: •

CNS Myalgia: A New Paradigm for Fibromyalgia Source: Fibromyalgia Frontiers. 7(5): 1-3,5. September-October 1999. Contact: Available from National Fibromyalgia Partnership. 140 Zinn Way, Linden, VA 22642-5609. Toll-free phone (866) 725-4404. Fax (540) 622-2998. E-mail: [email protected]. Website: www.fmpartnership.org. Summary: This newsletter article provides health professionals and people who have fibromyalgia with the views of a team of North American researchers who participated in a seminar sponsored by the Fibromyalgia Association of Greater Washington. One member of the team views fibromyalgia (FM) as a largely neurological condition that may first involve an injury to the muscles or soft tissues but is sustained thereafter by brain defenses that continue to compensate for the insult that has been received. This researcher argues that FM can be more accurately described as central nervous system myalgia. Another researcher has found that patients with FM seem to experience puzzling muscle cocontractions. For example, a simple turn of the head seems to fire muscles at rest in distant parts of the body in an inappropriate manner. This researcher also believes that the generalized body pain indicative of fibromyalgia indicates brain involvement. He has found characteristic spikes in patients with FM similar to those seen in patients with viral infections. Unlike patients with viral infections who return to normal once their virus is resolved, patients with FM seem to get stuck in this brain state. The third member of the team has observed the effects of the Flexyx Neurotherapy System (FNS) on patients with fibromyalgia. The team is currently embarking on a large, double blind, placebo controlled study that will examine the effects of FNS on patients with fibromyalgia.

Academic Periodicals covering Myalgia Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to myalgia. In addition to these sources, you can search for articles covering myalgia 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 7. 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 myalgia. 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 myalgia. 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 myalgia: Cyclobenzaprine •

Systemic - U.S. Brands: Flexeril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202172.html

Gemcitabine •

Systemic - U.S. Brands: Gemzar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203038.html

Influenza Virus Vaccine •

Systemic - U.S. Brands: FluShield; Fluvirin; Fluzone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202297.html

Lyme Disease Vaccine •

Systemic - U.S. Brands: LYMErix http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203759.html

Orphenadrine and Aspirin •

Systemic - U.S. Brands: Norgesic; Norphadrine; Orphenagesic http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202427.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.

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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

83

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •

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

•

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

•

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

•

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

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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/

11

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.12 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:13 •

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

12

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). 13 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 Gateway14 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.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “myalgia” (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 2679 10 1003 61 137 3890

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 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.18 Simply search by “myalgia” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

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

15

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). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

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 Biologists19 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.20 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.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

19 Adapted 20

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. 21 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 myalgia 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 myalgia. 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 myalgia. 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 “myalgia”:

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Movement Disorders http://www.nlm.nih.gov/medlineplus/movementdisorders.html Muscle Disorders http://www.nlm.nih.gov/medlineplus/muscledisorders.html Neck Disorders and Injuries http://www.nlm.nih.gov/medlineplus/neckdisordersandinjuries.html Neuromuscular Disorders http://www.nlm.nih.gov/medlineplus/neuromusculardisorders.html Sprains and Strains http://www.nlm.nih.gov/medlineplus/sprainsandstrains.html Weight Loss and Dieting http://www.nlm.nih.gov/medlineplus/weightlossanddieting.html

Within the health topic page dedicated to myalgia, the following was listed: •

General/Overviews Polymyalgia Rheumatica Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00441 What You Need to Know about Polymyalgia and Giant Cell Arteritis Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/arthritis/treat/facts/polymyalgia.htm

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Diagnosis/Symptoms ESR (Erythrocyte Sedimentation Rate): Sed Rate Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/esr/test.html

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Treatment Prednisone http://www.myasthenia.org/information/prednisone.pdf

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Specific Conditions/Aspects Giant Cell Arteritis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00440 Vasculitis Including Temporal Arteritis Source: National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/health_and_medical/disorders/vasculitis_doc.htm

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Organizations American College of Rheumatology http://www.rheumatology.org/

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Arthritis Foundation http://www.arthritis.org/ National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/ •

Research Giant-Cell Arteritis and Polymyalgia Rheumatica Source: American College of Physicians http://www.annals.org/cgi/content/full/139/6/I-55 Physical Examination or Duplex Ultrasonography for the Diagnosis of Giant-Cell Arteritis Source: American College of Physicians http://www.annals.org/cgi/content/full/137/4/I-26

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 myalgia. 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: •

Getting the Most Out of Your Medicines: A Guide for Patients With FMS/CFS (Fibromyalgia Syndrome/Chronic Fatigue Syndrome) Source: Tucson, AZ: Fibromyalgia Network. 2000. 82 p. Contact: Available from Fibromyalgia Network. P.O. Box 31750, Tucson, AZ 85751-1750. (800) 853-2929 or (520) 290-5508. Fax (520) 290-5550. Website: www.fmnetnews.com. PRICE: $10.00. Summary: This booklet provides people who have fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS) with information on medications used to improve sleep, reduce pain, and minimize fatigue. The booklet explains the role of the central nervous system in controlling pain, sleep, and neuroendocrine/stress functions. This is followed by a discussion of the mechanism of action, dosage, and side effects of various drugs, including tricyclic antidepressants, benzodiazepines, muscle relaxants, sleeping aids, selective serotonin reuptake inhibitors, mild stimulants and neuromodulating drugs, nonsteroidal anti-inflammatory drugs, immune system modulators, calcium and sodium channel blockers, pain relievers, and antiyeast regimens. Other treatment modalities discussed include combination therapies, trigger point injections, and nutritive supplements. In addition, the booklet describes common associated syndromes

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and their treatment, including temporomandibular dysfunction syndrome, chronic headaches, irritable bowel and bladder syndromes, and dysautonomia. The booklet concludes with information on medicines for the future. A list of additional information resources is included. 6 figures, 4 tables, and 82 references. •

Fibromyalgia Syndrome Source: Atlanta, GA: Arthritis Foundation. 1997. 12 p. Contact: Available from Arthritis Foundation. P.O. Box 1616, Alpharetta, GA 300091616. (800) 207-8633. Fax (credit card orders only) (770) 442-9742. http://www.arthritis.org. PRICE: Single copy free from local Arthritis Foundation chapter (call 800-283-7800 for closest local chapter); bulk orders may be purchased from address above. Summary: This brochure for people with fibromyalgia syndrome uses a question and answer format to provide information on the symptoms, diagnosis, triggers, and treatment of this condition. It discusses how fibromyalgia mainly affects muscles and their attachments to bones, and can be triggered by physical or emotional trauma, or both. The syndrome is diagnosed on the basis of the medical history and a physical examination; widespread pain in combination with tenderness at specific locations is the key to diagnosis. It explains that treatment includes medications to diminish pain and improve sleep, exercise programs, relaxation techniques and other measures to ease muscle tension, and educational programs to help patients understand and manage their condition. The brochure also provides information on the Arthritis Foundation. 2 figures.

•

Temporomandibular Joint Dysfunction and Its Relationship to the Fibromyalgia Patient Source: Washington, DC: Fibromyalgia Association of Greater Washington. 1994. [2 p.]. Contact: Available from Fibromyalgia Association of Greater Washington (FMAGW). 13203 Valley Drive, Woodbridge, VA 22191. (703) 790-2324. PRICE: Single copy free. Summary: This brochure outlines the relationship of temporomandibular joint dysfunction (TMD) and fibromylagia syndrome. The brochure stresses that TMD is a complex problem even for the otherwise healthy patient, but when it is combined with the multiple symptoms of a patient with fibromyalgia syndrome, it becomes difficult to diagnose and treat effectively without a team approach involving multiple disciplines. Because of the intricate neural pathways in and around the TM join and reflex referral arcs to far distant areas, the picture of TMD becomes complex when it is combined with the symptoms of fibromyalgia. The causes of TMD are varied and may include trauma, loss of teeth, improperly fitted dental appliances, improper orthodontic therapy, a variety of degenerative joint disease, growth and developmental problems, tumors, and bruxism (toothgrinding). Treatment ranges from simple appliance therapy along with warm, moist compresses, a soft diet and anti-inflammatory medication, to a multidisciplinary approach involving special x-rays, computerized measurement of jaw and muscle relationships and function, and specialized appliances along with physical therapy, and rheumatological evaluation. The brochure concludes that a dentist specializing in TMD or MPD (myofascial pain dysfunction) is necessary to determine the most appropriate therapy for each patient based on the presentation, severity, and dimensions of his or her symptoms and the nature of the problems present.

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Joint and Muscle Pain in Systemic Lupus Erythematosus (SLE) Source: Washington, DC: Lupus Foundation of America. 2003. 6 p. Contact: Available from Lupus Foundation of America. 2000 L. St., Suite 710, Washington, DC 20036-4916. (202) 349-1155 or (800) 558-0121. (800) 558-0231 (information in Spanish). Fax: (202) 349-1156. Website: www.lupus.org. Summary: This brochure provides information about joint and muscle pain to patients with systemic lupus erythematosus (SLE). More than 90 percent of patients with SLE will experience joint and/or muscle pain during the course of their illness. The main cause of joint pain is inflammation, which results in pain, swelling, tenderness, warmth, and fluid collection in the joint. Pain in or around the joints may also be due to other medical disorders, including fibromyalgia, avascular necrosis, tendinitis and bursitis, and other types of arthritis. Myositis (inflammation of skeletal muscle) may develop in patients with SLE. Symptoms of lupus myositis include muscle pain in the neck, pelvic girdle and thighs, shoulder girdle, and upper arms, and weakness. Diagnosis is confirmed by certain enzymes in the blood and abnormalities in the electromyogram test (a test which measures the electrical activity of muscle fibers). Corticosteroids are used to treat lupus myositis. Immunosuppressive drugs are prescribed for patients who do not respond to prednisone. Exercise may also help patients to regain muscle strength and function. Physicians should rule out drug-induced muscle disease (a possible sideeffect of medications such as prednsone and other corticosteroids) as a cause of weakness in patients with SLE.

•

Managing Fibromyalgia: Getting Past the Pain Source: San Bruno, CA: StayWell Company. 1997. 6 p. Contact: Available from StayWell Company. 1100 Grundy Lane, San Bruno, CA 940663030. (800) 333-3032. Website: www.staywell.com. PRICE: Call or write for current pricing on single and bulk orders. Summary: This brochure provides people who have fibromyalgia with information on managing this chronic disorder that causes muscle pain and body stiffness. Symptoms include the presence of tender points, a burning or throbbing pain in many parts of the body, stiffness or aching all over the body, trouble sleeping, constant tiredness, headaches, and bowel problems. People who have fibromyalgia can feel better by following a treatment plan that includes gentle exercise and good sleep habits. Other ways to feel better include reducing or managing stress, maintaining health, and consulting a doctor about sleep problems. Medications also may be used to promote sleep and relieve pain. The National Guideline Clearinghouse™

The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “myalgia” (or synonyms). The following was recently posted:

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1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infar Source: American College of Cardiology Foundation - Medical Specialty Society; 1996 November 1 (revised 1999 Sep); 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2006&nbr=1232&a mp;string=muscle+AND+pain

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2002 national guideline on the management of sexually acquired reactive arthritis Source: Association for Genitourinary Medicine - Medical Specialty Society; 1999 August (revised 2002); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3045&nbr=2271&a mp;string=muscle+AND+pain

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AACE medical guidelines for clinical practice for management of menopause Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1999 Nov-December; 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2138&nbr=1364&a mp;string=muscle+AND+pain

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AACE medical guidelines for clinical practice for the diagnosis and treatment of dyslipidemia and prevention of atherogenesis Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 2000 Mar-April; 52 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2199&nbr=1425&a mp;string=muscle+AND+pain

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AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1997 (updated 2001 May-Jun); 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2848&nbr=2074&a mp;string=muscle+AND+pain

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AAOS clinical guideline on osteoarthritis of the knee Source: American Academy of Orthopaedic Surgeons - Medical Specialty Society; 1996 (revised 2003); 17 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3856&nbr=3069&a mp;string=muscle+AND+pain

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AAOS clinical guideline on shoulder pain Source: American Academy of Orthopaedic Surgeons - Medical Specialty Society; 2001; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2998&nbr=2224&a mp;string=muscle+AND+pain

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ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Source: American College of Cardiology Foundation - Medical Specialty Society; 2000 (revised online 2002 Mar); 95 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3190&nbr=2416&a mp;string=muscle+AND+pain

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ACR Appropriateness Criteriatm for chronic elbow pain Source: American College of Radiology - Medical Specialty Society; 1998 (revised 2001); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3260&nbr=2486&a mp;string=muscle+AND+pain

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ACR Appropriateness Criteriatm for orbits, vision and visual loss Source: American College of Radiology - Medical Specialty Society; 1999; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2450&nbr=1676&a mp;string=muscle+AND+pain

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ACR Appropriateness Criteriatm for suspected cervical spine trauma Source: American College of Radiology - Medical Specialty Society; 1995 (revised 2002); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3564&nbr=2790&a mp;string=muscle+AND+pain

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Acute low back pain Source: University of Michigan Health System - Academic Institution; 1997 (revised 2003 Apr); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4112&nbr=3157&a mp;string=muscle+AND+pain

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Acute pain management Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 1997 (revised 1999 April 6); 38 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1888&nbr=1114&a mp;string=muscle+AND+pain

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Adult low back pain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1994 June (revised 2002 Sep); 61 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3498&nbr=2724&a mp;string=muscle+AND+pain

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American Gastroenterological Association medical position statement on anorectal testing techniques Source: American Gastroenterological Association - Medical Specialty Society; 1998 July 24 (reviewed 2001); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3066&nbr=2292&a mp;string=muscle+AND+pain

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American Gastroenterological Association medical position statement on treatment of patients with dysphagia caused by benign disorders of the distal esophagus Source: American Gastroenterological Association - Medical Specialty Society; 1998 November 8 (reviewed 2001); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3064&nbr=2290&a mp;string=muscle+AND+pain

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American Gastroenterological Association medical position statement: celiac sprue Source: American Gastroenterological Association - Medical Specialty Society; 2000 November 12 (reviewed 2001); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3058&nbr=2284&a mp;string=muscle+AND+pain

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American Gastroenterological Association medical position statement: diagnosis and care of patients with anal fissure Source: American Gastroenterological Association - Medical Specialty Society; 2003 January; 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3684&nbr=2910&a mp;string=muscle+AND+pain

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American Gastroenterological Association medical position statement: guidelines on constipation Source: American Gastroenterological Association - Medical Specialty Society; 2000 May 21 (reviewed 2001); 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3061&nbr=2287&a mp;string=muscle+AND+pain

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Angina pectoris and coronary artery disease (CAD) Source: Finnish Medical Society Duodecim - Professional Association; 2001 April 30 (revised 2003 October 5); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=4372&nbr=3294&a mp;string=muscle+AND+pain

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Ankle sprain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1997 August (revised 2002 Mar); 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3356&nbr=2582&a mp;string=muscle+AND+pain

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ASHP therapeutic guidelines on the pharmacologic management of nausea and vomiting in adult and pediatric patients receiving chemotherapy or radiation therapy or undergoing surgery Source: American Society of Health-System Pharmacists - Professional Association; 1999; 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1875&nbr=1101&a mp;string=muscle+AND+pain

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Assessment and management of acute pain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 2000 October (revised 2002 Oct); 74 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3500&nbr=2726&a mp;string=muscle+AND+pain

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Attention deficit and hyperkinetic disorders in children and young people. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2001 June; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2917&nbr=2143&a mp;string=muscle+AND+pain

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Benign prostatic hyperplasia Source: Finnish Medical Society Duodecim - Professional Association; 2001 April 30 (revised 2002 March 22); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3811&nbr=3037&a mp;string=muscle+AND+pain

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Bland aerosol administration: 2003 revision and update Source: American Association for Respiratory Care - Professional Association; 1993 December (revised 2003); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3752&nbr=2978&a mp;string=muscle+AND+pain

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Cancer pain Source: Singapore Ministry of Health - National Government Agency [Non-U.S.]; 2003 March; 88 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3748&nbr=2974&a mp;string=muscle+AND+pain

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Cardiovascular disease in women: a guide to risk factor screening, prevention and management Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2002; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3487&nbr=2713&a mp;string=muscle+AND+pain

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Carpal tunnel syndrome Source: Work Loss Data Institute - Public For Profit Organization; 2003; 99 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3799&nbr=3025&a mp;string=muscle+AND+pain

•

Chemotherapy and biotherapy: guidelines and recommendations for practice Source: Oncology Nursing Society - Professional Association; 2001; 226 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3209&nbr=2435&a mp;string=muscle+AND+pain

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Clinical practice guideline (second edition) for the diagnosis, treatment, and management of reflex sympathetic dystrophy/complex regional pain syndrome (RSD/CRPS) Source: Reflex Sympathetic Dystrophy Syndrome Association - Private Nonprofit Organization; 2002 February; 46 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3204&nbr=2430&a mp;string=muscle+AND+pain

•

Clinical practice guideline for post-deployment health evaluation and management Source: Department of Defense - Federal Government Agency [U.S.]; 2000 September (revised 2001 Dec); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3223&nbr=2449&a mp;string=muscle+AND+pain

•

Clinical practice guideline for the management of postoperative pain Source: Department of Defense - Federal Government Agency [U.S.]; 2001 July (revised 2002 May); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3284&nbr=2510&a mp;string=muscle+AND+pain

•

Clinical practice guidelines for chronic non-malignant pain syndrome patients II: An evidence-based approach Source: Siskin Hospital for Physical Rehabilitation Hospital/Medical Center; 1995 (updated 1999); 12 pages

(Chattanooga,

TN)

-

http://www.guideline.gov/summary/summary.aspx?doc_id=2812&nbr=2038&a mp;string=muscle+AND+pain •

Clinical utility of surface EMG: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology Source: American Academy of Neurology - Medical Specialty Society; 2000 July; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2828&nbr=2054&a mp;string=muscle+AND+pain

•

Common gynecologic problems: a guide to diagnosis and treatment Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2002; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3486&nbr=2712&a mp;string=muscle+AND+pain

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Criteria for shoulder surgery Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 1999 (revised 2002); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3424&nbr=2650&a mp;string=muscle+AND+pain

•

Deep venous thrombosis Source: Finnish Medical Society Duodecim - Professional Association; 2001 April 30 (revised 2002 Apr 20); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3384&nbr=2610&a mp;string=muscle+AND+pain

•

Diabetic foot disorders: a clinical practice guideline. Source: American College of Foot and Ankle Orthopedics and Medicine - Professional Association; 2000 September; 60 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2892&nbr=2118&a mp;string=muscle+AND+pain

•

Diagnosis and management of foodborne illnesses: a primer for physicians Source: American Medical Association - Medical Specialty Society; Reprint released 2001 January; 88 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2707&nbr=1933&a mp;string=muscle+AND+pain

•

Diagnosis and treatment of adult degenerative joint disease (DJD) of the knee Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 June (revised 2002 May); 42 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3355&nbr=2581&a mp;string=muscle+AND+pain

•

Diagnosis of chest pain Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1995 July (revised 2002 Oct); 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3674&nbr=2900&a mp;string=muscle+AND+pain

•

Disorders of the ankle and foot Source: Work Loss Data Institute - Public For Profit Organization; 2003; 76 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3798&nbr=3024&a mp;string=muscle+AND+pain

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Disorders of the elbow Source: Work Loss Data Institute - Public For Profit Organization; 2003; 78 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3800&nbr=3026&a mp;string=muscle+AND+pain

•

Disorders of the neck and upper back Source: Work Loss Data Institute - Public For Profit Organization; 2003; 109 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3803&nbr=3030&a mp;string=muscle+AND+pain

•

Evidence based clinical practice guideline for children with hypertrophic pyloric stenosis Source: Cincinnati Children's Hospital Medical Center - Hospital/Medical Center; 2001 August 8; 16 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3119&nbr=2345&a mp;string=muscle+AND+pain

•

Evidence based clinical practice guideline for managing an acute exacerbation of asthma Source: Cincinnati Children's Hospital Medical Center - Hospital/Medical Center; 1998 July 20 (revised 2002 September 3); 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3444&nbr=2670&a mp;string=muscle+AND+pain

•

Evidence-based protocol. Exercise promotion: walking in elders Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 2001 February; 53 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3074&nbr=2300&a mp;string=muscle+AND+pain

•

Exercise prescription for older adults with osteoarthritis pain: consensus practice recommendations Source: American Geriatrics Society - Medical Specialty Society; 2001 June; 16 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3188&nbr=2414&a mp;string=muscle+AND+pain

•

Fibromyalgia Source: Washington State Department of Labor and Industries - State/Local Government Agency [U.S.]; 1999; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1906&nbr=1132&a mp;string=muscle+AND+pain

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General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) Source: American Academy of Family Physicians - Medical Specialty Society; 2002 February 8; 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3180&nbr=2406&a mp;string=muscle+AND+pain

•

Global initiative for asthma. Global strategy for asthma management and prevention Source: National Heart, Lung, and Blood Institute (U.S.) - Federal Government Agency [U.S.]; 1995 January (revised 2002); 176 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3203&nbr=2429&a mp;string=muscle+AND+pain

•

Herniated disc. In: North American Spine Society phase III clinical guidelines for multidisciplinary spine care specialists Source: North American Spine Society - Medical Specialty Society; 2000; 104 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2803&nbr=2029&a mp;string=muscle+AND+pain

•

Hyperglycemic crises in patients with diabetes mellitus Source: American Diabetes Association - Professional Association; 2000 October (revised 2001; republished 2003 Jan); 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3582&nbr=2808&a mp;string=muscle+AND+pain

•

Infant and family-centered developmental care Source: National Association of Neonatal Nurses - Professional Association; 1993 (revised 2000); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2193&nbr=1419&a mp;string=muscle+AND+pain

•

Ingrown toenails Source: Academy of Ambulatory Foot and Ankle Surgery - Medical Specialty Society; 2000 (revised 2003 Sep); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4241&nbr=3241&a mp;string=muscle+AND+pain

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Intermittent positive pressure breathing: 2003 revision and update Source: American Association for Respiratory Care - Professional Association; 1993 December (revised 2003); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3753&nbr=2979&a mp;string=muscle+AND+pain

•

Low back Source: Work Loss Data Institute - Public For Profit Organization; 2003; 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3802&nbr=3029&a mp;string=muscle+AND+pain

•

Low back pain or sciatica in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 1999 May; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2578&nbr=1804&a mp;string=muscle+AND+pain

•

Lung cancer. Palliative care Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 28 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3653&nbr=2879&a mp;string=muscle+AND+pain

•

Management of chronic kidney disease and pre-ESRD in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 2000 November; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3099&nbr=2325&a mp;string=muscle+AND+pain

•

Management of patients with stroke. Rehabilitation, prevention and management of complications, and discharge planning. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 1998 April (revised 2002 Nov); 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3538&nbr=2764&a mp;string=muscle+AND+pain

104

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Management of postmenopausal osteoporosis: position statement of The North American Menopause Society Source: The North American Menopause Society - Private Nonprofit Organization; 2002 March; 18 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3179&nbr=2405&a mp;string=muscle+AND+pain

•

Management of type 2 diabetes mellitus Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 March (revised 2002 Sep); 77 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3499&nbr=2725&a mp;string=muscle+AND+pain

•

Management of unerupted and impacted third molar teeth. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2000 March; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2305&nbr=1531&a mp;string=muscle+AND+pain

•

Migraine headache Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1998 November (revised 2002 Jul); 74 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3441&nbr=2667&a mp;string=muscle+AND+pain

•

Myocardial infarction Source: Finnish Medical Society Duodecim - Professional Association; 2001 April 30 (revised 2003 July 11); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=4373&nbr=3295&a mp;string=muscle+AND+pain

•

North American Spine Society Phase III: clinical guidelines for multidisciplinary spine care specialists. Spinal stenosis version 1.0. Source: North American Spine Society - Medical Specialty Society; 2002; 91 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3609&nbr=2835&a mp;string=muscle+AND+pain

Patient Resources •

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Oral hygiene care for functionally dependent and cognitively impaired older adults Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 2002 November; 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3611&nbr=2837&a mp;string=muscle+AND+pain

•

Overview of implementation of outcome assessment case management in the clinical practice Source: Washington State Chiropractic Association - Professional Association; 2001; 54 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2786&nbr=2012&a mp;string=muscle+AND+pain

•

Pain Source: Work Loss Data Institute - Public For Profit Organization; 2003; 65 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3804&nbr=3031&a mp;string=muscle+AND+pain

•

Pain in osteoarthritis, rheumatoid arthritis, and juvenile chronic arthritis Source: American Pain Society - Professional Association; 2002; 179 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3691&nbr=2917&a mp;string=muscle+AND+pain

•

Physical activity in the prevention, treatment and rehabilitation of diseases Source: Finnish Medical Society Duodecim - Professional Association; 2002 May 7; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3398&nbr=2624&a mp;string=muscle+AND+pain

•

Practice guidelines for obstetrical anesthesia Source: American Society of Anesthesiologists - Medical Specialty Society; 1999; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1853&nbr=1079&a mp;string=muscle+AND+pain

106

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Practice parameter: the care of the patient with amyotrophic lateral sclerosis (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology: ALS Practice Parameters Task Force Source: American Academy of Neurology - Medical Specialty Society; 1999 April; 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2819&nbr=2045&a mp;string=muscle+AND+pain

•

Pressure ulcers Source: American Medical Directors Association - Professional Association; 1996 (reviewed January 2001, 2002, and 2003); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1811&nbr=1037&a mp;string=muscle+AND+pain

•

Prevention of pressure ulcers Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 1997 (revised 2002 May); 21 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3458&nbr=2684&a mp;string=muscle+AND+pain

•

Prevention of thromboembolism in spinal cord injury Source: Consortium for Spinal Cord Medicine - Private Nonprofit Organization; 1997 February (updated 1999 Sep); 29 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2965&nbr=2191&a mp;string=muscle+AND+pain

•

Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update Source: American College of Rheumatology - Medical Specialty Society; 2000 September; 11 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2935&nbr=2161&a mp;string=muscle+AND+pain

•

Recommendations regarding selected conditions affecting women's health Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 2000 March 31 http://www.guideline.gov/summary/summary.aspx?doc_id=2277&nbr=1503&a mp;string=muscle+AND+pain

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Reduction of the influenza burden in children Source: American Academy of Pediatrics - Medical Specialty Society; 2002 December; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3527&nbr=2753&a mp;string=muscle+AND+aches

•

Reflex sympathetic dystrophy/complex regional pain syndrome clinical practice guidelines - third edition Source: International Research Foundation for RSD/CRPS - Private Nonprofit Research Organization; 2003 January 1; 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4117&nbr=3162&a mp;string=muscle+AND+pain

•

Screening and management of lipids Source: University of Michigan Health System - Academic Institution; 2000 May (revised 2003 Apr); 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4114&nbr=3159&a mp;string=muscle+AND+aches

•

Specialty referral guidelines for cardiovascular evaluation and management Source: American Healthways, Inc - Public For Profit Organization; 2002; 26 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3168&nbr=2394&a mp;string=muscle+AND+pain

•

Spondylolysis, lytic spondylolisthesis and degenerative spondylolisthesis (SLD). In: North American Spine Society phase III clinical guidelines for multidisciplinary spine care specialists Source: North American Spine Society - Medical Specialty Society; 2000; 106 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2804&nbr=2030&a mp;string=muscle+AND+pain

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Surgical management of hemorrhoids Source: Society for Surgery of the Alimentary Tract, Inc - Medical Specialty Society; 1996 (revised 2000); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2171&nbr=1397&a mp;string=muscle+AND+pain

108

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The management of diabetes mellitus in the primary care setting Source: Department of Defense - Federal Government Agency [U.S.]; 1999 December; 147 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2583&nbr=1809&a mp;string=muscle+AND+pain

•

The management of persistent pain in older persons Source: American Geriatrics Society - Medical Specialty Society; 1998 October (revised 2002 Jun); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3365&nbr=2591&a mp;string=muscle+AND+pain

•

Treatment for stimulant use disorders Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1999; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2540&nbr=1766&a mp;string=muscle+AND+pain

•

Treatment of acute myocardial infarction Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 May (revised 2002 Nov); 68 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3659&nbr=2885&a mp;string=muscle+AND+pain

•

Treatment of pressure ulcers Source: University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core - Academic Institution; 1997 (revised 2002 Aug); 30 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3457&nbr=2683&a mp;string=muscle+AND+pain

•

Ultrasonographic examinations: indications and preparation of the patient Source: Finnish Medical Society Duodecim - Professional Association; 2000 April 18 (revised 2001 October 24); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3385&nbr=2611&a mp;string=muscle+AND+pain

•

Unremitting low back pain. In: North American Spine Society phase III clinical guidelines for multidisciplinary spine care specialists Source: North American Spine Society - Medical Specialty Society; 2000; 96 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2805&nbr=2031&a mp;string=muscle+AND+pain

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Vaccine preventable STDs. Sexually transmitted diseases treatment guidelines 2002 Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 1993 (revised 2002 May 10); 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3242&nbr=2468&a mp;string=muscle+AND+pain

•

VHA/DOD clinical practice guideline for the management of chronic obstructive pulmonary disease. Source: Department of Defense - Federal Government Agency [U.S.]; 1999 August; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2584&nbr=1810&a mp;string=muscle+AND+pain

•

VHA/DoD clinical practice guideline for the management of medically unexplained symptoms: chronic pain and fatigue Source: Department of Defense - Federal Government Agency [U.S.]; 2002 August; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3415&nbr=2641&a mp;string=muscle+AND+pain

•

VHA/DoD clinical practice guideline for the management of substance use disorders Source: Department of Defense - Federal Government Agency [U.S.]; 2001 September; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3169&nbr=2395&a mp;string=muscle+AND+pain 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: •

Polymyalgia Rheumatica--NLM Summary: Polymyalgia rheumatica is a rheumatic disorder that is associated with moderate to severe muscle pain and stiffness in the neck, shoulder, and hip area. Stiffness is most noticeable in the morning. Source: National Library of Medicine, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6981

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Questions and Answers about Polymyalgia Rheumatica and Giant Cell Arteritis Summary: Polymyalgia rheumatica is a rheumatic disorder that is associated with moderate to severe muscle pain and stiffness in the neck, shoulder, and hip area. Stiffness is most noticeable in the morning. Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6729 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 myalgia. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to myalgia. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with myalgia.

Patient Resources

111

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 myalgia. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “myalgia” (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 “myalgia”. 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 “myalgia” (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 “myalgia” (or a synonym) into the search box, and click “Submit Query.”

113

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.22

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

22

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)23: •

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

•

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

•

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

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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/

23

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

Finding Medical Libraries 115

•

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/

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

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

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

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

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

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

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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). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on myalgia: •

Basic Guidelines for Myalgia Muscle aches Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003178.htm

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Signs & Symptoms for Myalgia Arthralgia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm General ill feeling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm Joint pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm

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Malaise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003089.htm Muscle Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Muscle spasms Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Tension Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Weakness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003174.htm •

Diagnostics and Tests for Myalgia Blood differential Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003657.htm CBC Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003642.htm EMG Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003929.htm

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Background Topics for Myalgia Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Pain medications Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002123.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Sprains Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000041.htm

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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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MYALGIA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 5-Hydroxytryptophan: Precursor of serotonin used as antiepileptic and antidepressant. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [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] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acquired Immunodeficiency Syndrome: An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive Tlymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. [NIH] Actin: Essential component of the cell skeleton. [NIH] Actinin: A protein factor that regulates the length of R-actin. It is chemically similar, but immunochemically distinguishable from actin. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal 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] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy.

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[EU]

Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Alanine: A non-essential amino acid that occurs in high levels in its free state in plasma. It is produced from pyruvate by transamination. It is involved in sugar and acid metabolism, increases immunity, and provides energy for muscle tissue, brain, and the central nervous system. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] 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] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allium: A genus of liliaceous herbs containing onions (Allium cepa), garlic (Allium sativum), and others; many produce pungent, often bacteriostatic and physiologically active compounds and are used as food, condiment, and medicament, the latter in traditional medicine. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] 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

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acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acid Substitution: The naturally occurring or experimentally induced replacement of one or more amino acids in a protein with another. If a functionally equivalent amino acid is substituted, the protein may retain wild-type activity. Substitution may also diminish or eliminate protein function. Experimentally induced substitution is often used to study enzyme activities and binding site properties. [NIH] Amino-terminal: The end of a protein or polypeptide chain that contains a free amino group (-NH2). [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] Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [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] Anal Fissure: A small tear in the anus that may cause itching, pain, or bleeding. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] 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] Angina: Chest pain that originates in the heart. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Ankle: That part of the lower limb directly above the foot. [NIH]

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Ankylosis: Fixation and immobility of a joint. [NIH] Anorectal: Pertaining to the anus and rectum or to the junction region between the two. [EU] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antiepileptic: An agent that combats epilepsy. [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] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Anti-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] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [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]

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Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthralgia: Pain in the joint. [NIH] Articular: Of or pertaining to a joint. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atracurium: A non-depolarizing neuromuscular blocking agent with short duration of action. Its lack of significant cardiovascular effects and its lack of dependence on good kidney function for elimination provide clinical advantage over alternate non-depolarizing neuromuscular blocking agents. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [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] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical

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manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance 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]

Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] 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 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] 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] Body Fluids: Liquid components of living organisms. [NIH]

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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] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] 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]

Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bruxism: A disorder characterized by grinding and clenching of the teeth. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bupivacaine: A widely used local anesthetic agent. [NIH] Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] 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] Capsid: The outer protein protective shell of a virus, which protects the viral nucleic acid. [NIH]

Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU]

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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 Glycosides: Substances obtained from species of Digitalis, Strophanthus, and other plants that contain specific steroid glycosides or their semisynthetic derivatives and used in congestive heart failure. They increase the force of cardiac contraction without significantly affecting other parameters, but are very toxic at larger doses. Their mechanism of action usually involves inhibition of the Na(+)-K(+)-exchanging ATPase and they are often used in cell biological studies for that purpose. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiotoxic: Having a poisonous or deleterious effect upon the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Castor Oil: Oil obtained from seeds of Ricinus communis that is used as a cathartic and as a plasticizer. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cauda Equina: The lower part of the spinal cord consisting of the lumbar, sacral, and coccygeal nerve roots. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] 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 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 Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [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]

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Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] 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 Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH]

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Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [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] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] 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 characteristics. [NIH] Colchicine: A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (periodic disease). [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] 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] Communis: Common tendon of the rectus group of muscles that surrounds the optic foramen and a portion of the superior orbital fissure, to the anterior margin of which it is attached at the spina recti lateralis. [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] Concomitant: Accompanying; accessory; joined with another. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU]

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Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constitutional: 1. Affecting the whole constitution of the body; not local. 2. Pertaining to the constitution. [EU] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contracture: A condition of fixed high resistance to passive stretch of a muscle, resulting from fibrosis of the tissues supporting the muscles or the joints, or from disorders of the muscle fibres. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] 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]

Contusion: A bruise; an injury of a part without a break in the skin. [EU] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Coronavirus: A genus of the family Coronaviridae which causes respiratory or gastrointestinal disease in a variety of vertebrates. [NIH] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic

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hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Creatine: An amino acid that occurs in vertebrate tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as creatinine in the urine. [NIH]

Creatine Kinase: A transferase that catalyzes formation of phosphocreatine from ATP + creatine. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic isoenzymes have been identified in human tissues: MM from skeletal muscle, MB from myocardial tissue, and BB from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins. EC 2.7.3.2. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with longitudinal studies which are followed over a period of time. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] 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, .

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New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytomegalovirus: A genus of the family Herpesviridae, subfamily Betaherpesvirinae, infecting the salivary glands, liver, spleen, lungs, eyes, and other organs, in which they produce characteristically enlarged cells with intranuclear inclusions. Infection with Cytomegalovirus is also seen as an opportunistic infection in AIDS. [NIH] 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] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [NIH]

Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Desmoid tumor: A tumor of the tissue that surrounds muscles, usually in the abdomen. Desmoid tumors rarely metastasize. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH]

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Diastolic: Of or pertaining to the diastole. [EU] Diclofenac: A non-steroidal anti-inflammatory agent (NSAID) with antipyretic and analgesic actions. It is primarily available as the sodium salt, diclofenac sodium. [NIH] Diclofenac Sodium: The sodium form of diclofenac. It is used for its analgesic and antiinflammatory properties. [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] Digitalis: A genus of toxic herbaceous Eurasian plants of the Scrophulaceae which yield cardiotonic glycosides. The most useful are Digitalis lanata and D. purpurea. [NIH] 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] Dislocation: The displacement of any part, more especially of a bone. Called also luxation. [EU]

Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dose-limiting: Describes side effects of a drug or other treatment that are serious enough to prevent an increase in dose or level of that treatment. [NIH] 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] 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] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyslipidemia: Disorders in the lipoprotein metabolism; classified as hypercholesterolemia, hypertriglyceridemia, combined hyperlipidemia, and low levels of high-density lipoprotein (HDL) cholesterol. All of the dyslipidemias can be primary or secondary. Both elevated levels of low-density lipoprotein (LDL) cholesterol and low levels of HDL cholesterol predispose to premature atherosclerosis. [NIH] Dyspareunia: Painful sexual intercourse. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dyspnoea: Difficult or laboured breathing. [EU] Dystrophin: A muscle protein localized in surface membranes which is the product of the Duchenne/Becker muscular dystrophy gene. Individuals with Duchenne muscular dystrophy usually lack dystrophin completely while those with Becker muscular dystrophy have dystrophin of an altered size. It shares features with other cytoskeletal proteins such as spectrin and alpha-actinin but the precise function of dystrophin is not clear. One possible role might be to preserve the integrity and alignment of the plasma membrane to the myofibrils during muscle contraction and relaxation. MW 400 kDa. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular

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dystrophies. [EU] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Electroacupuncture: A form of acupuncture using low frequency electrically stimulated needles to produce analgesia and anesthesia and to treat disease. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electromyography: Recording of the changes in electric potential of muscle by means of surface or needle electrodes. [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Emaciation: Clinical manifestation of excessive leanness usually caused by disease or a lack of nutrition. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Enalapril: An angiotensin-converting enzyme inhibitor that is used to treat hypertension. [NIH]

Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endocarditis: Exudative and proliferative inflammatory alterations of the endocardium, characterized by the presence of vegetations on the surface of the endocardium or in the endocardium itself, and most commonly involving a heart valve, but sometimes affecting the inner lining of the cardiac chambers or the endocardium elsewhere. It may occur as a primary disorder or as a complication of or in association with another disease. [EU] Endocardium: The innermost layer of the heart, comprised of endothelial cells. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH]

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Endometrium: The layer of tissue that lines the uterus. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] 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] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [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] Eosinophil: A polymorphonuclear leucocyte with large eosinophilic granules in its cytoplasm, which plays a role in hypersensitivity reactions. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Erysipeloid: An infection caused by Erysipelothrix rhusiopathiae that is almost wholly restricted to persons who in their occupation handle infected fish, shellfish, poultry, or meat. Three forms of this condition exist: a mild localized form manifested by local swelling and redness of the skin; a diffuse form that might present with fever; and a rare systemic form associated with endocarditis. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ethnic Groups: A group of people with a common cultural heritage that sets them apart

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from others in a variety of social relationships. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciitis: Inflammation of the fascia. There are three major types: 1) Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orangepeel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2) Necrotizing fasciitis, a serious fulminating infection (usually by a beta hemolytic Streptococcus) causing extensive necrosis of superficial fascia; 3)

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Nodular/Pseudosarcomatous/Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Febrile: Pertaining to or characterized by fever. [EU] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosarcoma: A type of soft tissue sarcoma that begins in fibrous tissue, which holds bones, muscles, and other organs in place. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flexor: Muscles which flex a joint. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Foodborne Illness: An acute gastrointestinal infection caused by food that contains harmful bacteria. Symptoms include diarrhea, abdominal pain, fever, and chills. Also called food poisoning. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Fructose: A type of sugar found in many fruits and vegetables and in honey. Fructose is used to sweeten some diet foods. It is considered a nutritive sweetener because it has calories. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored

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in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Deletion: A genetic rearrangement through loss of segments of DNA or RNA, bringing sequences which are normally separated into close proximity. This deletion may be detected using cytogenetic techniques and can also be inferred from the phenotype, indicating a deletion at one specific locus. [NIH] Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [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] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and

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used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycoside: Any compound that contains a carbohydrate molecule (sugar), particularly any such natural product in plants, convertible, by hydrolytic cleavage, into sugar and a nonsugar component (aglycone), and named specifically for the sugar contained, as glucoside (glucose), pentoside (pentose), fructoside (fructose) etc. [EU] Gonadal: Pertaining to a gonad. [EU] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [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] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [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] Hantavirus: A genus of the family Bunyaviridae causing Hantavirus infections, first identified during the Korean war. Infection is found primarily in rodents and humans. Transmission does not appear to involve arthropods. The genus has one recognized group (Hantaan group) consisting of several species including Dobrava-Belgrade virus, Seoul virus, Prospect Hill virus, Puumala virus, Thottapalayam virus, and Hantaan virus, the type species. [NIH] Hantavirus Pulmonary Syndrome: Acute respiratory illness in humans caused by the Muerto Canyon virus whose primary rodent reservoir is the deer mouse Peromyscus maniculatus. First identified in the southwestern United States, this syndrome is characterized most commonly by fever, myalgias, headache, cough, and rapid respiratory failure. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH]

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Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhagic Fever with Renal Syndrome: An acute febrile disease occurring predominately in Asia. It is characterized by fever, prostration, vomiting, hemorrhagic phenonema, shock, and renal failure. It is caused by any one of several closely related species of the genus Hantavirus. The most severe form is caused by Hantaan virus whose natural host is the rodent Apodemus agrarius. A milder form is caused by Seoul virus and related species and transmitted by the rodents Rattus rattus and R. norvegicus. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterozygote: An individual having different alleles at one or more loci in homologous chromosome segments. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histamine Release: The secretion of histamine from mast cell and basophil granules by exocytosis. This can be initiated by a number of factors, all of which involve binding of IgE, cross-linked by antigen, to the mast cell or basophil's Fc receptors. Once released, histamine binds to a number of different target cell receptors and exerts a wide variety of effects. [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] 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

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intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] 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] Hydrogenation: Specific method of reduction in which hydrogen is added to a substance by the direct use of gaseous hydrogen. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperlipidemia: An excess of lipids in the blood. [NIH] Hypersecretion: Excessive secretion. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] 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] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH]

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

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon

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and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [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] 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] Interleukin-1: A soluble factor produced by monocytes, macrophages, and other cells which activates T-lymphocytes and potentiates their response to mitogens or antigens. IL-1 consists of two distinct forms, IL-1 alpha and IL-1 beta which perform the same functions but are distinct proteins. The biological effects of IL-1 include the ability to replace macrophage requirements for T-cell activation. The factor is distinct from interleukin-2. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Internal radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called brachytherapy, implant radiation, or interstitial radiation therapy. [NIH] Interphase: The interval between two successive cell divisions during which the chromosomes are not individually distinguishable and DNA replication occurs. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH]

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Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [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] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketorolac: A drug that belongs to a family of drugs called nonsteroidal anti-inflammatory agents. It is being studied in cancer prevention. [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] Lactate Dehydrogenase: A tetrameric enzyme that, along with the coenzyme NAD+, catalyzes the interconversion of lactate and pyruvate. In vertebrates, genes for three different subunits (LDH-A, LDH-B and LDH-C) exist. [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] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [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]

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] Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Library Services: Services offered to the library user. They include reference and circulation.

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[NIH]

Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Lipid: Fat. [NIH] Lipopolysaccharide: Substance consisting of polysaccaride and lipid. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [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] Lovastatin: A fungal metabolite isolated from cultures of Aspergillus terreus. The compound is a potent anticholesteremic agent. It inhibits 3-hydroxy-3-methylglutaryl coenzyme A reductase (hydroxymethylglutaryl CoA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It also stimulates the production of low-density lipoprotein receptors in the liver. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lupus Nephritis: Glomerulonephritis associated with systemic lupus erythematosus. It is classified into four histologic types: mesangial, focal, diffuse, and membranous. [NIH] Luxation: The displacement of the particular surface of a bone from its normal joint, without fracture. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenitis: Inflammation of the lymph nodes. [NIH]

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Lymphadenopathy: Disease or swelling of the lymph nodes. [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] Lymphocyte Count: A count of the number of lymphocytes in the blood. [NIH] Lymphocytic: Referring to lymphocytes, a type of white blood cell. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lysine: An essential amino acid. It is often added to animal feed. [NIH] Lytic: 1. Pertaining to lysis or to a lysin. 2. Producing lysis. [EU] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant fibrous histiocytoma: A sarcoma that usually begins in soft tissue. It usually appears as an enlarging, painful mass that can cause fracture due to destruction of the bone by a spreading tumor. [NIH] Malignant Hyperthermia: Rapid and excessive rise of temperature accompanied by muscular rigidity following general anesthesia. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Masseter Muscle: A masticatory muscle whose action is closing the jaws. [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Masticatory: 1. subserving or pertaining to mastication; affecting the muscles of mastication. 2. a remedy to be chewed but not swallowed. [EU] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms

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the upper jaw. [EU] Maxillary Sinus: One of the paired paranasal sinuses, located in the body of the maxilla, communicating with the middle meatus of the nasal cavity. [NIH] Meat: The edible portions of any animal used for food including domestic mammals (the major ones being cattle, swine, and sheep) along with poultry, fish, shellfish, and game. [NIH]

Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [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] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [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] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [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

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the original (primary) tumor. The plural is metastases. [NIH] Metastasize: To spread from one part of the body to another. When cancer cells metastasize and form secondary tumors, the cells in the metastatic tumor are like those in the original (primary) tumor. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Methylprednisolone: (6 alpha,11 beta)-11,17,21-Trihydroxy-6-methylpregna-1,4-diene-3,2dione. A prednisolone derivative which has pharmacological actions similar to prednisolone. [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] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [NIH] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone

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marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]

Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Myalgia: Pain in a muscle or muscles. [EU] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] 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] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH]

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Myoclonus: Involuntary shock-like contractions, irregular in rhythm and amplitude, followed by relaxation, of a muscle or a group of muscles. This condition may be a feature of some central nervous systems diseases (e.g., epilepsy, myoclonic). Nocturnal myoclonus may represent a normal physiologic event or occur as the principal feature of the nocturnal myoclonus syndrome. (From Adams et al., Principles of Neurology, 6th ed, pp102-3). [NIH] Myofibrils: Highly organized bundles of actin, myosin, and other proteins in the cytoplasm of skeletal and cardiac muscle cells that contract by a sliding filament mechanism. [NIH] Myopathy: Any disease of a muscle. [EU] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Myositis: Inflammation of a voluntary muscle. [EU] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Neck Pain: Discomfort or more intense forms of pain that are localized to the cervical region. This term generally refers to pain in the posterior or lateral regions of the neck. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural Pathways: Neural tracts connecting one part of the nervous system with another. [NIH]

Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH]

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Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Blocking Agents: Drugs that interrupt transmission of nerve impulses at the skeletal neuromuscular junction. They can be of two types, competitive, stabilizing blockers (neuromuscular nondepolarizing agents) or noncompetitive, depolarizing agents (neuromuscular depolarizing agents). Both prevent acetylcholine from triggering the muscle contraction and they are used as anesthesia adjuvants, as relaxants during electroshock, in convulsive states, etc. [NIH] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] 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] Neutrophil: A type of white blood cell. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [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] 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] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the

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chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleocapsid: A protein-nucleic acid complex which forms part or all of a virion. It consists of a capsid plus enclosed nucleic acid. Depending on the virus, the nucleocapsid may correspond to a naked core or be surrounded by a membranous envelope. [NIH] Nucleoli: A small dense body (sub organelle) within the nucleus of eukaryotic cells, visible by phase contrast and interference microscopy in live cells throughout interphase. Contains RNA and protein and is the site of synthesis of ribosomal RNA. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Ofloxacin: An orally administered broad-spectrum quinolone antibacterial drug active against most gram-negative and gram-positive bacteria. [NIH] Ophthalmoplegia: Paralysis of one or more of the ocular muscles due to disorders of the eye muscles, neuromuscular junction, supporting soft tissue, tendons, or innervation to the muscles. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum; lysomomes; plastids; and vacuoles. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [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] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [NIH] Pain Threshold: Amount of stimulation required before the sensation of pain is experienced. [NIH]

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Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] 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] Pancuronium: A bis-quaternary steroid that is a competitive nicotinic antagonist. As a neuromuscular blocking agent it is more potent than curare but has less effect on the circulatory system and on histamine release. [NIH] Panniculitis: General term for inflammation of adipose tissue, usually of the skin, characterized by reddened subcutaneous nodules. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]

Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs.

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[NIH]

Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericarditis: Inflammation of the pericardium. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peritonitis: Inflammation of the peritoneum; a condition marked by exudations in the peritoneum of serum, fibrin, cells, and pus. It is attended by abdominal pain and tenderness, constipation, vomiting, and moderate fever. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH]

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Phenoxybenzamine: An alpha-adrenergic anatagonist with long duration of action. It has been used to treat hypertension and as a peripheral vasodilator. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Medicine: A medical specialty concerned with the use of physical agents, mechanical apparatus, and manipulation in rehabilitating physically diseased or injured patients. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many bacteria. Plasmids are widely used as carriers of cloned genes. [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] Pleura: The thin serous membrane enveloping the lungs and lining the thoracic cavity. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Pleural Effusion: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymyalgia Rheumatica: A syndrome in the elderly characterized by proximal joint and

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muscle pain, high erythrocyte sedimentation rate, and a self-limiting course. Pain is usually accompanied by evidence of an inflammatory reaction. Women are affected twice as commonly as men and Caucasians more frequently than other groups. The condition is frequently associated with temporal arteritis and some theories pose the possibility that the two diseases arise from a single etiology or even that they are the same entity. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] 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] 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] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [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] Preclinical: Before a disease becomes clinically recognizable. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Preoperative: Preceding an operation. [EU] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Procollagen: A biosynthetic precursor of collagen containing additional amino acid sequences at the amino-terminal ends of the three polypeptide chains. Protocollagen, a precursor of procollagen consists of procollagen peptide chains in which proline and lysine have not yet been hydroxylated. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [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

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antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propofol: A widely used anesthetic. [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] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [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] Prostatic Hyperplasia: Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells. [NIH] Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific protein-

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binding measures are often used as assays in diagnostic assessments. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] 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] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pseudoxanthoma: A rare disease of the skin characterized by the appearance of elevated yellowish papules or plaques, particularly on the neck, chest an abdomen and infrequently on the eyelids. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]

Ptosis: 1. Prolapse of an organ or part. 2. Drooping of the upper eyelid from paralysis of the third nerve or from sympathetic innervation. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible

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collection of pus within or beneath the epidermis). [EU] Pyloric Stenosis: Obstruction of the pyloric canal. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Ramipril: A long-acting angiotensin-converting enzyme inhibitor. It is a prodrug that is transformed in the liver to its active metabolite ramiprilat. [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] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] 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] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Rehabilitative: Instruction of incapacitated individuals or of those affected with some

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mental disorder, so that some or all of their lost ability may be regained. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Relaxation Techniques: The use of muscular relaxation techniques in treatment. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Replicon: In order to be replicated, DNA molecules must contain an origin of duplication and in bacteria and viruses there is usually only one per genome. Such molecules are called replicons. [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Rhabdomyolysis: Necrosis or disintegration of skeletal muscle often followed by myoglobinuria. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rheumatology: A subspecialty of internal medicine concerned with the study of inflammatory or degenerative processes and metabolic derangement of connective tissue structures which pertain to a variety of musculoskeletal disorders, such as arthritis. [NIH] Rhusiopathiae: Causal agent of the anthropozoonosis called erysipeloid. [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] Ruminants: A suborder of the order Artiodactyla whose members have the distinguishing feature of a four-chambered stomach. Horns or antlers are usually present, at least in males. [NIH]

Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] 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] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is

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usually highly malignant. [NIH] Sciatica: A condition characterized by pain radiating from the back into the buttock and posterior/lateral aspects of the leg. Sciatica may be a manifestation of sciatic neuropathy; radiculopathy (involving the L4, L5, S1 or S2 spinal nerve roots; often associated with intervertebral disk displacement); or lesions of the cauda equina. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] 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] Sedimentation: The act of causing the deposit of sediment, especially by the use of a centrifugal machine. [EU] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Serologic: Analysis of a person's serum, especially specific immune or lytic serums. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] 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] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skin Manifestations: Dermatologic disorders attendant upon non-dermatologic disease or injury. [NIH]

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Skin test: A test for an immune response to a compound by placing it on or under the skin. [NIH]

Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [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] Spectrin: A high molecular weight (220-250 kDa) water-soluble protein which can be extracted from erythrocyte ghosts in low ionic strength buffers. The protein contains no lipids or carbohydrates, is the predominant species of peripheral erythrocyte membrane proteins, and exists as a fibrous coating on the inner, cytoplasmic surface of the membrane. [NIH]

Spectroscopic: The recognition of elements through their emission spectra. [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] Spike: The activation of synapses causes changes in the permeability of the dendritic membrane leading to changes in the membrane potential. This difference of the potential travels along the axon of the neuron and is called spike. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Nerve Roots: The paired bundles of nerve fibers entering and leaving the spinal cord at each segment. The dorsal and ventral nerve roots join to form the mixed segmental spinal

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nerves. The dorsal roots are generally afferent, formed by the central projections of the spinal (dorsal root) ganglia sensory cells, and the ventral roots efferent, comprising the axons of spinal motor and autonomic preganglionic neurons. There are, however, some exceptions to this afferent/efferent rule. [NIH] Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Spondylolisthesis: Forward displacement of one vertebra over another. [NIH] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Sprue: A non febrile tropical disease of uncertain origin. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

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] Streptococcal: Caused by infection due to any species of streptococcus. [NIH] Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU]

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Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Succinylcholine: A quaternary skeletal muscle relaxant usually used in the form of its bromide, chloride, or iodide. It is a depolarizing relaxant, acting in about 30 seconds and with a duration of effect averaging three to five minutes. Succinylcholine is used in surgical, anesthetic, and other procedures in which a brief period of muscle relaxation is called for. [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] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Synovitis: Inflammation of a synovial membrane. It is usually painful, particularly on motion, and is characterized by a fluctuating swelling due to effusion within a synovial sac. Synovitis is qualified as fibrinous, gonorrhoeal, hyperplastic, lipomatous, metritic, puerperal, rheumatic, scarlatinal, syphilitic, tuberculous, urethral, etc. [EU] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Tendinitis: Inflammation of tendons and of tendon-muscle attachments. [EU] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Tendonitis: Inflammation of tendons attached to the biceps muscle, i. e. the main flexor muscle of the upper arm. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH]

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Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombocytopenia: A decrease in the number of blood platelets. [NIH] Thromboembolism: Obstruction of a vessel by a blood clot that has been transported from a distant site by the blood stream. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Distribution: Accumulation of a drug or chemical substance in various organs (including those not relevant to its pharmacologic or therapeutic action). This distribution depends on the blood flow or perfusion rate of the organ, the ability of the drug to penetrate organ membranes, tissue specificity, protein binding. The distribution is usually expressed as tissue to plasma ratios. [NIH] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Traction: The act of pulling. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle

Dictionary 169

(pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] 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] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubocurarine: A neuromuscular blocker and active ingredient in curare; plant based alkaloid of Menispermaceae. [NIH] Tubulin: A microtubule subunit protein found in large quantities in mammalian brain. It has also been isolated from sperm flagella, cilia, and other sources. Structurally, the protein is a dimer with a molecular weight of approximately 120,000 and a sedimentation coefficient of 5.8S. It binds to colchicine, vincristine, and vinblastine. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body

170

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breaks down this protein, uric acid levels rise and can form stones. [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] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [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] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virion: The infective system of a virus, composed of the viral genome, a protein core, and a protein coat called a capsid, which may be naked or enclosed in a lipoprotein envelope called the peplos. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation

Dictionary 171

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] War: Hostile conflict between organized groups of people. [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] 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]

173

INDEX 5 5-Hydroxytryptophan, 13, 23, 61, 123 A Abdomen, 6, 123, 129, 135, 147, 148, 157, 161, 166, 167 Abdominal, 123, 135, 140, 156, 157, 169 Abdominal Pain, 123, 140, 157, 169 Acetaminophen, 50, 123 Acetylcholine, 123, 154 Acidosis, 39, 123 Acquired Immunodeficiency Syndrome, 38, 123 Actin, 123, 152, 153 Actinin, 123, 136 Adipose Tissue, 123, 156 Adjuvant, 9, 123 Adrenal Glands, 123, 125 Adrenergic, 28, 123, 138, 158 Adverse Effect, 52, 123, 164 Aerobic, 61, 123, 139, 151 Aerosol, 5, 98, 123 Affinity, 124, 165 Age of Onset, 124, 169 Alanine, 14, 54, 124 Algorithms, 124, 128 Alimentary, 107, 124, 156 Alkaline, 12, 123, 124, 125, 129 Alkaline Phosphatase, 12, 124 Alkaloid, 124, 132, 169 Alleles, 7, 124, 143 Allium, 28, 124 Alpha Particles, 124, 162 Alternative medicine, 74, 124 Amino Acid Sequence, 125, 126, 139, 159 Amino Acid Substitution, 7, 125 Amino-terminal, 125, 159 Ammonia, 26, 125 Amyloid, 125 Amyloidosis, 6, 125 Anaesthesia, 11, 17, 18, 21, 26, 30, 35, 41, 44, 47, 49, 52, 125, 145 Anal, 96, 125, 138 Anal Fissure, 96, 125 Analgesic, 60, 123, 125, 136 Analog, 7, 125 Analytes, 90, 125 Anatomical, 125, 131, 133, 145, 164

Anesthesia, 21, 41, 105, 125, 134, 137, 149, 154, 159 Angina, 97, 125 Angiogenesis, 125, 149 Animal model, 4, 7, 125 Ankle, 97, 100, 102, 125 Ankylosis, 72, 126 Anorectal, 96, 126 Anorexia, 67, 126 Antibacterial, 126, 155, 165 Antibiotic, 22, 126, 129, 165 Antibodies, 11, 13, 16, 126, 138, 144, 149, 158 Antibody, 5, 13, 19, 124, 126, 143, 145, 150, 151, 162, 165 Antidepressant, 123, 126 Antiepileptic, 123, 126 Antigen, 5, 13, 124, 126, 135, 138, 143, 144, 145, 150 Antigen-presenting cell, 126, 135 Anti-inflammatory, 8, 91, 92, 123, 126, 134, 136, 141, 147, 159 Anti-Inflammatory Agents, 126, 134, 147 Antimetabolite, 126, 151 Antineoplastic, 14, 126, 134, 151, 155, 170 Antipyretic, 123, 126, 136 Antiviral, 7, 126, 146 Anus, 125, 126, 129, 132 Apoptosis, 7, 126 Aqueous, 127, 128, 135, 148 Arachidonic Acid, 127, 160 Arginine, 127, 154 Arterial, 127, 144, 161, 167 Arteries, 54, 127, 128, 133, 148, 151, 152 Arteritis, 12, 90, 91, 110, 127, 159 Artery, 43, 97, 127, 128, 133, 137, 150, 161, 170 Arthralgia, 6, 8, 20, 26, 35, 45, 71, 119, 127 Articular, 127, 148, 155 Asymptomatic, 66, 127 Atracurium, 26, 54, 127 Atypical, 8, 127 Autonomic, 65, 123, 127, 154, 157, 166 Autonomic Nervous System, 127, 157 Axons, 127, 153, 166 B Back Pain, 103, 127

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Bacteria, 126, 127, 137, 138, 140, 142, 151, 155, 158, 163, 165, 166, 168, 170 Bacteriophage, 127, 168 Bacteriostatic, 124, 127 Basal Ganglia, 127 Basal Ganglia Diseases, 127 Base, 128, 135, 147, 167 Benign, 20, 96, 98, 128, 143, 153, 162 Benzene, 128 Benzodiazepines, 91, 128 Bile, 128, 140, 144, 148, 166 Biochemical, 18, 26, 34, 35, 124, 126, 128, 140, 155, 164 Biological response modifier, 128, 146 Biological therapy, 128, 142 Biopsy, 23, 128 Biotechnology, 9, 74, 85, 128 Bladder, 14, 92, 128, 153, 160, 169, 170 Blood Coagulation, 128, 129 Blood Platelets, 128, 164, 168 Blood pressure, 128, 144, 151, 165 Blood vessel, 125, 128, 130, 131, 132, 138, 143, 149, 157, 165, 166, 168, 170 Body Fluids, 128, 136, 165 Bone Marrow, 26, 128, 129, 141, 145, 149, 152 Bowel, 59, 92, 93, 125, 129, 136, 146, 147, 157, 169 Bowel Movement, 129, 136 Brachytherapy, 129, 146, 162 Bradykinin, 129, 154 Branch, 54, 117, 129, 137, 149, 150, 156, 161, 165, 167 Broad-spectrum, 129, 155 Bronchitis, 129, 131 Bruxism, 92, 129 Buccal, 129, 148 Bulimia, 67, 129 Bupivacaine, 129, 148 Bursitis, 70, 93, 129 C Cachexia, 67, 129 Calcium, 56, 64, 66, 91, 129, 149 Calculi, 129, 142 Capsid, 129, 155, 170 Carbohydrate, 129, 134, 142, 159 Carcinogenic, 128, 130, 160, 166 Carcinoma, 94, 130 Cardiac, 15, 66, 130, 137, 138, 139, 148, 152, 153, 166 Cardiac Glycosides, 66, 130 Cardiomyopathy, 43, 130

Cardiotonic, 66, 130, 136 Cardiotoxic, 66, 130 Cardiovascular, 98, 107, 127, 130, 139, 164 Carnitine, 45, 56, 57, 130 Case report, 22, 47, 55, 70, 130, 132 Case series, 24, 130, 132 Castor Oil, 64, 130 Catecholamine, 130, 157 Cauda Equina, 130, 164 Causal, 4, 130, 138, 163 Cell Death, 126, 130 Cell Division, 127, 130, 142, 146, 151, 158 Cell Respiration, 130, 151 Cell Size, 130, 140 Cell Survival, 130, 142 Cellulose, 131, 158 Central Nervous System, 75, 91, 123, 124, 127, 128, 131, 141, 143, 153, 164 Central Nervous System Infections, 131, 143 Cerebellar, 131, 169 Cerebellar Diseases, 131, 169 Cerebral, 127, 131, 133, 138 Cervical, 3, 95, 131, 153 Cervix, 131 Character, 131, 135 Chemotherapeutic agent, 6, 131 Chemotherapy, 6, 97, 98, 131 Chest Pain, 100, 131 Chin, 131, 150 Cholecystitis, 25, 131 Cholesterol, 128, 131, 136, 144, 148, 166 Chromatin, 126, 131 Chromosomal, 131, 158 Chromosome, 131, 142, 143 Chronic Disease, 129, 131 Chronic Fatigue Syndrome, 4, 27, 28, 38, 91, 131 Chronic Obstructive Pulmonary Disease, 67, 109, 131 Circulatory system, 132, 137, 156 Clamp, 6, 132 Clinical study, 132, 133 Clinical trial, 5, 9, 59, 62, 85, 132, 133, 136, 161, 162 Cloning, 5, 128, 132 Coenzyme, 132, 147, 148 Cohort Studies, 132, 138 Colchicine, 45, 132, 169 Colitis, 132 Collagen, 22, 29, 54, 124, 132, 139, 140, 149, 158, 159, 160

Index 175

Colon, 132, 145, 147, 169 Communis, 130, 132 Computational Biology, 85, 132 Concomitant, 45, 132 Conduction, 54, 61, 132 Congestion, 133, 138 Congestive heart failure, 130, 133 Conjugated, 133, 134 Conjunctiva, 133, 146, 169 Connective Tissue, 129, 132, 133, 140, 141, 148, 163, 167 Consciousness, 125, 133, 135 Constipation, 97, 133, 157 Constitutional, 133, 152 Constriction, 133, 170 Constriction, Pathologic, 133, 170 Consumption, 43, 133, 155 Contractility, 66, 133 Contracture, 30, 71, 133 Contraindications, ii, 133 Control group, 60, 133 Controlled clinical trial, 40, 133 Controlled study, 50, 75, 133 Contusion, 71, 133 Convulsions, 66, 133 Coronary, 43, 54, 97, 133, 151, 152 Coronary Thrombosis, 133, 151, 152 Coronavirus, 8, 133 Corticosteroid, 133, 159 Cortisone, 134, 159 Cranial, 134, 143, 156, 157, 169 Craniocerebral Trauma, 128, 134, 143 Creatine, 36, 57, 134 Creatine Kinase, 36, 134 Creatinine, 134 Cross-Sectional Studies, 134, 138 Curare, 134, 152, 156, 169 Curative, 134, 154, 167 Cutaneous, 18, 19, 33, 134, 148 Cyclic, 134, 142, 154, 160 Cytochrome, 27, 50, 134 Cytokine, 5, 7, 8, 67, 135 Cytomegalovirus, 20, 135 Cytoplasm, 126, 135, 138, 142, 152, 153 Cytoskeleton, 135, 151 Cytotoxic, 5, 135, 162 D Data Collection, 4, 135 Decision Making, 20, 135 Degenerative, 64, 92, 100, 107, 135, 152, 155, 163 Deletion, 12, 126, 135, 141

Dementia, 123, 135 Dendrites, 135, 154 Dendritic, 5, 6, 135, 165 Dendritic cell, 5, 6, 135 Density, 135, 136, 140, 148, 165 Dermal, 19, 54, 135 Desmoid tumor, 33, 135 Diabetes Mellitus, 102, 108, 135, 141, 146 Diagnostic procedure, 63, 74, 135 Diaphragm, 135, 158 Diarrhea, 135, 140 Diastolic, 136, 144 Diclofenac, 21, 136 Diclofenac Sodium, 136 Digestion, 124, 128, 129, 136, 147, 148, 166 Digestive system, 62, 136 Digitalis, 66, 130, 136 Diploid, 136, 158 Direct, iii, 3, 5, 59, 77, 136, 144, 162, 167 Dislocation, 71, 136, 166 Distal, 96, 136, 157, 161 Dose-limiting, 6, 136 Double-blind, 50, 136 Drug Interactions, 78, 136 Duct, 136, 163, 166 Dyskinesia, 136 Dyslipidemia, 94, 136 Dyspareunia, 31, 136 Dysphagia, 96, 136 Dyspnoea, 10, 136 Dystrophin, 12, 34, 46, 136 Dystrophy, 34, 46, 99, 107, 136 E Effector, 5, 22, 123, 137 Efficacy, 9, 59, 60, 137 Effusion, 137, 167 Elastin, 132, 137, 139 Electroacupuncture, 60, 137 Electrocardiogram, 61, 137 Electrolyte, 134, 137, 159, 165 Electromyography, 15, 27, 34, 35, 137 Electrophysiological, 6, 137 Elementary Particles, 137, 149, 154, 161 Emaciation, 123, 137 Embolus, 137, 145 Embryo, 137, 145 Emphysema, 131, 137 Enalapril, 35, 137 Encephalopathy, 12, 137 Endocarditis, 14, 137, 138 Endocardium, 137 Endocrine System, 137, 153

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Endogenous, 22, 29, 137, 160 Endometrium, 138, 150 Endothelial cell, 5, 137, 138 Endothelium, 138, 154 Endothelium-derived, 138, 154 Endotoxin, 138, 169 Environmental Health, 84, 86, 138 Enzymatic, 124, 129, 138, 143 Enzyme, 124, 125, 132, 137, 138, 141, 142, 147, 148, 150, 162, 170 Eosinophil, 54, 138 Eosinophilic, 16, 18, 23, 25, 32, 138, 139 Epidemic, 4, 8, 51, 138 Epidemiologic Studies, 4, 14, 138 Epidemiological, 30, 138 Epidermis, 138, 162 Epinephrine, 123, 138, 154 Epitopes, 5, 9, 138 Erysipeloid, 6, 138, 163 Erythema, 6, 138, 170 Esophagus, 96, 136, 138, 157, 166 Ethnic Groups, 7, 138 Eukaryotic Cells, 139, 155 Evacuation, 133, 139 Excitability, 6, 139 Excitation, 139, 140, 154 Exercise Test, 26, 139 Exogenous, 137, 139, 160, 169 Exon, 7, 139 Extensor, 139, 161 External-beam radiation, 139, 162 Extracellular, 125, 133, 139, 140, 149, 165 Extracellular Matrix, 133, 139, 140, 149 Extracellular Matrix Proteins, 139, 149 Extremity, 52, 139 F Family Planning, 85, 139 Fasciitis, 11, 18, 22, 23, 25, 28, 32, 139 Fat, 123, 127, 129, 134, 137, 140, 148, 163, 165 Fatigue, 4, 16, 22, 27, 39, 60, 91, 109, 131, 140, 143 Fatty acids, 140, 160 Febrile, 38, 42, 45, 140, 143, 166 Feces, 133, 140 Fibrin, 128, 140, 157, 168 Fibroblasts, 6, 29, 140 Fibrosarcoma, 140 Fibrosis, 19, 133, 140, 164 Flexor, 139, 140, 167 Flow Cytometry, 5, 140 Fluorescence, 140

Fluorescent Dyes, 140 Foodborne Illness, 100, 140 Forearm, 128, 140 Fructose, 140, 142 G Gallbladder, 123, 131, 136, 140 Gamma Rays, 141, 162 Ganglia, 123, 127, 141, 153, 157, 166 Gas, 125, 141, 144, 154, 163 Gastric, 130, 141, 143 Gastrointestinal, 28, 129, 133, 138, 140, 141, 164, 167 Gastrointestinal tract, 141, 164 Gene, 8, 12, 29, 38, 46, 124, 128, 136, 141 Gene Deletion, 46, 141 Gene Expression, 29, 141 Gene Therapy, 8, 141 Genetic Engineering, 128, 132, 141 Gland, 4, 134, 141, 148, 156, 160, 164, 166, 168 Glucocorticoid, 20, 21, 45, 141, 159 Glucose, 131, 135, 141, 142, 146, 163 Glucose Intolerance, 135, 141 Glycine, 124, 141, 154 Glycoprotein, 142, 169 Glycoside, 66, 142, 163 Gonadal, 142, 166 Gout, 67, 132, 142 Governing Board, 142, 159 Grade, 64, 142 Graft, 142, 144 Gram-negative, 142, 155 Gram-positive, 142, 155, 166 Granulocytes, 142, 147, 171 Growth, 22, 27, 92, 125, 126, 127, 130, 140, 142, 146, 149, 153, 158, 161, 168, 169 Growth factors, 27, 142 Guanylate Cyclase, 142, 154 H Hantavirus, 5, 142, 143 Hantavirus Pulmonary Syndrome, 5, 142 Haploid, 142, 158 Headache, 66, 71, 104, 142, 143, 146 Headache Disorders, 143 Heart failure, 66, 143 Heartbeat, 66, 143 Heme, 134, 143 Hemoglobinopathies, 141, 143 Hemolytic, 139, 143 Hemorrhage, 134, 143, 166 Hemorrhagic Fever with Renal Syndrome, 5, 143

Index 177

Hemorrhoids, 107, 143 Hemostasis, 143, 164 Heredity, 141, 143 Heterozygote, 7, 143 Histamine, 143, 156 Histamine Release, 143, 156 Homologous, 124, 141, 143 Hormone, 134, 138, 143, 146, 159, 163, 168 Host, 5, 127, 143, 144, 145, 170 Humoral, 5, 144 Humour, 144 Hydrogen, 123, 128, 129, 139, 144, 151, 154, 155, 161 Hydrogenation, 128, 144 Hydroxylysine, 132, 144 Hydroxyproline, 124, 132, 144 Hyperalgesia, 6, 144 Hypercholesterolemia, 136, 144 Hyperlipidemia, 136, 144 Hypersecretion, 65, 144 Hypersensitivity, 138, 144, 163 Hypertension, 42, 67, 137, 143, 144, 158 Hyperthermia, 34, 144 Hypertriglyceridemia, 136, 144 Hypertrophy, 40, 46, 144 Hyperuricemia, 142, 144 Hypotension, 133, 144 I Id, 56, 90, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 116, 118, 144 Idiopathic, 18, 144 Immune response, 5, 9, 123, 126, 134, 144, 145, 165, 167, 170 Immune Sera, 144, 145 Immune system, 9, 91, 126, 128, 144, 145, 149, 170, 171 Immunity, 7, 9, 123, 124, 145, 169 Immunization, 8, 102, 145 Immunodeficiency, 123, 145 Immunologic, 5, 145, 162 Immunology, 13, 123, 124, 140, 145 Immunosuppressant, 145, 151 Immunosuppressive, 93, 141, 145 Impairment, 25, 136, 145, 150 Implant radiation, 145, 146, 162 In vitro, 6, 7, 8, 30, 141, 145 In vivo, 6, 7, 8, 141, 145 Indicative, 70, 75, 145, 156, 170 Induction, 9, 35, 145 Infancy, 45, 145 Infarction, 145

Infiltration, 54, 145, 159 Inflammatory bowel disease, 7, 67, 145 Influenza, 78, 107, 146 Infusion, 45, 146 Ingestion, 14, 19, 22, 23, 25, 36, 40, 43, 55, 146, 158 Inhalation, 123, 146, 158 Innervation, 146, 155, 161 Insomnia, 61, 146 Insulin, 146, 169 Interferon, 7, 146 Interferon-alpha, 146 Interleukin-1, 67, 146 Interleukin-2, 146 Intermittent, 10, 103, 146 Internal Medicine, 22, 24, 33, 36, 37, 38, 43, 44, 47, 49, 146, 163 Internal radiation, 146, 162 Interphase, 146, 155 Interstitial, 10, 129, 146, 163 Intervertebral, 146, 148, 164 Intervertebral Disk Displacement, 146, 148, 164 Intestinal, 54, 147 Intestinal Mucosa, 54, 147 Intestine, 129, 144, 147, 166 Intracellular, 5, 6, 66, 145, 147, 154, 159, 160, 162 Intramuscular, 65, 147, 156 Intravenous, 146, 147, 156 Invasive, 145, 147, 149 Involuntary, 127, 147, 152, 153, 162, 165 Ion Channels, 6, 147 Isoenzyme, 134, 147 J Joint, 64, 70, 71, 92, 93, 100, 119, 126, 127, 140, 147, 148, 155, 158, 166, 167 K Kb, 84, 147 Ketorolac, 52, 147 Kidney Disease, 62, 84, 103, 147 L Lactate Dehydrogenase, 44, 147 Large Intestine, 136, 147, 162 Latent, 65, 147 Leucocyte, 138, 147 Leukemia, 33, 141, 147 Leukocytes, 129, 142, 146, 147, 151, 169 Leukopenia, 7, 147 Library Services, 116, 147 Lidocaine, 11, 15, 26, 148 Ligaments, 133, 148

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Lipid, 8, 146, 148 Lipopolysaccharide, 9, 142, 148 Lipoprotein, 136, 142, 148, 170 Liposome, 8, 148 Liver, 123, 125, 127, 128, 130, 135, 136, 140, 148, 159, 162 Localized, 6, 28, 39, 45, 65, 125, 136, 138, 145, 148, 153, 158, 164, 170 Locomotion, 148, 158 Lovastatin, 28, 148 Low Back Pain, 95, 96, 108, 148 Low-density lipoprotein, 136, 148 Lumbar, 127, 130, 146, 148 Lupus, 45, 93, 148, 167 Lupus Nephritis, 45, 148 Luxation, 136, 148 Lymph, 36, 131, 132, 138, 144, 148, 149 Lymph node, 131, 148, 149 Lymphadenitis, 4, 148 Lymphadenopathy, 36, 149 Lymphatic, 138, 145, 148, 149, 166, 168 Lymphatic system, 148, 149, 166, 168 Lymphocyte, 5, 50, 123, 126, 149, 150 Lymphocyte Count, 123, 149 Lymphocytic, 33, 149 Lymphoid, 126, 147, 149 Lysine, 144, 149, 159 Lytic, 107, 149, 164 M Macrophage, 146, 149 Magnetic Resonance Imaging, 61, 149 Magnetic Resonance Spectroscopy, 30, 39, 149 Malaise, 10, 67, 120, 149 Malignant, 33, 34, 44, 99, 123, 126, 140, 149, 153, 162, 164 Malignant fibrous histiocytoma, 33, 149 Malignant Hyperthermia, 44, 149 Malnutrition, 129, 149 Masseter Muscle, 20, 21, 45, 149 Mastication, 149, 169 Masticatory, 3, 70, 71, 149 Matrix metalloproteinase, 67, 149 Maxillary, 3, 149, 150, 156 Maxillary Sinus, 3, 150 Meat, 138, 150 Meatus, 150 Mediate, 67, 150 Mediator, 146, 150, 164 Medicament, 124, 150 MEDLINE, 85, 150

Membrane, 8, 133, 136, 139, 142, 147, 150, 152, 153, 155, 158, 165, 167 Memory, 9, 61, 126, 135, 150 Meninges, 131, 134, 150 Menopause, 94, 104, 150, 159 Menstrual Cycle, 42, 150, 160 Menstruation, 150 Mental, iv, 4, 52, 61, 62, 84, 86, 108, 131, 135, 140, 150, 161, 163 Mental Disorders, 62, 150, 161 Mental Health, iv, 4, 61, 62, 84, 86, 108, 150, 161 Mercury, 140, 150 Metabolic disorder, 142, 150 Metabolite, 148, 150, 159, 162 Metastasis, 149, 150, 153 Metastasize, 135, 151 Methotrexate, 9, 20, 151 Methylprednisolone, 45, 151 MI, 121, 151 Microbe, 151, 168 Microbiology, 127, 151 Microorganism, 151, 156, 171 Microscopy, 151, 155 Microtubules, 6, 151, 155 Millimeter, 65, 151 Mitochondria, 35, 151, 155 Mitosis, 126, 151 Modification, 124, 141, 151 Molecular, 7, 85, 87, 128, 132, 151, 162, 165, 168, 169 Molecular Structure, 151, 169 Molecule, 7, 126, 128, 132, 137, 138, 139, 142, 143, 151, 155, 158, 162, 170 Monitor, 134, 151, 154 Monoclonal, 151, 162 Monocytes, 6, 146, 147, 151 Mononuclear, 140, 151, 152, 169 Morphology, 15, 17, 152 Motility, 152, 164 Motion Sickness, 152, 153 Motor Activity, 133, 152 Motor nerve, 152 Movement Disorders, 90, 152 Mucins, 152, 163 Mucosa, 148, 152 Mucus, 152, 169 Muscle Contraction, 66, 136, 152, 154 Muscle Fibers, 65, 93, 152, 153 Muscle relaxant, 91, 152, 167 Muscle Relaxation, 152, 167 Muscle tension, 92, 152

Index 179

Muscular Dystrophies, 137, 152 Musculature, 66, 152, 166 Myalgia, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 54, 55, 56, 61, 64, 67, 70, 71, 75, 146, 152 Myasthenia, 90, 152 Myocardial infarction, 94, 104, 108, 133, 151, 152 Myocarditis, 22, 152 Myocardium, 151, 152 Myoclonus, 34, 153 Myofibrils, 136, 153 Myopathy, 17, 33, 36, 153 Myosin, 152, 153 Myositis, 3, 46, 71, 93, 153 N Nasal Mucosa, 146, 153 Nausea, 10, 97, 153 NCI, 1, 62, 83, 153 Neck Pain, 15, 153 Need, 3, 49, 69, 71, 74, 90, 111, 123, 149, 153 Neoplasia, 4, 153 Neoplasms, 123, 126, 153, 162 Nephropathy, 147, 153 Nerve, 6, 14, 16, 19, 61, 123, 125, 127, 130, 131, 135, 146, 150, 152, 153, 154, 157, 159, 161, 164, 165, 166, 169 Nerve Fibers, 6, 153, 165 Nervous System, 15, 127, 131, 150, 153, 154, 157 Neural, 54, 92, 125, 144, 153 Neural Pathways, 92, 153 Neuroendocrine, 91, 153 Neurogenic, 4, 153 Neuromuscular, 37, 45, 50, 65, 90, 123, 127, 154, 155, 156, 169 Neuromuscular Blocking Agents, 127, 154 Neuromuscular Junction, 123, 154, 155 Neurons, 6, 135, 141, 152, 153, 154, 166, 167 Neuropathy, 6, 14, 154, 157, 164 Neurotransmitter, 123, 124, 129, 142, 143, 147, 154, 167 Neutrons, 124, 154, 162 Neutrophil, 12, 154 Niacin, 56, 154, 169 Nitric Oxide, 67, 154 Nitrogen, 124, 139, 154, 169

Norepinephrine, 123, 154 Nuclear, 14, 28, 127, 139, 141, 154 Nuclei, 124, 141, 149, 151, 154, 161 Nucleic acid, 129, 154, 155 Nucleocapsid, 8, 155 Nucleoli, 11, 155 Nucleus, 126, 127, 131, 134, 135, 137, 139, 141, 146, 152, 154, 155, 161 O Ocular, 155 Ofloxacin, 47, 155 Ophthalmoplegia, 16, 155 Opportunistic Infections, 123, 155 Organelles, 135, 152, 155 Orofacial, 6, 69, 71, 155 Osteoarthritis, 64, 67, 71, 94, 101, 105, 106, 155 Osteoporosis, 70, 104, 155 Outpatient, 30, 155 Oxidation, 134, 155 Oxygen Consumption, 139, 155 P Paclitaxel, 6, 73, 155 Pain Threshold, 41, 42, 60, 155 Palliative, 103, 156, 167 Palpation, 66, 156 Pancreas, 123, 136, 146, 156 Pancreatic, 130, 156 Pancuronium, 47, 156 Panniculitis, 36, 156 Paralysis, 134, 155, 156, 161 Paranasal Sinuses, 150, 156 Parasite, 156 Parasitic, 64, 156 Parenteral, 7, 22, 26, 156 Parenteral Nutrition, 26, 156 Paresthesias, 6, 156 Parietal, 156, 157, 158 Patch, 6, 156 Pathogen, 7, 9, 156 Pathogenesis, 7, 29, 31, 39, 47, 54, 156 Pathologic, 31, 39, 123, 126, 128, 133, 144, 156, 161 Pathologic Processes, 126, 156 Pathophysiology, 4, 6, 39, 65, 156 Patient Education, 91, 114, 116, 121, 156 Pelvic, 14, 93, 157, 160 Pelvis, 123, 148, 157, 170 Peptide, 5, 9, 124, 157, 159, 161 Perception, 12, 27, 45, 46, 70, 157 Perfusion, 157, 168 Pericarditis, 6, 157

180

Myalgia

Pericardium, 157, 167 Periodontal disease, 67, 157 Peripheral blood, 8, 146, 157 Peripheral Nervous System, 15, 154, 157, 167 Peripheral Neuropathy, 6, 157 Peritoneal, 6, 157 Peritoneum, 157 Peritonitis, 6, 157 Pharmacologic, 97, 125, 157, 168 Pharmacotherapy, 72, 157 Pharynx, 146, 157 Phenotype, 141, 157 Phenoxybenzamine, 65, 158 Phosphorus, 129, 158 Physical Examination, 61, 91, 92, 158 Physical Medicine, 30, 47, 52, 72, 158 Physical Therapy, 92, 158 Physiologic, 150, 153, 158, 160, 162, 169 Physiology, 27, 34, 137, 158 Plants, 66, 124, 130, 136, 141, 142, 152, 154, 158, 163, 168 Plasma, 124, 126, 136, 141, 143, 158, 168 Plasma cells, 126, 158 Plasmid, 8, 158, 170 Platelet Aggregation, 154, 158 Platelets, 154, 158, 168 Pleura, 158 Pleural, 32, 158 Pleural cavity, 158 Pleural Effusion, 32, 158 Pneumonia, 8, 133, 158 Poisoning, 140, 150, 153, 158 Polymyalgia Rheumatica, 10, 12, 14, 26, 50, 90, 91, 109, 110, 158 Polysaccharide, 126, 131, 159 Posterior, 125, 127, 153, 156, 159, 164 Postmenopausal, 104, 155, 159 Postoperative, 11, 15, 18, 30, 41, 47, 99, 159 Potassium, 45, 159 Potentiates, 146, 159 Practice Guidelines, 86, 93, 94, 99, 107, 159 Preclinical, 7, 159 Precursor, 123, 127, 137, 138, 154, 159, 169 Prednisolone, 22, 151, 159 Prednisone, 73, 90, 93, 159 Preoperative, 21, 159 Procaine, 148, 159 Procollagen, 29, 159 Prodrug, 159, 162 Progesterone, 159, 166 Progression, 125, 160

Progressive, 16, 135, 142, 152, 155, 160, 163 Proline, 132, 144, 159, 160 Promoter, 29, 160 Prophylaxis, 160, 170 Propofol, 11, 18, 21, 35, 160 Prospective study, 12, 160 Prostaglandin, 21, 160 Prostaglandins A, 160 Prostate, 160 Prostate gland, 160 Prostatic Hyperplasia, 98, 160 Protein Binding, 160, 168 Protein S, 128, 161 Protocol, 101, 161 Protons, 124, 144, 149, 161, 162 Proto-Oncogene Proteins, 155, 161 Proto-Oncogene Proteins c-mos, 155, 161 Proximal, 136, 158, 161 Pseudoxanthoma, 33, 42, 161 Psoriasis, 52, 161 Psychiatric, 4, 27, 42, 61, 150, 161 Psychiatry, 16, 25, 30, 36, 46, 52, 161 Psychic, 150, 161 Psychogenic, 4, 161 Ptosis, 65, 161 Public Health, 24, 86, 161 Public Policy, 85, 161 Pulmonary, 20, 42, 43, 128, 133, 138, 139, 161, 170 Pulse, 45, 151, 161 Pustular, 52, 161 Pyloric Stenosis, 101, 162 Q Quaternary, 156, 162, 167 R Radiation, 97, 137, 139, 140, 141, 144, 146, 162, 171 Radiation therapy, 97, 139, 146, 162 Radioactive, 144, 145, 146, 154, 162 Radiolabeled, 162 Radiotherapy, 129, 162 Ramipril, 35, 162 Randomized, 50, 60, 137, 162 Receptor, 126, 162, 164 Receptors, Serotonin, 162, 164 Recombinant, 7, 162, 170 Recombination, 141, 162 Rectum, 126, 129, 132, 136, 141, 146, 147, 160, 162 Reductase, 148, 151, 162 Refer, 1, 66, 71, 129, 148, 154, 162, 168 Reflex, 92, 99, 107, 162

Index 181

Refraction, 162, 165 Refractory, 64, 162 Regimen, 137, 157, 162 Rehabilitative, 17, 30, 162 Relaxant, 44, 163, 167 Relaxation Techniques, 92, 163 Renal failure, 143, 163 Replicon, 8, 163 Respiratory failure, 142, 163 Restoration, 158, 163, 171 Retroviral vector, 141, 163 Rhabdomyolysis, 34, 44, 163 Rheumatic Diseases, 13, 19, 26, 27, 32, 49, 52, 60, 71, 163 Rheumatism, 14, 17, 22, 30, 32, 34, 38, 40, 41, 44, 47, 48, 50, 51, 163 Rheumatoid, 50, 64, 67, 105, 163 Rheumatoid arthritis, 50, 64, 67, 105, 163 Rhusiopathiae, 138, 163 Rigidity, 149, 158, 163 Risk factor, 44, 98, 138, 160, 163 Rod, 132, 163 Ruminants, 7, 163 S Saliva, 163 Salivary, 4, 135, 136, 163 Salivary glands, 135, 136, 163 Saponins, 163, 166 Sarcoma, 140, 149, 163 Sciatica, 103, 164 Scleroderma, 139, 164 Sclerosis, 106, 164 Screening, 5, 43, 98, 107, 132, 164 Secretion, 7, 134, 143, 144, 152, 164 Sedimentation, 90, 159, 164, 169 Semisynthetic, 130, 164 Senile, 155, 164 Sensibility, 27, 125, 144, 164 Septic, 14, 67, 164 Serologic, 22, 164 Serotonin, 20, 27, 91, 123, 154, 157, 162, 164, 169 Serum, 26, 44, 134, 144, 148, 157, 164, 169 Shock, 67, 143, 153, 164, 169 Side effect, 7, 60, 77, 91, 123, 128, 136, 144, 164, 168 Signs and Symptoms, 3, 164 Skeletal, 4, 39, 65, 93, 132, 134, 152, 153, 154, 163, 164, 165, 167 Skeleton, 123, 147, 160, 164, 165 Skin Manifestations, 6, 164 Skin test, 61, 165

Skull, 134, 165, 167 Smooth muscle, 143, 165, 167 Sodium, 66, 91, 136, 142, 165 Soft tissue, 75, 129, 140, 149, 155, 164, 165 Somatic, 144, 151, 157, 165 Sound wave, 132, 165 Spasm, 43, 65, 66, 71, 165 Specialist, 111, 165 Species, 66, 130, 132, 134, 138, 142, 143, 151, 156, 165, 166, 167, 169, 170, 171 Specificity, 5, 124, 165, 168 Spectrin, 136, 165 Spectroscopic, 14, 37, 149, 165 Spectrum, 5, 19, 49, 165 Spike, 8, 165 Spinal cord, 106, 130, 131, 150, 153, 154, 157, 162, 165, 166 Spinal Nerve Roots, 164, 165 Spinal Nerves, 157, 166 Spleen, 125, 135, 149, 166 Spondylolisthesis, 107, 166 Sprains and Strains, 90, 148, 166 Sprue, 96, 166 Steel, 132, 166 Stenosis, 104, 166 Steroid, 36, 46, 130, 134, 156, 163, 166 Stimulant, 108, 143, 166 Stimulus, 133, 139, 146, 147, 156, 162, 166, 168 Stomach, 123, 136, 138, 141, 143, 153, 157, 163, 166 Streptococcal, 12, 41, 166 Streptococci, 41, 166 Streptococcus, 139, 166 Stress, 91, 93, 120, 127, 130, 153, 163, 166, 170 Stricture, 166 Stroke, 62, 84, 90, 103, 166 Subacute, 38, 145, 166 Subarachnoid, 143, 167 Subclinical, 46, 145, 167 Subcutaneous, 36, 156, 167 Subspecies, 165, 167 Substance P, 150, 164, 167 Succinylcholine, 11, 15, 17, 18, 21, 26, 30, 41, 44, 47, 54, 167 Synapse, 123, 154, 167, 169 Synovial, 6, 167 Synovial Membrane, 167 Synovitis, 67, 71, 167 Systemic, 3, 36, 78, 93, 125, 128, 138, 145, 148, 159, 162, 164, 167, 169

182

Myalgia

Systemic lupus erythematosus, 93, 148, 167 Systolic, 144, 167 T Temporal, 5, 12, 90, 143, 150, 159, 167 Tendinitis, 70, 93, 167 Tendon, 129, 132, 167 Tendonitis, 3, 167 Therapeutics, 5, 41, 79, 99, 167 Thoracic, 10, 127, 135, 158, 167, 171 Thorax, 123, 148, 167 Threshold, 139, 144, 168 Thrombocytopenia, 5, 168 Thromboembolism, 106, 168 Thrombosis, 161, 166, 168 Thrombus, 133, 145, 158, 168, 170 Thymus, 145, 149, 168 Thyroid, 94, 168 Tin, 65, 157, 168 Tissue Distribution, 11, 168 Tonic, 130, 168 Torsion, 145, 168 Toxic, iv, 8, 13, 14, 15, 27, 29, 42, 43, 48, 50, 54, 128, 130, 134, 136, 145, 154, 168 Toxicity, 7, 8, 136, 150, 168 Toxicology, 14, 18, 22, 38, 46, 86, 168 Toxin, 40, 138, 168 Trace element, 168 Trachea, 157, 168 Traction, 132, 168 Transduction, 6, 168 Transfection, 128, 141, 169 Transfer Factor, 145, 169 Translation, 124, 169 Transmitter, 123, 147, 150, 154, 169 Transplantation, 26, 145, 169 Trauma, 92, 95, 169 Tremor, 34, 169 Tricyclic, 91, 169 Trigeminal, 26, 169 Tubocurarine, 17, 21, 169 Tubulin, 151, 169

Tumor Necrosis Factor, 67, 169 Type 2 diabetes, 104, 169 U Ulcerative colitis, 67, 146, 169 Unconscious, 144, 169 Urethra, 160, 169, 170 Uric, 142, 144, 169 Urine, 25, 36, 61, 128, 134, 169, 170 Urticaria, 7, 170 Uterus, 131, 138, 150, 159, 170 V Vaccination, 8, 170 Vaccine, 5, 8, 78, 109, 123, 161, 170 Vascular, 4, 5, 138, 143, 145, 154, 168, 170 Vasculitis, 6, 90, 170 Vasoconstriction, 65, 138, 170 Vasodilator, 129, 143, 158, 170 Vector, 8, 168, 170 Vein, 147, 154, 170 Venous, 100, 143, 161, 170 Venous Thrombosis, 100, 170 Ventricle, 161, 167, 170 Vertebrae, 146, 165, 170 Veterinary Medicine, 85, 170 Vinca Alkaloids, 170 Vincristine, 6, 169, 170 Viral, 5, 7, 8, 75, 129, 146, 168, 170 Virion, 155, 170 Virulence, 168, 170 Virus, 5, 9, 75, 78, 123, 127, 129, 131, 141, 142, 143, 146, 155, 163, 168, 170 Vitro, 170 Vivo, 171 W War, 40, 142, 171 White blood cell, 61, 64, 126, 147, 149, 152, 154, 158, 171 Windpipe, 157, 168, 171 Wound Healing, 149, 171 X Xenograft, 125, 171 X-ray, 92, 140, 141, 154, 162, 171

Index 183

184

Myalgia

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