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

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

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AUSEA 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., 1960Nausea: 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: 0-597-84525-5 1. Nausea-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 nausea. 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 NAUSEA .................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Nausea........................................................................................... 4 E-Journals: PubMed Central ....................................................................................................... 34 The National Library of Medicine: PubMed ................................................................................ 35 CHAPTER 2. NUTRITION AND NAUSEA .......................................................................................... 59 Overview...................................................................................................................................... 59 Finding Nutrition Studies on Nausea ......................................................................................... 59 Federal Resources on Nutrition ................................................................................................... 61 Additional Web Resources ........................................................................................................... 61 CHAPTER 3. ALTERNATIVE MEDICINE AND NAUSEA .................................................................... 67 Overview...................................................................................................................................... 67 The Combined Health Information Database............................................................................... 67 National Center for Complementary and Alternative Medicine.................................................. 69 Additional Web Resources ........................................................................................................... 79 General References ..................................................................................................................... 103 CHAPTER 4. DISSERTATIONS ON NAUSEA .................................................................................... 105 Overview.................................................................................................................................... 105 Dissertations on Nausea ............................................................................................................ 105 Keeping Current ........................................................................................................................ 106 CHAPTER 5. CLINICAL TRIALS AND NAUSEA ............................................................................... 107 Overview.................................................................................................................................... 107 Recent Trials on Nausea ............................................................................................................ 107 Keeping Current on Clinical Trials ........................................................................................... 110 CHAPTER 6. PATENTS ON NAUSEA ............................................................................................... 113 Overview.................................................................................................................................... 113 Patents on Nausea...................................................................................................................... 113 Patent Applications on Nausea.................................................................................................. 139 Keeping Current ........................................................................................................................ 172 CHAPTER 7. BOOKS ON NAUSEA .................................................................................................. 173 Overview.................................................................................................................................... 173 Book Summaries: Federal Agencies............................................................................................ 173 Book Summaries: Online Booksellers......................................................................................... 182 Chapters on Nausea ................................................................................................................... 183 Directories.................................................................................................................................. 184 CHAPTER 8. MULTIMEDIA ON NAUSEA ........................................................................................ 187 Overview.................................................................................................................................... 187 Video Recordings ....................................................................................................................... 187 CHAPTER 9. PERIODICALS AND NEWS ON NAUSEA ..................................................................... 191 Overview.................................................................................................................................... 191 News Services and Press Releases.............................................................................................. 191 Newsletters on Nausea............................................................................................................... 193 Newsletter Articles .................................................................................................................... 194 Academic Periodicals covering Nausea...................................................................................... 195 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 197 Overview.................................................................................................................................... 197 U.S. Pharmacopeia..................................................................................................................... 197 Commercial Databases ............................................................................................................... 208 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 213

Contents

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Overview.................................................................................................................................... 213 NIH Guidelines.......................................................................................................................... 213 NIH Databases........................................................................................................................... 215 Other Commercial Databases..................................................................................................... 217 The Genome Project and Nausea ............................................................................................... 217 APPENDIX B. PATIENT RESOURCES ............................................................................................... 221 Overview.................................................................................................................................... 221 Patient Guideline Sources.......................................................................................................... 221 Finding Associations.................................................................................................................. 242 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 245 Overview.................................................................................................................................... 245 Preparation................................................................................................................................. 245 Finding a Local Medical Library................................................................................................ 245 Medical Libraries in the U.S. and Canada ................................................................................. 245 ONLINE GLOSSARIES................................................................................................................ 251 Online Dictionary Directories ................................................................................................... 254 NAUSEA DICTIONARY.............................................................................................................. 255 INDEX .............................................................................................................................................. 349

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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 nausea is indexed in search engines, such as www.google.com or others, a nonsystematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about nausea, 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 nausea, 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 nausea. 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 nausea, 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 nausea. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON NAUSEA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on nausea.

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

Nausea, Vomiting and Diarrhea: An Unusual Presentation of Multiple Sclerosis Source: Canadian Journal of Gastroenterology. 11(4): 367-370. May-June 1997. Contact: Available from Pulsus Group, Inc. 2902 South Sheridan Way, Oakville, Ontario, Canada L6J 7L6. Summary: This article presents the case of a young woman who presented with nausea, vomiting, and diarrhea. The etiology turned out to be a first attack of multiple sclerosis (MS). MS is a multifocal demyelinating disorder that usually affects young adults with subacute onset of focal neurological symptoms. The majority (80 percent) of patients present with visual, sensory or gait disturbances; patients older than 40 years more commonly exhibit symptoms of progressive myelopathy. The 33-year-old woman presented to the emergency room with a two-week history of nausea, vomiting and

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intermittent (one to four times per day) loose watery stools without blood. The vomiting and diarrhea were not associated with cramps, fever, or chills. She experienced mild light- headedness, especially on arising, and complained of mild left neck pain. There was no history of alcohol or substance abuse. The patient's mother died of disabling MS and a younger brother was recently diagnosed with MS. Physical examination at admission disclosed a thin woman in no acute distress, with normal vital signs; general and neurological examinations were entirely within normal limits. The gastroenterologic workup was normal. Because symptoms persisted and nausea was a prominent feature, and because of the family history, neurological consultation was obtained and supported the diagnosis of MS. The authors describe her treatment and subsequent improvement. She has been well without gastrointestinal or neurological symptoms for the five years of followup. The authors conclude that cases such as these should alert non-neurology physicians that persistent upper and lower gastrointestinal symptoms may, on occasion, be a consequence of primary central nervous system pathology. 1 figure. 23 references. (AA-M). •

Will the Nausea Ever End? Source: Diabetes Forecast. 50(7): 31-32, 35-36. July 1997. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article, the first in a series on how diabetes affects the gastrointestinal tract, discusses gastroparesis (stomach paralysis). When severe, gastroparesis can be one of the most debilitating of all gastrointestinal complications of diabetes. Typical symptoms of gastroparesis include nausea, vomiting, abdominal bloating, the feeling of filling up too quickly while eating, loss of appetite, and heartburn. The author also describes the problems of matching food absorption to insulin delivery when food remains in the stomach because of gastroparesis. The author discusses diagnostic tests that may be used to confirm gastroparesis, treatment options including diet therapy and drug therapy, and prognosis issues. Drugs discussed include bethanecol, metoclopramide, cisapride, erythromycin, and domperidone. The author encourages readers to continue to search for treatments that work in their own individual cases, and not to be discouraged if it takes some time to get the symptoms under control. The article also presents the experiences of two patients and their struggles with gastroparesis.

Federally Funded Research on Nausea The U.S. Government supports a variety of research studies relating to nausea. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions.

2

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

Studies

5

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 nausea. 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 nausea. The following is typical of the type of information found when searching the CRISP database for nausea: •

Project Title: 153 SM-EDTMP FOR BONE METASTASES--PHASE I DOSE ESCALATION STUDY Principal Investigator & Institution: Anderson, Peter; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002 Summary: The purpose of this study is to learn the dose of the investigational drug 153Sm-EDTMP that can be given to patients with cancer or those whom have not responded to therapy with surgery and chemotherapy. The study will also evaluate the side effects of this drug. 153Sm-EDTMP was eliminated relatively quickly after each infusion with uptake remaining in metastases or skeleton only by 24 hr. Bladder toxicity has not occurred. We are currently using IV hydration as the only means of cystitis prevention. Total body radiation levels on day 13 have been consistently very low, well below 1 mRem/hr at 1 meter safety limit. All patients have had stem cells infused 14 days after high dose 153Sm-EDTMP. Stem cell infusions have been given as outpatient observation with side effects limited to those usually associated with DMSO cryopreservative (temporary nausea, anorexia for 4-6 hrs). All patients have become temporarily pancytopenic after 153Sm-EDTMP. Once ANC is less than 500, patients have been provided with G-CSF to speed neutrophil recovery. Platelet transfusion requirements have been variable. Most patients have required only 1-3 platelet transfusions for platelet counts <20,000. Some but not all patients have also been transfused with packet red blood cells. Recovery of neutrophil count has generally occurred before day 14. No serious infections have been documented. Only 1 patient out of 8 has had a hospital admission associated with fever and antibiotic administration during neutropenia. The fever was probably catheter related and resolved with catheter removal. Since all patients have recovered from hematopoietic toxicity within 30 days, stem cell support successfully ameliorated hematopoietic toxicity in all patients treated with high dose 153Sm-EDTMP. Furthermore, since no serious non-hematologic toxicities have been seen, stem cell infusion offers promise of a means to escalate doses of 153Sm-EDTMP to even higher levels. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: A GASTROPARESIS

MULTI-CHANNEL

GASTRIC

PACER

FOR

TREATING

Principal Investigator & Institution: Ross, Robert A.; Virginia Technologies, Inc. 2015 Ivy Rd, Ste 423 Charlottesville, Va 22903 Timing: Fiscal Year 2003; Project Start 15-SEP-2000; Project End 31-JUL-2006 Summary: (provided by applicant): In a new therapeutic approach for delayed gastric emptying and gastroparesis, Virginia Technologies, Inc. (VTI) proposes: (1) to develop a 4-channel implantable gastric pacemaker, using pulse train electrical signals and capacitive coupling for patient safety and energy efficiency; (2) to develop a multi-

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channel pacing lead, optimized for gastric applications; (3) to develop a transcutaneous programmer and wand, enabling healthcare providers to customize and optimize pacing parameters to the needs of each patient; and (4) to test this system in animal models, studying safety and efficacy. The long-term goal of this research is to develop an implantable device for the superior treatment of motility disorders associated with gastroparesis in humans. Electrical stimulation of the gastrointestinal organs represents a promising new treatment for gastric motility disorders. These organs have natural pacemakers that generate myoelectrical activity, regulating contractions and motility. Myoelectrical abnormalities can disturb muscular activity, impairing contraction and leading to delay or failure of gastric emptying. In gastroparesis, impaired gastric emptying can lead to nausea, vomiting, premature satiety, abdominal pain, abdominal bloating, weight loss, bacterial overgrowth, and obstruction, as well as difficulties in managing blood glucose levels in diabetics. Traditional therapies for gastroparesis including, prokinetic medications, tube feeding via jejunostomy and total parenteral nutrition (TPN), have various limitations. A number of patients are refractory to the available medications, which also pose the risk of side effects and medicinal interactions. Jejunostomy and TPN offer nutritional support and address the symptoms of gastroparesis, but pose quality-of-life issues and do not correct the underlying disorder. Single-point, low-energy electrical stimulation, such as that provided by Medtronic's Enterra TM Therapy, also generally treats symptoms of nausea and vomiting, rather than the underlying disorder. In a new treatment option for motility disorders, the multi-channel phased gastric pacemaker uses electrical pacing to mimic the natural propagation of gastric slow waves. It generates peristaltic electrical waves that progress from the proximal to the distal stomach, seeking to entrain gastric slow waves, normalize gastric myoelectrical dysrhythmias, and normalize gastric emptying. Recent studies have shown that multi-channel pacing entrains gastric slow waves more effectively than prior single-channel high-energy approaches, and that a multi-channel design requires less energy, making it more appropriate for a long-term humanimplantable therapeutic device. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ACUPUNCTURE TO PREVENT POSTOPERATIVE PARALYTIC LLEUS Principal Investigator & Institution: Chiang, Joseph S.; Anesthesiology; University of Texas Md Anderson Can Ctr Cancer Center Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 15-JUN-2003; Project End 28-FEB-2005 Summary: (provided by applicant): The primary aim of this prospective randomized trial is to determine if acupuncture is effective in preventing postoperative paralytic ileus (PPI) among cancer survivors undergoing colostomy/ileostomy closure. Additional objectives are to: 1) compare post-surgical quality of life status between treatment and control groups in terms of pain, use of opioid analgesics, nausea, vomiting, insomnia, abdominal distention/fullness, activity, and sense of well-being; and 2) compare costs due to extended hospital stay and care related to ileus between patients who develop PPI and those who do not. This study will also provide preliminary data for subsequent large scale projects and serve as a basis for future research in an area where existing evidence is sparse, yet potential benefits to patient care are considerable. The treatment group will receive acupuncture with electrical stimulation twice each day for 20 minutes beginning on postoperative day 1 and ending on postoperative day 4 for a total of 8 treatments. With each treatment session, 10 needles will be placed on points LI-4, Sp-6, St-36, St-25, CV-6, and CV-12, and electro-

Studies

7

acupuncture will be applied at points LI-4 and St-36. A bowel motility index including bowel sounds, passage of flatus, bowel movement, and diet tolerance will be recorded for both groups until 72 hours after acupuncture treatments have been stopped or until hospital discharge. Information regarding pain, use of opioid analgesics, nausea, vomiting, insomnia, abdominal distention/fullness, activity, and general sense of wellbeing will be compared between groups. Time (in hours) for each bowel motility indicator (bowel sounds, passage of flatus, and bowel movement) and time to hospital discharge will be compared between groups using standard survival techniques both as Kaplan-Meier analysis and adjusting for the other measured parameters in the study using proportional hazards analyses. Contingency table methods and logistic regression will be used to determine related parameters. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AGGREGATIVE E COLI Principal Investigator & Institution: Wanke, Christine A.; Associate Professor; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BEHAVIORAL AND NEURAL EFFECTS OF STATIC MAGNETIC FIELDS Principal Investigator & Institution: Houpt, Thomas A.; Assistant Professor; Biological Science; Florida State University 97 South Woodward Avenue Tallahassee, Fl 323064166 Timing: Fiscal Year 2002; Project Start 01-MAY-2001; Project End 30-APR-2004 Summary: Advances in magnetic resonance imaging (MRI) are driving the development of MRI machines beyond conventional static magnetic field strengths to fields of 4-9 tesla (T). Little is known about the sensory or physiological effects of high strength static magnetic fields on mammals and humans. We have recently discovered that 30 min exposure to a 9.4 T field has behavioral and neural effects in rats. At the behavioral level, magnetic field exposure induced a conditioned taste aversion (CTA) after pairing with the taste of saccharin. CTA has proven to be a sensitive index of visceral perturbation or malaise induced by a treatment; therefore the magnetic field may be experienced by the rat as an aversive stimulus. At the neural level, the same exposure induced specific and significant c-Fos immunoreactivity in brainstem visceral relays (e.g. the nucleus of the solitary tract and parabrachial nucleus) and in vestibular nucluei (e.g., medial vestibular nucleus). Both the behavioral response and the pattern of c-Fos activation are similar to the effects of vestibular disturbances, such as rotation. We hypothesize that the magnetic field activates the rats' vestibular apparatus, causing vertigo; this would b consistent with reports of vertigo and nausea in humans exposed to 4 T fields. These findings suggest that CTA and c-Fos expression can be used in an animal model of the effects of high-strength, static magnetic fields. We propose to determine the sensitivity of rats using the large-bore, high-strength NMR magnets available at the National High Magnetic Field Laboratory. We will make lesions of sensory sites and nerves to determine the pathways for detection of the magnetic field. We will probe the underlying pharmacology with anti-emetics and other drugs that may attenuate the effects of the field. The acute behavioral effects will be measured by observational scoring; aversive or delayed effects will be measured by CTA expression; and the neural response will be quantified by c-Fos expression throughout the brain. These experiments

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Nausea

will help predict the effects of future high-strength MRI on humans, and contribute to understanding the neural pathways underlying the effects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CEREBROVASCULAR HYPERTENSION

CHANGES

IN

PREGNANCY

AND

Principal Investigator & Institution: Cipolla, Marilyn J.; Neurology; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): Eclampsia is a serious complication of pregnancy that occurs when hypertension develops with neurologic symptoms, including headaches, nausea, visual disturbances and convulsions. While numerous organs are affected by hypertension in pregnancy, cerebrovascular involvement is the direct cause of death in approximately 40 percent of patients. The major cerebrovascular changes that occur have been shown to be similar to hypertensive encephalopathy in which acute elevations in blood pressure (i.e., acute hypertension) overcome the myogenic vasoconstriction of the cerebral arteries and arterioles causing autoregulatory failure, hyperperfusion and edema. Because women who develop eclampsia in general are normotensive prior to pregnancy, there is evidence that pregnancy affects the cerebral circulation in a way that makes the vessels susceptible to autoregulatory failure and hyperperfusion during acute hypertension. The long-term objective of this proposal is to investigate how pregnancy affects the structure and function of the cerebral circulation focusing on diameter regulation in response to changes in pressure (myogenic reactivity) and how those changes affect vascular permeability that promotes edema. Aim 1 will use isolated and pressurized posterior cerebral arteries from pregnant and nonpregnant rats to determine the pressure at which forced dilatation occurs and investigate underlying mechanisms of pregnancy-induced alterations in diameter regulation, including vascular smooth muscle actin and endothelial cell influences (e.g., nitric oxide and prostaglandins). In addition, since hypertension alone has been shown to cause significant remodeling and reactivity changes in the cerebral circulation, Aim 1 will also investigate how elevated mean arterial pressure during pregnancy affects myogenic activity and diameter regulation in a rat model of hypertension in pregnancy (nitric oxide inhibition). Acute hypertension and eclampsia are associated with significant edema formation due to disruption of the normally impermeable cerebral endothelium. Therefore, Aim 2 will investigate pregnancy-induced changes in endothelial cell permeability during acute hypertension, including enhanced fluid phase endocytosis (transcellular flux) and tight junction disruption (paracellular flux). The influence of pregnancy on permeability during forced dilatation will be determined using a combination of techniques, including clearance of fluorescent tracers and transmission electron microscopy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COMBINATION THERAPY RITONAVIR (ABT 538), LAMIVUDINE AND ZIDOVUDINE IN HIV Principal Investigator & Institution: Markowitz, Martin H.; Clincal Director; Rockefeller University New York, Ny 100216399 Timing: Fiscal Year 2002 Summary: Our group has recently reported a mean reduction in viral load of 2.1 logs in our series of 20 patients treated with the protease inhibitor ritonavir (ABT-538) in a dose

Studies

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range of 600 mg to 1200 mg daily. Durability of response appears to be dose related. Data recently presented by others were equally encouraging, with the most durable responses seen in the patients treated with 600 mg BID. Therefore, we have chosen the most active drugs available -- zidovudine (AZT) and lamivudine (3TC) and ritonavir -to treat the acutely infected person, the host with the least genetic diversity, and therefore the one least likely to harbor multiply resistant viruses. We propose that achieving a four-to-five-log reduction in viral load, which would then be followed by the appearance of the immune response, should dramatically alter the natural history of HIV-1 infection. Ritonavir (ABT-538) will be administered at 300 mg orally BID on Day 1, 400 mg orally BID on days 2 and 3, 500 mg orally BID on day 4, and 600 mg orally BID on Day 5 and subsequently, provided the patient can tolerate the dose escalation without severe nausea and/or vomiting. If needed, the dose escalations may be delayed. AZT will be administered at 200 mg orally TID, and 3TC at 150 mg orally BID. Virologic studies will include plasma RNA determinations, quantitative plasma and cell culture for HIV-1, and quantitative DNA PCR on patient PBMC. In addition, frequent monitoring of T-cell subsets will be performed to assess the viral load in the cellular compartment using flow cytometric techniques. Pharmacokinetic studies will also be performed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COMBINED PHARMACOTHERAPIES FOR ALCOHOLISM Principal Investigator & Institution: Johnson, Bankole A.; Wurzbach Distinguished Professor and Dep; Psychiatry; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2002; Project Start 10-SEP-2001; Project End 31-JUL-2006 Summary: Recent scientific and clinical interest in combining therapeutic agents for the treatment of alcoholism are based on the fact that derangement of multipleneurotransmitter systems are likely to underlie biological predisposition to the disease. Thus, combining effective medications working at different neurotransmitters should produce a synergistic or at least an added clinical response. In animals, the combination of the 5-HT3 antagonist, ondansetron, and the mu receptor antagonist, naltrexone show synergism of action at reducing ethanol consumption. Alcoholics with an early onset of disease are effectively treated by ondansetron, and those with a family history of alcoholism in first degree relatives may have the best clinical outcome to treatment with naltrexone. Given that family history of alcoholism is associated with an early onset of disease, it reasonable for us to predict that the combination of ondansetron and naltrexone should be more optimal than either alone for the treatment of Early Onset Alcoholics (EOA). Indeed, preliminary clinical data from our group provide strong support that the medication combination is an effective treatment for EOA. We will test this hypothesis by comparing the effectiveness of ondansetron (4 mg/kg) and naltrexone(50 mg/day), both alone and in combination, in treating EOA vs. Late Onset Alcoholics (LOA) (total N of 45 subjects/cell x 8 cells = 360) in a randomized, doubleblind, placebo-controlled, 12-week (1 week of single-blind placebo followed by 11 weeks of the double-blind condition) outpatient clinical trial. All subjects will receive standardized Cognitive Behavioral Therapy, and follow-up at 1, 3, 6, and 9 months posttreatment. Specifically, we predict that: 1) EOA, compared with LOA, will be more responsive to treatment with either ondansetron or naltrexone alone, and 2) that the combination of ondansetron and naltrexone will be superior to either medication alone in the treatment of EOA. We will have the unique opportunity to test with adequate power the secondary hypothesis that the combination of ondansetron and naltrexone

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will be better tolerated than naltrexone alone, thereby improving compliance. This is because nausea is an important side-effect of naltrexone which can limit compliance, and as shown in our preliminary study, ondansetron by having anti-nausea and antiemetic properties counteracts this naltrexone side-effect. We support NIAAA's mission to develop effective pharmacotherapies as adjuncts to psychotherapy for the treatment of alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: VOMITING

CORTICOTROPIN-RELEASING

FACTOR

ROLE

IN

CYCLIC

Principal Investigator & Institution: Li, B U.; Children's Memorial Hospital (Chicago) Chicago, Il 606143394 Timing: Fiscal Year 2002; Project Start 15-AUG-2002; Project End 31-JUL-2005 Summary: (provided by applicant): Cyclic vomiting syndrome (CVS) is the most severe recurrent vomiting disorder in humans and is more prevalent than previously appreciated (1 in 50 school-aged children). Although the pathogenesis remains unknown, corticotropin-releasing factor (CRF) is a tenable candidate brain-gut neuroendocrine mediator of vomiting in CVS. CRF has a well-established role in inducing gastric stasis and vomiting in animals and its resulting behavioral, autonomic, endocrine effects resemble those clinical features seen in CVS. The model of CRFinduced emeses may explain the antiemetic utility of dexamethasone during chemotherapy-induced vomiting and migraine headaches. We hypothesize that systemic CRF levels and hypothalamic-pituitary-ad renal (HPA) axis activity are heightened during episodes of CVS and migraine headache especially in those who experience concomitant nausea and vomiting. To provide direct clinical evidence of involvement of CRF pathways in CVS and migraine, we will examine CRF and HPA axis activation (ACTH, cortisol, catecholamines) in subjects with CVS, migraine headaches and controls under three conditions including: 1) when well (i.e. in between episodes), 2) during acute episodes of cyclic vomiting or migraine headaches treated with a saline placebo, and, 3) during acute episodes of cyclic vomiting or migraine headaches in which CRF is treated by dexamethasone. Under each condition, we will establish the diurnal variation of CRF and HPA axis activity and compare them to pediatric controls, both healthy and with non-CVS vomiting (gastroenteritis). In a randomized, double blind, cross-over design, we will examine the effect of dexamethasone on CRF and HPA axis activity, objective signs and subjective GI and migraine headache symptoms. CVS and migraine headaches may ultimately both be disorders involving dysregulation of CRF pathways. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DETERMINING THERAPEUTIC EFFICACY OF AGE IN AD Principal Investigator & Institution: Chauhan, Neelima B.; Assistant Professor; Anesthesiology; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2004; Project Start 01-FEB-2004; Project End 31-JAN-2006 Summary: (provided by applicant): Based on the fact that genesis of A-beta derived from amyloidogenic processing of APP is a key event in Alzheimer's pathogenesis including inflammation, and that cholesterol homeostasis and cholinergic system regulate APP processing, current Alzheimer's therapy targets cholinergic enhancement [Tacrine, Aricept/Donezepil, Rivastigmine, Galantamine]; and regulation of inflammation by NSAIDs [Aspirin, Ibuprofen, Indomethacin]; COX-2 inhibitors

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[Celebrex, Vioxx]. These drugs exert serious side effects including gastrointestinal bleeding, liver and renal toxicity, nausea, and are not effective with patients carrying ApoE gene 1. Current investigational drugs include Xanthine derivativesPropentofylline and cholesterol-lowering agents [HMG-CoA reductase inhibitorsStatins]. Although some statins are shown to be anti-amyloidogenic, few clinical trials with statins are non-conclusive due to their proinflammatory nature/39. In this respect, natural alternative(s) with pleiotropic useful properties and with least adverse effects may provide greater therapeutic benefit over single-ingredient synthetic pharmaceutical drugs having serious side effects. One such alternative is garlic. Aged garlic extract (AGE) contains multipotent phytochemicals. S-Allyl-Cystein (SAC) component of AGE inhibits NFkAPPAB, TNFalpha, IL-1Beta 3, 20, and iNOS/24. Our preliminary data show that AGE reduced TNFalpha and IL-1Beta in Tg2576 in a dose-dependent manner. SAC and Diallyl disulfide (DADS) components of AGE are natural HMG-CoA reductase inhibitors 34/46. Our preliminary data show that AGE reduced cerebral amyloid in AIzheimer's transqenic model (Tg2576). In addition, AGE is known to be free-radical scavenger that enhances anti-oxidant enzymes (SOD, catalase and glutathione reductase) 3, inhibits lipid peroxidation 20, inhibits A-beta-induced apoptosis and improves memory deficits in senescence-accelerated mice. Thus, AGE is a natural "NSAID, Statin, anti-oxidant and anti-apoptotic agent"-a combination of many singleingredient synthetic pharmaceutical drugs currently used for Alzheimer's therapy. However, the validity of AGE as Alzheimer's therapy has not been explored. This project is to determine pleiotropic effects of AGE in Alzheimer's Swedish double mutant (K670M/N671L) model (Tg2576). Hypothesis: Multi-potent natural alternative AGE will prevent or reverse AD-like pathology and ameliorate behavioral deficits in Tg2576. Specific Aims: [1] Determine if dietary AGE will promote non-amyloidogenic processing and reduce pre-existing amyloid burden in Tg2576; [2] Determine if dietary AGE will attenuate A-beta-induced inflammatory cascade in Tg2576; [3] Determine if dietary AGE will inhibit apoptosis in Tg2576; [4] Determine if dietary AGE will improve hippocampal-based Morris Water Maze performance in Tg2576. Significance: Current AD-treatment utilizing cholinergic enhancers and NSAIDs is limited due to their adverse side effects and do not modify the disease process. If successful, this project will validate the use of safe, naturally well-tolerated, cost-effective and alternative herbal pharmacotherapy for treating AD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEVELOPMENT OF POLY-L-GLUTAMIC ACID PACLITAXEL CONJUGATE Principal Investigator & Institution: Wallace, Sidney; Fem Cadet 3324 Pittsburgh St Houston, Tx 77005 Timing: Fiscal Year 2002; Project Start 15-APR-1999; Project End 31-MAY-2006 Summary: Chemoradiation improves survival for patients with locally advanced nonsmall cell lung cancer (NSCLC) over radiotherapy (R) alone. Les than 20% of patients have complete pathologic response to combination therapy. Paclitaxel (TXL) is effective as an anti-tumor agent and a radiosensitizer. Peripheral neurotoxicity and granulocytopenia limit its dosage; acute effects from TXL's infusion include nausea, hypotension, and cardiac arrhythmias related to Cremophor and ethanol. Conjugating TXL with poly-L-glutamate (PG-TXL/CT-2103) makes it water-soluble, allowing infusion of twice the amount of free TXL and higher intratumoral drug concentrations, which was confirmed by preclinical testing. Combining PG-TXL with radiation demonstrated synergistic radiation enhancement higher than that seen with other

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taxane or nucleoside analog. A phase I clinical trial of CT-2103 as single agent salvage therapy for patients with advanced solid tumors demonstrated safety and tolerability in dose up to 266 mg equivalent paclitaxel/m2 without significant alopecia. This Phase II STTR proposes a Phase I/II clinical trial of CT-213 given concurrently with chest RT in patients with unresectable Stage III or medically inoperable Stage II NSCLC. This study will determine MTD, DLT, pharmacokinetics, assess toxicity, and document patient costs. We expect this combination RT and CT-2103 to improve patient survival and response to treatment. PROPOSED COMMERCIAL APPLICATIONS: At M.D. Anderson Cancer Center, the combination of Taxol and cisplatin given concurrently with radiation therapy is the treatment of choice for lung cancer patients. In animal studies, CT-2103 is water soluble, infectable intravenously in 10 minutes without premedication, more effective (2-3X) and less toxic than Taxol. CT-2103 could possibly replace Taxol. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEVELOPMENT STUDIES OF THE INNER EAR Principal Investigator & Institution: Fekete, Donna M.; Associate Professor; Biological Sciences; Purdue University West Lafayette West Lafayette, in 479072040 Timing: Fiscal Year 2002; Project Start 01-AUG-1995; Project End 31-AUG-2004 Summary: (Adapted from the Investigator's Abstract) The goal of this research is to understand the molecular mechanisms that control patterning and cell fate determination in the developing inner ear. The inner ear, unique to vertebrates, is remarkable for the complex three-dimensional arrangement of its constituent cells, which include neurons, sensory receptors and non-sensory cells organized into tubules, ducts and other specialized tissues. It is likely that the morphogenetic mechanisms required to form such structures will be shared by vertebrates. In humans and animal models, disruption of the precise morphology of the inner ear due to congenital anomalities or disease can result in deafness, and/or difficulties with balance and equilibrium, often accompanied by profound vertigo and nausea. The PI's efforts to understand the fundamental defects that result in inner ear abnormalities are focused on both the normal processes of development and on the cascade of events that can arise as a result of a specific gene defect. The aims are to: (1) undertake a lineage analysis of the progenitor cells in the early chick otocyst to reveal when distinct cell lineages diverge, such as neurogenic vs. non-neurogenic or sensory vs. non-sensory; (2) undertake a lineage analysis of the mouse organ of Corti to determine whether hair cells and supporting cells share a common progenitor; (3) generate a fate map the chick otic cup to understand the relationships between gene expression and morphogenetic movements; and (4) force both focal and global perturbations of gene expression domains to help define the rules governing pattern formation in the eveloping inner ear. The studies will employ focal dye injections as well as infection with pseudotyped replication-defective retroviral vectors to limit gene transfer to a small number of otic cells and their progeny. The fourth aim will use replication-competent viruses to generate widespread misexpression of patterning genes. Together, the proposed studies should provide insight on the divergence of inner ear lineages and what role, if any, morphogenic movements and patterning genes play in the process. Their studies are designed to test a model of inner ear patterning that is based on the establishment of compartments and boundaries. The information provided by these animal studies may aid in understanding the molecular-genetic basis of human birth defects that cause deafness and vestibular dysfunction in humans. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DIFFERENCES BETWEEN MEN & WOMEN IN ACUTE PAIN FROM INTRATHECAL NEOSTI Principal Investigator & Institution: Eisenach, James C.; Professor; Wake Forest University 2240 Reynolda Rd Winston-Salem, Nc 27106 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EFFECTS OF ACUPUNCTURE ON PAIN,NAUSEA,QUALITY OF LIFE Principal Investigator & Institution: Rosenthal, David S.; Dana-Farber Cancer Institute 44 Binney St Boston, Ma 02115 Timing: Fiscal Year 2003; Project Start 28-SEP-2001; Project End 29-FEB-2004 Summary: (provided by applicant): Over the past several decades, an increasing number of the US public are using complementary and alternative medicine (CAM) to maintain or improve health and well being. It is estimated that within the US alone, the use of CAM has grown 380 percent since 1990 and that the public is now spending billions of dollars per year for these therapies. A large percentage of the practice and use of these methods is focused on cancer. Whether the CAM use is aimed at reducing one's risk of developing cancer or improving the quality of life of a cancer patient during treatment or at the end of life, the public focus on CAM and cancer has created a driving force for cancer centers to address the efficacy and science of these methods. At the Dana Farber Cancer Institute, CAM clinical services have been established and integrated within the oncology practice. Acupuncture, massage therapy, Reiki, spirituality programs, mind body techniques, herbal consults and a number of other clinical programs are offered through the newly established Zakim Center for Integrated Therapies. The issues of palliative care in the end of life of a cancer patient are extremely important as currently, the majority of cancer patients do not receive adequate palliative care. In this proposal, we are addressing the use of' acupuncture by traditional Chinese clinicians to address the quality of life and symptoms of patients with incurable cancer. Acupuncture has been shown to be effective in the treatment of pain and nausea and has also been shown to improve one's general well being. Acupuncture has some effectiveness in anxiety and depression as well. We seek to determine if studying such an intervention be feasible in ambulatory patients at the end of life? The study population will be women with recurrent metastatic ovarian cancer and similar patients with advanced cancer who are ambulatory and receiving conventional palliative care. These patients will continue to receive high quality conventional clinical interventions, including chemotherapy and pain and symptom reduction programs, but in addition receive acupuncture. Evaluation tools such as Satisfaction with Life Domains Scale for Cancer (SLDS-C), Brief Pain Inventory and Rotterdam Symptom Check List will be piloted to determine appropriate end points of the study as well as the feasibility of end of life patients completing the surveys. The Behavioral Research Center of the American Cancer Society will provide additional in-kind support for data analysis and evidence of effectiveness of Quality of Life measures for end of life evaluation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EFFECTS OF ORAL MARINOL ON TIME ESTIMATION AND REGIONAL CEREBRAL BLOOD FLOW Principal Investigator & Institution: Pearlson, Godfrey D.; Professor; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218

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Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: Very little research has been conducted on marijuana in the past 25 years. The AMA is urging federal funding of research to determine the validity of marijuana as an effective medical treatment and to further evaluate the abuse potential of this drug. Marinol (dronabinol) is a synthetic orally active cannabinoid with few/no mind-altering properties and limited abuse potential, prescribed for clinicaL use in AIDS and chemotherapy patients in order to reduce nausea and/or stimulate appetite. This project is based on the hypothesis that Marinol will provoke similar cerebral blood flow changes, assessed via Oxygen (015) Water PET, to those observed by other researchers after their subjects were administered THC via injection or by smoking marijuana, although Marinol will not cause intoxication ('high'). Subjects are assessed blind to dose, on 2 doses of Marinol and placebo. Data will be analyzed when the subject N is sufficiently large. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFICACY OF ACUPUNCTURE WITH PT FOR KNEE OSTEOARTHRITIS Principal Investigator & Institution: Farrar, John T.; Senior Scholar; Biostatistics and Epidemiology; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 15-JUL-2001; Project End 31-MAR-2006 Summary: Acupuncture is an ancient Chinese technique of using a fine needle to stimulate points along theoretical meridians of energy to correct imbalances thought to be responsible for specific disease states. In the United States, acupuncture is often used for the treatment of painful conditions. The 1997 NIH Consensus Conference concluded that there was adequate evidence of efficacy in an acute dental pain model and in nausea. In chronic pain, most studies were too small, poorly designed, poorly executed, or improperly controlled to adequately demonstrate that needle acupuncture worked better than sham acupuncture, placebo, standard medical therapy, or even no treatment. Osteoarthritis (OA) of the knee has been proposed as a good model to test the efficacy of acupuncture in a chronic pain condition because it is an extremely common, well defined, and disabling condition with well established outcome measures for symptoms and functional status. There is clinical trial evidence of efficacy for the standard treatments of acetaminophen and NSAIDs, and exercise physical therapy (EPT), which is usually added when the patient develops functional limitations. One high quality study of acupuncture for knee OA, demonstrated moderate benefit in an unblinded comparison to a usual care control group. As such, a major question remains about whether acupuncture, used in addition to exercise therapy, will provide a clinically meaningful improvement in pain and function. Since pain can be the primary limiting factor in improved exercise capacity, if acupuncture has any efficacy in reducing the pain of knee OA, then the combination with an EPT program should be substantially more effective than EPT alone. Another major concern is that the effect of the acupuncture may be predominantly mediated by non- specific placebo effects rather than the specific effects of the placement of a needle. Another important component of this proposal is our use of a validated blinded placebo needle instead of sham acupuncture points. Therefore, the primary goal of this proposal is to use a properly designed randomized blinded clinical trial, using American College of Rheumatology (ACR) criteria and Food and Drug Administration (FDA) recommended outcome measures, to determine whether the addition of acupuncture to standard EPT provides an overall clinically important benefit to patients with symptomatic knee OA compared to placebo acupuncture. As a secondary goal, we will use the clinical trial data to

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develop prognostic and etiologic models for the patients that are most likely to respond to acupuncture. If a clinically important benefit for acupuncture is found, a broader application of this technique would be justified. However, if the results are negative, then the addition of acupuncture to EPT should be generally curtailed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EVALUATION OF CHEMOTHERAPY CLAIMS FOR BREAST CANCER Principal Investigator & Institution: Du, Xianglin; Internal Medicine; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2002; Project Start 01-MAR-2001; Project End 28-FEB-2004 Summary: (provided by applicant): Over the past several decades, numerous clinical trials have consistently demonstrated that chemotherapy is efficacious in both premenopausal and postmenopausal women with breast cancer. However, little is known about the use of chemotherapy and its effectiveness in the community because of a lack of large population-based data. While the Surveillance, Epidemiology and End Results (SEER) tumor registries provide data on radiation therapy and surgical treatment for breast cancer, they do not provide information on chemotherapy. They are not required to collect this information, and the medical records in oncologists' offices, where chemotherapy is likely to be administered, may not be routinely reviewed for data on the primary course of cancer-directed therapy. Medicare claims are a potential source of national data on chemotherapy use for breast cancer cases aged 65 and older. However, no study has examined the validity of this information. If Medicare claims provide accurate and complete data on chemotherapy, their utility for breast cancer research would be considerably enhanced, allowing for population-based analyses of the current uses of chemotherapy as well as effectiveness studies in the community. Therefore, we propose to examine the utility of information on chemotherapy from Medicare claims data for women aged 65 and older who have been diagnosed with breast cancer. Our approach is to identify women aged 65 years or older who have been diagnosed with breast cancer in the New Mexico Tumor Registry (a SEER registry), that can be linked with Medicare claims data by unique identifiers. We will contract with the registry to abstract the medical records on chemotherapy administration for eligible patients in all facilities including medical oncologists' offices where patients may have received chemotherapy. We will then compare information on the use of chemotherapy from medical chart review with information obtained from Medicare claims data. Our aims are 1) to determine whether Medicare data can identify women who received chemotherapy for breast cancer; 2) to determine whether Medicare data can differentiate among the specific regimens of chemotherapy; and 3) to determine whether the number of claims can be used to estimate the number of cycles of chemotherapy. Based on this information, we will characterize the nature and extent of error in using Medicare claims for chemotherapy effectiveness research among older women diagnosed with breast cancer. We will then use the Medicare-SEER linked data for all SEER areas to examine patterns and outcomes of chemotherapy among older women with breast cancer. Information generated from the medical chart reviews will also allow us to examine patterns of chemotherapy care independent of the Medicare claims data or independent of those parts of the claims that we find generate invalid estimates. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GINGER CONTROL OF CHEMOTHERAPY INDUCED NAUSEA AND EMESIS Principal Investigator & Institution: Zick, Suzanna M.; Family Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2003; Project Start 15-MAY-2003; Project End 28-FEB-2005 Summary: (provided by applicant): Chemotherapy induced nausea and vomiting significantly reduces patients' quality of life, increases fatigue, anxiety, and increases costs of health care delivery. Ginger (Zingiber officinalis) is already used in traditional folk medicine to treat nausea and vomiting in various populations. Ginger's ability to block 5-HT3 receptors and its free-radical scavenging in the intestines suggest that it may be beneficial for reducing both the prevalence and severity of chemotherapy induced nausea and vomiting. Despite ginger's possible benefits in reducing the prevalence and severity of chemotherapy induced nausea and vomiting, no dosing and/or safety studies have been performed. Therefore we propose a double-blind, placebo-controlled, five-armed, randomized clinical trial to assess the efficacy and safety of four dose levels (100 mg, 500 mg, 1000 mg, or 1500 mg, orally/day) of Zingiber officinalis extract (standardized for 5% gingerols) in patients undergoing chemotherapy (cisplastin or adriamycin) who have experienced at least one episode of chemotherapy induced nausea and vomiting despite optimal conventional medical therapy. The primary aim of the study is to determine the most efficacious dose of powdered gingerroot for reducing the prevalence and severity of acute nausea and vomiting. Secondary aims of the study include (1) determination of the most efficacious dose of powdered ginger-root for reducing the prevalence and severity of delayed nausea and vomiting; (2) assessment of the safety of different doses of oral powdered ginger root in patients receiving chemotherapy; and (3) determination if study participants can discern if they are receiving placebo or ginger. Participants receiving either adriamycin or cisplatin for cancer related treatment will be randomized to receive one of four doses of powdered ginger or placebo immediately prior to chemotherapy infusion. Participants will be followed for 48 hours after infusion in order to assess frequency and severity of nausea and vomiting. Baseline and 48 hour post chemotherapy labs will be used to assess safety profile of ginger. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SENSITIVITY

INTERSTITIAL

CELL

OF

CAJAL

IN

VAGAL

AFFERENT

Principal Investigator & Institution: Ward, Sean M.; Associate Professor; Physiology and Cell Biology; University of Nevada Reno 204 Ross Hall Mailstop 325 Reno, Nv 89557 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 30-JUN-2005 Summary: The smooth muscle layers of the gastric fundus generate tonic contraction or relaxation and are critical in the regulation of gastric volume. Upon food ingestion the proximal stomach relaxes to accommodate the increases in gastric volume without concurrent changes in gastric pressure. This accommodation, known as adaptive relaxation, is under both intrinsic and extrinsic neural control. Vagal afferent stretch sensitive fibers located in the muscle layers are stimulated by gastric distension and trigger vagovagal efferent and local enteric pathways that increase gastric motility and gastric emptying. Millions of patients with functional dyspepsia and gastroparesis, both idiopathic and that associated with diabetes mellitus, have low vagal tone and impaired postprandial gastric meal accommodation which is often accompanied with symptoms of abdominal pain, bloating and nausea. Using a combined morphological and

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physiological approach, the broad long term objective of the present study is to determine the changes which occur in vagal and enteric afferent sensitive mechanisms that are associated with dramatic changes in gastric accommodation in animals lacking interstitial cells of Cajal (ICC). To address this main objective, the specific aims of this project will examine the importance of interstitial cells of Cajal (ICC), which are found as intramuscular arrays in the muscle layers of the stomach in: I) The development, guidance and maintenance of vagal afferent fibers in the stomach. ii) Whether ICC possess in-series stretch sensitive channels that could trigger afferent pathways and stomach accommodation. iii) To determine the role of ICC in gastric accommodation and whether loss of ICC affects vagal afferent discharge and gastric accommodation in mutant mice lacking ICC. These studies work will be combined with structural studies to determine the morphological relationships between vagal afferent arrays and intramuscular ICC in adult and developing animals. Experiments outlined in this proposal will provide important novel information on the role of ICC in afferent stretch sensitivity in the stomach. This information could also be extended to other organs of the gastrointestinal tract. In doing so we will aid future studies toward understanding how these cells may be critical in pathophysiological disease states. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MASSAGE FOR HOSPITALIZED PATIENTS WITH METASTATIC CANCER Principal Investigator & Institution: Phillips, Russell S.; Chief, Division of General Medicine And; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2004; Project Start 01-APR-2004; Project End 31-MAR-2006 Summary: (provided by applicant): Symptoms such as pain and nausea are common among patients with metastatic cancer, and symptom control is often inadequate. Massage therapy has been advocated as adjunctive therapy in the management of cancer related pain, but has received little careful study. We propose to examine the safety, acceptability, and tolerated duration of massage therapy among hospitalized patients with metastatic solid malignancies associated with poor prognoses. We will determine the feasibility of a randomized controlled trial of massage among hospitalized patients with cancer, and gather preliminary data on the efficacy of massage. Hospitalized patients will be screened at the time of admission for enrollment into the proposed study. Patients with a planned length of stay of 3 days or less will be excluded, as will patients who do not report pain related to their cancer. After obtaining informed consent, we will randomize patients to receive either daily massage, to a simple presence non-touch control group, or usual care. To optimize our ability to study safety and tolerated duration of massage, 50 patients will be randomized to massage while 25 patients will be randomized to usual care, and 25 patients will be randomized to a simple presence control group. The massage intervention will be provided daily by therapists using a standard scope of practice. Detailed data will be obtained by chart review and patient, physician, nurse, and caregiver interviews. Primary outcomes evaluated will be the safety and tolerated duration of massage. We will gather preliminary data on massage efficacy by collecting data on pain, anxiety, nausea, depression, shortness of breath, and satisfaction with symptom management during the hospitalization, and gain experience with a novel control group. Following completion of the first phase of data collection, we will provide instruction to caregivers enabling them to provide massage for patients at home, and we will gather data on the use of caregiver massage. We will also explore the potential for the intervention to improve the caregivers' experience caring for a loved one with metastatic cancer. The results of the

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proposed study will provide information on safety and dosage and provide the basis for more extensive study of the effects of massage among patients with cancer. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MATERNAL HYPOTENSION & EPIDURAL ANESTHESIA FOR CSECTION Principal Investigator & Institution: Fiedler, Michael A.; None; University of Tennessee Health Sci Ctr Memphis, Tn 38163 Timing: Fiscal Year 2002; Project Start 01-APR-2002 Summary: Data on central hemodynamics of pregnant women during regional anesthesia is lacking. The purpose of this study is to determine the 1) influence of heart rate (HR), stroke volume (SV), systemic vascular resistance (SVR) and IV fluid administration on maternal hypotension after epidural anesthesia and 2) the pattern of these variables throughout C-section. Despite preventative measures, hypotension during regional anesthesia for cesarean section is common. Maternal hypotension poses a risk to fetal oxygenation, causes maternal nausea and vomiting, and poses maternal danger when extreme. Intravenous fluid is most often used to prevent hypotension, but an optimal volume of fluid has not been found and the incidence of hypotension varies widely. Fluid alone at best reduces the incidence of hypotension at 38%. An underlying practice assumption is that regional anesthesia, which results in a chemical sympathectomy, causes hypotension by reducing venous return and does not significantly reduce widely. Fluid alone at best reduces the incidence of hypotension at 38%. An underlying practice assumption is that regional anesthesia, which results in a chemical sympathectomy, causes hypotension by reducing venous return and does not significantly reduce SVR. This view is based on an average 15% (range up to 40%) reduction in SVR in non-pregnant persons. But there is evidence that SVR is reduced more in pregnant than non-pregnant women during regional anesthesia. If SVR is reduced sufficiently, fluid alone will not increase cardiac output enough to prevent hypotension. In this case, addressing SVR should result in superior prevention of hypotension. Determining which variables have a significant influence on the pattern of hypotension over time is necessary to direct future interventional studies. Elimination of maternal hypotension will reduce the risk of fetal hypoxemia, maternal discomfort, and maternal morbidity while improving maternal enjoyment of the birth experience. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MECHANISMS OF REGULATION OF CARDIAC AFFERENTS Principal Investigator & Institution: Longhurst, John C.; Professor; Medicine; University of California Irvine Irvine, Ca 926977600 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2006 Summary: (provided by the applicant): Reflexes from the heart play an important role in regulation of the cardiovascular system during myocardial ischemia and reperfusion. Responses can include profound alterations in hemodynamic function manifested as either reflex cardiovascular depression during stimulation of vagal afferent endings or excitation with activation of sympathetic (spinal) afferents. Stimulation of sensory nerves in the heart thus can cause hypotension, bradyarrhythmias, nausea and vomiting (vagal afferents) or angina, hypertension and tachyarrhythmias (sympathetic afferents). Limited information is available on mechanisms of activation of sympathetic cardiac afferents that also function as cardiac nociceptors, although our recent data in cats indicate that, in contrast to adenosine, reactive oxygen species (ROS), especially

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hydroxyl radicals ('OH), kinins, protons (H+) and prostaglandins are important stimuli. Because inhibition of these stimuli and their receptor interactions does not fully eliminate the response of these sensory afferent endings to ischemia, we suspect that other metabolic or mechanical stimuli play a role in their activation and that interactions between stimuli are present. We propose a series of studies to test the hypotheses that platelets are a source of serotonin (5HT) and histamine. Activated platelets release serotonin and histamine that, through 5HT3 and H1 and possibly H2 receptors, respectively, stimulate cardiac sympathetic afferents during ischemia and reperfusion. Interactions between these two putative and other known chemical mediators will be explored. In addition, the role of diacylglycerol/protein kinase C (PKC) and cyclic adenosine monophosphate (cAMP)/protein kinaseA (PKA) signaling systems in histamine's action on ischemically sensitive cardiac sympathetic afferents will be defined. We will employ liquid chromatography to measure the production of mediators in blood and tissue. Single unit afferent electrical activity will be recorded and selective pharmacological receptor blockade or enzymatic pathway inhibition will be used to evaluate the role of each potential chemical mediator. Chemosensitive, mechanosensitive and bimodal endings of unmyelinated and myelinated fibers will be identified through a series of chemical and mechanical challenges, the latter assessed by hemodynamic measurement and regional myocardial deformation. The proposed studies therefore will define mechanisms by which cardiac sympathetic endings are activated during ischemia and reperfusion. Such information will provide physicians with a better understanding of angina and potentially dangerous sympathoexcitatory cardiac reflexes and may suggest therapeutic approaches designed to limit these events that impact patient morbidity and mortality during myocardial ischemia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MITOCHONDRIAL DNA ANALYSIS IN CYCLIC VOMITING SYNDROME Principal Investigator & Institution: Boles, Richard G.; Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, Ca 90027 Timing: Fiscal Year 2002; Project Start 01-SEP-2000; Project End 31-AUG-2004 Summary: (from applicants abstract): Cyclic vomiting syndrome (CVS) is a disabling condition characterized by multiple severe and distinct episodes of nausea, vomiting, lethargy and variable other symptoms separated by asymptomatic intervals. Although CVS is generally believed to be a (predominantly) childhood variant of migraine, its etiology and pathogenesis are poorly understood. Several features of CVS, including a maternal bias in inheritance, suggest that mitochondrial DNA (mtDNA) sequence variations/mutations may be involved in its etiology. A significant subset of children with CVS have additional neuromuscular disease manifestations including cognitive dysfunction and epilepsy. Maternal inheritance of migraine and/or various neuromuscular disorders and lactic acidosis are present in ten children with CVS followed by the investigators, strongly suggesting that mtDNA mutations are involved in at least some cases. An inherited complex mtDNA rearrangement was found in one. Preliminary results using temporal temperature gradient gel electrophoresis (TTGE) found heteroplasmic sequence variations in the mtDNA D-loop in 2 additional CVS cases. TTGE is a novel mutation detection assay which was developed for use with mtDNA by the PI and collaborators. TTGE is sensitive and cost effective relative to other methods and for the first time permits the screening of large groups of patients for mutations throughout the entire mtDNA. Since mtDNA sequence variations are postulated to be more likely involved among CVS sufferers with additional

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neuromuscular disease manifestations, in the first sub-study 50 of these individuals will be screened by TTGE for all sequence variations throughout the mtDNA. The incidence of CVS cases caused by mtDNA sequence variations will be determined in a second substudy in which the mtDNA in an unbiased group of 100 CVS sufferers will be screened. All sequence variations found in CVS sufferers will be compared against those found upon an identical screening of 100 control individuals, and any of interest will be sequenced. Pathogenicity of suspected mutations will be determined in rho negative cybrids. An extensive amount of clinical and laboratory data will be collected in all patients, allowing for the comparison of CVS sufferers with and without mtDNA mutations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NK1 ONDANSETRON

ANTAGONIST

GR205171

&

IN

COMBINATION

W

Principal Investigator & Institution: Koch, Kenneth L.; Pennsylvania State Univ Hershey Med Ctr 500 University Drive Hershey, Pa 170332390 Timing: Fiscal Year 2002 Summary: There is no text on file for this abstract. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NOVEL DYSMOTILITY

EVALUATION

AND

TREATMENT

OF

GASTRIC

Principal Investigator & Institution: Parkman, Henry P.; Associate Professor; Medicine; Temple University 406 Usb, 083-45 Philadelphia, Pa 19122 Timing: Fiscal Year 2002; Project Start 01-MAR-2001; Project End 28-FEB-2006 Summary: Gastric dysmotility may be due to delayed gastric emptying, antral hypomotility, and/or gastric dysrhythmias. Gastric motor dysfunction is an important component of several clinical disorders including gastroparesis, functional dyspepsia, and intestinal pseudoobstruction. Our overall hypothesis is that gastric motility can be measured conveniently with noninvasive tests which can have widespread availability and provide clinically relevant information. The studies described in this research protocol will address our long-term research objectives of evaluating and treating disorders of gastric motility using simpler, less expensive, and less invasive techniques. Each of these patient-oriented research protocols involves the close interaction between the principal investigator and beginning clinical investigators in order to encourage and develop their clinical research potential. The first specific aim is to demonstrate the clinical validity of two novel noninvasive techniques to assess gastric motility. We will develop the 13C-octanoate breath test for gastric emptying into a practical, clinically useful test for the measurement of gastric emptying using an easily prepared standardized meal. We will also assess the clinical utility of a newly modified electrogastrographic instrument that records high frequency gastric myoelectric activity (up to 120 cycles per minute), in addition to the usual 3 cpm activity. The second specific aim is to use these two noninvasive tests (breath testing and electrogastrography) to assess gender-related aspects of gastric motility. We will demonstrate the effects of gender and the menstrual cycle on gastric motility and determine if the changes in gastric motility during the menstrual cycle correlate with estrogen. and progesterone levels. We will determine whether gastric motility is altered during pregnancy, and to investigate if nausea and vomiting that occurs in the first trimester of pregnancy are related to gastric dysmotility and/or alterations of estrogen, progesterone, and/or

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chorionic gonadotropin blood levels. The third specific aim is to explore novel treatment strategies for abnormal gastric emptying. We will determine whether accelerating or delaying gastric emptying affects postprandial glucose tolerance in diabetic patients. We will determine whether botulinum toxin injection into the pyloric sphincter improves gastric emptying and symptoms in gastroparesis. The fourth specific aim is to enable the principal investigator to continue and even expand his mentoring activities for beginning clinical investigators in patient- oriented research to include mentoring of specialized motility fellows, gastroenterology fellows, medical residents, medical students, and college students. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NOVEL INHALATION DEVICE FOR DELIVERING VAPOR-STATE DRUGS Principal Investigator & Institution: Rabinowitz, Joshua D.; Alexza Molecular Delivery Corporation 1001 E Meadow Cir Palo Alto, Ca 94303 Timing: Fiscal Year 2003; Project Start 01-NOV-2001; Project End 31-MAR-2005 Summary: (provided by applicant): Poor appetite is one of the subjective symptoms that cancer patients find most frustrating, and resulting cachexia is a common cause of death from cancer. In addition, nausea is a frequent side effect of cancer treatment. Oral delivery of the cannabinoid agonist dronabinol is approved by the FDA as both an antiemetic agent and an appetite-enhancer. Its clinical utility, however, is limited by extensive first pass metabolism and resulting inconsistent oral bioavailability. In Phase I of this grant application, we have demonstrated the ability to form high purity, small particle size aerosols of dronabinol for reliable systemic delivery through inhalation. These aerosols can be produced by simple, breath-actuated devices. In Phase II of the grant, we now propose to prove the consistency of systemic absorption of these aerosols when inhaled by dogs. In addition, we plan to conduct the animal toxicology experiments and produce the clinical trial materials required to initiate human studies of inhaled dronabinol. Accomplishment of these goals of Phase II will lead directly to human clinical testing of a cost effective, commercially viable dronabinol inhalation delivery system. Beyond providing for improved dronabinol delivery, this drug product addresses a major unmet need in the cancer area: an appetite-enhancing and nauseadecreasing medication that works rapidly and does not require painful injection or for patients with gastrointestinal distress to consume oral medication. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NOVEL INHALATION SYSTEM FOR DELIVERING VAPOR-STATE DRUGS Principal Investigator & Institution: Mufson, Daniel; Alexza Molecular Delivery Corporation 1001 E Meadow Cir Palo Alto, Ca 94303 Timing: Fiscal Year 2002; Project Start 27-AUG-2002; Project End 31-OCT-2002 Summary: Delta-9-tetrahydrocannibinol (THC) is approved for AIDS-related anorexia, chemotherapy-related nausea and vomiting, and clinical evidence supports efficacy of THC in pain, even suggesting an opioid sparing strategy with equivalent analgesia. Current THC formulations have significant disadvantages, including imprecise dosing, variable absorption, poor bioavailability, slow onset of action, and toxic components and legal issues if smoked. Medical experts agree that a rapid-onset, reliable and safe delivery system for THC represents an unmet patient need. MDC proposes its handheld inhaler to meet this need. The inhaler is the first to deliver vapor-state drug

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without excipients. The inhaled, reproducible dose will be absorbed from the lung rapidly with high bioavailability, providing effective blood levels, and rapid-onset of action. Utilizing an in vitro test apparatus, MDC demonstrate feasibility by generating ultrafine particles of optimal size and distribution, without degradation, for vapor-state inhalation delivery. In Phase I we propose developing a benchtop prototype device and conducting in-vitro verification. Phase I AIMS include: 1) designing, constructing and testing a benchtop prototype producing acceptable, ultrafine particle sizes and PSD, 2) producing doses reproducibly without degradation, and 3) analyzing economical scaledown for hand-help operation. The ultimate goal is clinical evaluation of efficacy and safety leading to an NDA and regulatory approval. PROPOSED COMMERCIAL APPLICATION: The commercial market potential for the MDC Inhalation Delivery of THC alone includes, among others, millions of cancer patients and thousands of AIDS patients who would benefit from improved management of pain, cachexia, nausea, and other symptoms using inhaled analgesia medications (as prescribed by their doctors) in the United States and other countries. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PERIPHERAL TRANSMISSION

CANNABINOID

MODULATION

OF

PAIN

Principal Investigator & Institution: Hohmann, Andrea G.; Assistant Professor; Psychology; University of Georgia 617 Boyd, Gsrc Athens, Ga 306027411 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): One in three Americans suffer from chronic pain. Available therapeutic interventions show limited efficacy and are plagued by adverse side effects (e g, altered mental status, sedation, nausea) that accompany systemic routes of drug administration Novel pharmacotherapies that specifically target the periphery therefore represent an alternative strategy for managing pain in the absence of unwanted central side-effects. Activation of a cannabinoid system- a nonopioid system that acts through a marijuana-like mechanism- in the periphery attenuates nociceptive responding The proposed research combines correlative behavioral and neurophysiological approaches to examine the functional consequences of peripheral cannabinoid actions on nociceptive transmission in vivo The use of subtype selective competitive antagonists and high affinity agonists provide the pharmacological tools required to study peripheral cannabinoid actions The proposed work uses a rat model of inflammation to test the hypothesis that a peripheral cannabinoid mechanism suppresses responses evoked by natural cutaneous stimulation in physiologically identified neurons of the spinothalamic tract Behavioral correlates for the electrophysiological studies will be established by assessing peripheral cannabinoid modulation of responsiveness to thermal and punctate mechanical stimulation under similar conditions The consequences of peripheral inflammation on axonal transport of cannabinoid receptors to peripheral nerve terminals is evaluated The development of effective pharmacotherapies for pain that are non-toxic, non-addicting and devoid of side-effects is likely to have a profound impact by improving quality of human life and reducing socioeconomic costs associated with inadequate pain management. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PHOTOPHYSICAL PROPERTIES OF TRICYCLIC ANTIEPILEPTIC DRUGS Principal Investigator & Institution: Garcia, Carmelo; University of Puerto Rico at Humacao Box 428, Barrio Tejas Humacao, Pr 00791

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Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: The intense research devoted over the last few years to the study of epilepsy and antiepileptic drugs (AEDs) has only dealt with the physiology of the disease. This quality research has been aimed to replace the older AEDs with broad activity profiles and several severe side effects with new AEDs with better defined mechanism of action and fewer side effects. Nevertheless, most of these drugs still produce serious adverse reactions, including among others, dizziness, ataxia, somnolence, headache, blurred vision, nausea, vomiting, skin, allergy and photosensitization. The molecular photochemical mechanisms for the photosensitizing ability of some AEDs has never been studied, even through it was reported over ten years ago. Recent studies on the laser flash phototysis of related neuroleptic drugs (imipramine) showed that the triplet state can be efficiently quenched by the protons in the solution. The effectiveness of the quenching is very sensitive to the structure of the drug and seems to be involve in their phototoxicity. We propose to perfor the same set of experiments on several phototoxic antiepileptics. The goal of this project is to measure the photophysicat properties of a selected group of tricydic antiepileptic drugs and to study their short-lived transients. Special attention will be given to those transients associated with adverse effects in vivo: the cation radical, the first triplet excited state and singlet oxygen, Basic UV-Vis and luminescence techniques will be employed to study their absorption/emission properties. The transients will be characterized using optical absorption measurements with a Nd-YAG laser set-up. For the triplet state of these compounds, the extinction coefficient and the quantum yield will be determined using a comparative method and the triplet-triplet energy transfer principle, respectively. The triplet state will be bleached with a second delayed pulse to elucidate the reaction mechanism of these u'ansients. Combined MM+/PM3/RHF theoretical calculations will be performed with HyperCHEM (TM) 7.0 on the whole set ofphotophysical parameters, The theoretical values will be correlated with the experimental ones. The major goal of this project is to find a molecular/photophysical descriptor for the phototoxic side effect of tricydic antiepileptics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREGNANCY ESTROGENS, DIET, AND BREAST CANCER RISK Principal Investigator & Institution: Hilakivi-Clarke, Leena A.; Professor; V T Lombardi Cancer Res Center; Georgetown University Washington, Dc 20057 Timing: Fiscal Year 2002; Project Start 15-AUG-2001; Project End 31-JUL-2006 Summary: Estrogen levels are elevated by 50-100 -fold during pregnancy, and interindividual variability in pregnancy estrogen levels is 4-6 -fold. Women exhibiting highest pregnancy estrogen levels are suggested to be at a significantly increased risk to develop breast cancer, perhaps due to an estrogen-induced promotion of existing transformed cells. Diet, particularly dietary fats, may affect pregnancy estrogen levels and later breast cancer risk. In our animal study, a high fat intake significantly increased pregnancy estrogen levels and increased pregnancy-promoted mammary tumor incidence. Polymorphism in genes that metabolize estrogens and have been linked to increased breast cancer risk, may also affect pregnancy estrogen levels. Our proposed study has two general aims: (1) to study whether dietary fat intake affects pregnancy estrogen levels in women, perhaps by interacting with polymorphism in CYP17 and COMT, and (2) to study whether highest pregnancy estrogen levels might increase breast cancer risk by increasing growth factor levels. These growth factors could originate from mutated or already transformed mammary cells, which during pregnancy are stimulated by high estrogen levels. Growth factor levels will be measured

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in nipple aspirate fluid (NAF) that can be obtained using a breast pump from nonlactating breast. Consequently, the following hypotheses will be tested: Hypothesis-1. We hypothesize that high dietary fat intake and weight gain increase pregnancy estrogen levels. We further hypothesize that polymorphism in CYP17 or COMT influences these interactions. Hypothesis-2. We hypothesize that higher circulating estradiol levels during pregnancy are associated with increased growth factor levels in nipple aspirate fluid, including EGF, TGFalpha and IGF-1/IGF binding protein 3. These aims will be studied in 200 pregnant women attending the Maternity Clinic at Solna in NAF will be obtained 12 months after giving birth. Our results may lead to modifications of pregnancy diet to reduce the risk to develop breast cancer. In particular, women who already are at high risk, for example, due to family history of breast cancer, age at first pregnancy (greater than 30 years), or other reproductive risk factors, may significantly benefit from pregnancy dietary modifications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PRESURGERY HYPNOSIS--BENEFITS ANALYSIS IN BREAST CANCER Principal Investigator & Institution: Montgomery, Guy; Ruttenberg Cancer Center; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 17-AUG-2001; Project End 31-JUL-2004 Summary: Over 90% of the 184,000 women diagnosed with breast cancer in 2000 will undergo surgery as part of their curative treatment. Despite improvements in pharmacological management, surgical procedures under general anesthesia continue to be associated with clinically significant side effects, chief among which are pain and nausea. These clinical problems are particularly severe following surgical treatment for breast cancer and can require additional pharmacologic intervention, prolong recovery room stay, delay discharge, and lead to unanticipated readmission. Clinical research with other surgical populations has indicated that hypnosis can reduce intraoperative complications, reduce postoperative symptoms and enhance recovery (e.g., reduce pain, nausea, hospital stays), however, the treatment efficacy of hypnotic techniques with breast cancer surgical patients has yet to be established. A separate line of previous clinical research with surgery populations has indicated that preoperative psychological factors (emotional distress and cognitive expectations) are predictive of patients' postoperative experiences of side effects, but again research on breast cancer surgical patients is scant. The proposed research will bridge the two previous lines of research by combining a randomized clinical trial, (in which the effects of a preoperative hypnosis intervention to control side effects are compared to attention control), with a prospective quasi-naturalistic study, (in which the relations between preoperative psychological factors and patients' reactions to surgery are examined). In addition to establishing the applicability to breast cancer patients of findings in the general psychological, hypnosis and surgical literatures, the goal of proposed study is to make novel theoretical contribution by examining the potential role of psychological factors as the "active ingredients" in the beneficial effects of hypnosis. The proposed study will also make a novel practical contribution by examining cost-effectiveness of the hypnosis intervention, an approach which may have compelling implications for clinical practice as well as future behavioral research. The Specific Aims of the study are: 1) To investigate the impact of a presurgical hypnosis intervention on women scheduled for surgical treatment for breast cancer; 2) To investigate the contribution of preoperative emotional distress, and cognitive expectations to post- surgery side effects and recovery; 3) To determine whether the beneficial effects of the hypnosis intervention are

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accounted for (mediated) by differences in presurgery cognitive expectations and emotional distress; and 4) To investigate the cost-effectiveness of the presurgical hypnosis invention. o achieve these aims, 140 breast cancer patients scheduled for mastectomy will be randomly assigned to a hypnosis intervention group or an attention control group. The impact of the hypnosis intervention on postoperative nausea, pain, recovery from surgery, and cost- effectiveness will be analyzed within an experimental study design. The influence of presurgery distress and expectations of side effects will be analyzed within quasi-naturalistic study designs. The possible mediational role of these factors in hypnosis effects will be examined will classic statistical approaches. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PSYCHOIMMUNE OUTCOMES: INTERVENTION IN BREAST CANCER Principal Investigator & Institution: Kang, Duck-Hee H.; Associate Professor; None; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 01-MAY-2000; Project End 31-JAN-2004 Summary: The specific aims of this study are (1) to examine immunological, psychosocial, and clinical symptom outcomes of an 8-week integrated support program for patients with newly diagnosed breast cancer, and (2) to determine whether the support program has differential effects on patients with persistently low versus high baseline natural killer cell (NK) activity pattern (below versus above median NK activity x 2). The integrated support program includes weekly stress management and social support programs and exercise training activities three times a week. Background and Significance: Cancer diagnosis and treatment are a major source of significant psychological, emotional, and physical distress. Most previous interventions have been limited by a unidimensional approach (psychosocial or physical support, not both), and by the lack of immunological assessments. Given the importance of mind-body interactions in human functioning, an integrated approach of concurrent psychological and physical support will be most beneficial to assist patients in distress. Further, there is indication that breast cancer patients with lower baseline NK activity pattern have a poorer prognosis than those with higher baseline NK activity pattern. A comprehensive examination of an integrated approach will provide insights to improving quality of life for patients with newly diagnosed breast cancer. Design and Method: Using a longitudinal, experimental design with pretest and posttest, 90 patients with stage I-IV newly diagnosed breast cancer will be stratified by disease stage (I-IIB vs. locally advanced) and randomly assigned to the Experimental (intervention) or Control (waitlist) group. NK activity will be examined twice prior to the beginning of intervention to determine the pattern of NK activity. The intervention will begin at the start of chemoor radiotherapy. Post-intervention data will be collected immediately after intervention and at 6 and 12 months from the initiation of intervention, coinciding with patients' routine clinic visits. Dependent Measures and Analysis: The impact of intervention will be measured on immune responses (NK activity and number, lymphokine activated killer cell activity, IL-1alpha, IL-2 and interferon-gamma), psychosocial well-being (distress, mood states, and quality of life), and clinical symptoms (fatigue, nausea, vomiting, and sleep). Longitudinal data analysis methods will be employed to analyze repeated measures of outcome variables, whereas 2-sample t-test or nonparametric Wilcoxon rank-sum test will be used to perform univariate analysis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: QUALITATIVE STUDY OF PROSTATE CANCER SYMPTOM MANAGEMENT Principal Investigator & Institution: Latini, David M.; Urology; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant.) Prostate cancer is the second-most common cancer among American men Various options for treatment exist, with approximately equal effectiveness However, the choice of treatment can result in different side effects that severely impact quality of life These side-effects include medical problems, such as erectile dysfunction and urinary and bowel incontinence The experience of those sideeffects can cause a number of emotional and psychological concerns, including changes in self-concept, difficulties in a man's primary relationship, and social isolation to avoid the embarrassment of incontinence in a social setting Numerous interventions have been developed for patients with other types of cancers, but few interventions have been developed for men with localized prostate cancer None of the existing prostate cancer interventions focus on symptom management, an important part of the prostate cancer survivor's quality of life Moreover, interventions that target more general cancer symptoms (e g, pain or nausea) have less relevance for the unique needs of men with localized prostate cancer Our study proposes to use the Critical Incident Technique to collect data on how patients with treatment-related side-effects are able to successfully manage the physical and psychosocial impact of their symptoms The critical incident reports will be organized into a taxonomy of effective and ineffective symptom management practices. As part of the proposed study, the investigator will accomplish the following aims: 1. Collect qualitative data describing effective and ineffective symptom management knowledge, skills, and behaviors in men treated for localized prostate cancer from prostate cancer patients, their partners, and health care providers. 2. Analyze the critical incidents to develop a hierarchical classification or taxonomy of critical symptom management competencies. 3. Using the taxonomy of symptom management competencies from Specific Aim 2, develop the instructional objectives for a tailored intervention that will help men treated for prostate cancer manage their treatment-related side-effects and related psychosocial concerns more effectively. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: QUANTITATIVE MRI AND 1H-MRS IN TRAUMATIC BRAIN INJURY Principal Investigator & Institution: Grossman, Robert I.; Chairman; Radiology; New York University School of Medicine 550 1St Ave New York, Ny 10016 Timing: Fiscal Year 2002; Project Start 15-SEP-2000; Project End 31-JUL-2005 Summary: (Adapted from Applicant's Abstract): Traumatic brain injury 9TBI) has an incidence of nearly 2,000,000 cases per year, and is the leading cause of disability and death in children and young adults (peak incidence in 15 to 24 year olds) in the United States. Following mild head injury patients may suffer from a multitude of cognitive deficits including decreased speed in information processing, poor attention, concentration, and memory, and impaired logical reasoning skill, as well as more focal deficits including impairment of language or constructional abilities. A variety of other symptoms including headache, dizziness, nausea, neurasthenia, hyperesthesia, and emotional liability are commonly perceived. Head injury has been associated with shortterm increased b-amyloid protein deposition and long-term neurotic plaques characteristic of Alzheimer's Disease. Epidemiological studies have observed a

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statistically-significant relationship between TBI and the subsequent onset of AD. Indeed, there is growing evidence that head injury, even mild in nature, may have greater consequences than previously assumed. The investigators hypothesize that mild/moderate TBI can cause neuronal cell death (reflected primarily by gray matter volume lose) and that this is the primary factor in induction and progression of neurocognitive disability in head injured patients. The central hypothesis is to test this hypothesis that the investigators have developed and validated computerized quantitative methods based upon magnetic resonance (MR) imaging (MRI) to measure the effect of TBI on brain substance. The investigators have also devised and implemented a proton (+H) magnetic resonance spectroscopy (MRS) technique to quantitative the neuronal concentration of the entire brain based upon the measurement of N-acetylaspartate (WBNAA) which is considered to be a marker of neuronal integrity. This proposal will correlate these quantitative MR measures with clinical measures of disability and neurocognitive tests. The overarching goal is to utilize MRI and 'H MRS to detect and quantify the effects TBI in a well-characterized cohort of mild/moderate head injured patients over a duration of 5 years. The results from this research will provide new and important information regarding the full extent of TBI, aid in categorizing these patients, and serve as an arbiter to assess proposed treatment strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SEX ANTINOCICEPTION

DIFFERENCES

IN

CANNABINOID-INDUCED

Principal Investigator & Institution: Tseng, Alan H.; Pharmacology-Toxicology; Washington State University 423 Neill Hall Pullman, Wa 99164 Timing: Fiscal Year 2002; Project Start 01-APR-2002 Summary: Cannabinoids have been shown to produce analgesia in rodents, monkeys and humans. However, males and females may be differentially sensitive to cannabinoids. For example, perinatal exposure to the cannabinoid delta-9-THC alters midbrain opioid receptor binding and opioid analgesia differentially in female vs. male rats. Sex differences have been found in midbrain cannabinoid receptor density and liver metabolism of cannabinoids, which may contribute to sex differences in the behavioral effects of cannabinoids. Because cannabinoids may provide a significant alternative analgesic pharmacotherapy to opioids -- and in fact are already being used for their anti-nausea and appetite stimulation effects -- it is important to determine whether these substances are equi-effective in men and women. The goal of the proposed research is to compare cannabinoid-induced antinociception in male vs. female rats. The first aim is to determine the potency and time course of cannabinoidinduced antinociception and sedation. Three agonists will be examined: the major psychoactive compound in marijuana, delta-9-THC; the major active metabolite of delta9-THC,11- hydroxy-delta-9-THC; and the synthetic cannabinoid, CP55,940. Complete dose- and time-effect curves will be obtained for each agonist administered i.p. on the warm water tail withdrawal, paw pressure and spontaneous locomotor activity tests. The second aim is to compare supraspinal vs. spinal CB1 receptor mediation of cannabinoid effects in males and females. Complete dose- and time-effect curves will be obtained for antagonism of i.p. CP55,940 by the CB1 receptor-selective antagonist SR141716A administered i.c.v. and i.t. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SLOWING OF TRANSIT - THE THIRD ENTERIC FUNCTION OF 5HT Principal Investigator & Institution: Lin, Henry C.; Director Gastrointestinal Motility Progr; Cedars-Sinai Medical Center Box 48750, 8700 Beverly Blvd Los Angeles, Ca 900481804 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): In order to optimize nutrition, the movement of a meal through the small intestine must be precisely controlled to ensure that there is adequate time to complete the time-demanding steps of digestion and absorption. Abdominal pain, nausea, bloating, diarrhea and malnutrition are the consequences of impaired control of intestinal transit. After a fat-containing meal, inhibitory feedback mechanisms are activated by the proximal and distal small intestine as the jejunal and ileal brake, respectively. In contrast to this focus of the postprandial gut to slow transit, much of the research efforts over the past 100 years have been directed at the peristaltic reflex, which is responsible for the acceleration of intestinal transit and are known to be mediated by 5-HT. Currently, two roles of enteric 5-HT have been established: the triggering of the peristaltic and mucosal secretory reflexes via intrinsic primary afferent neurons and gut-to-CNS and gut-to-pancreas communications via extrinsic sensory nerves. We have recently found a third role of enteric 5-HT. Specifically, 5-HT is also involved in the slowing of transit by fat via a 5-HT3 pathway that is dependent on 5-HT transmission via myenteric neurons. In this proposal, we will test our overall hypothesis that slowing of intestinal transit by fat depends on primary afferent nerves, betaadrenergic pathway and 5-HT transmission via myenteric neurons, which in turn activates opioid neurons, that slow transit. We will test the hypotheses using pharmacologic and physiologic approaches. The results of these studies will help us to refine our hypotheses so that we can test the neuroanatomic components of this pathway using immunohistochemistry. We have developed a collaboration with 2 leading neuroscientists who will provide this project with additional expertise in immunohistochemistry. In addition, to test the role of a novel beta-adrenergic system in the slowing of intestinal transit by fat, we have developed a multi-disciplinary team approach by including a cardiologist experienced in the 13- adrenergic system. The PI has a track record of success in bench-to-bedside translational research in the area of nutrient control of intestinal transit. His experience includes the discovery of a novel, nutrient-based strategy to slow intestinal transit. This application will bring this new treatment back to basic research so that we can understand the neural pathways that underpin the slowing response to fat. The hypotheses to be tested in this project will expand our understanding of a new role for enteric 5-HT which may explain conditions such as irritable bowel syndrome and provide better understanding of the effects of drugs that are directed at 5-HT pathways. In addition, by investigating the mediators of the control of intestinal transit, we will gain knowledge that can be used to control the movement of a meal through the small intestine and, in turn, reduce symptoms and improve nutrition. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ST. JOHN'S WORT VS PLACEBO IN SOCIAL PHOBIA Principal Investigator & Institution: Kobak, Kenneth A.; Senior Research Scientist; Dean Fdn for Health, Research & Educatn Research and Education Middleton, Wi 53562 Timing: Fiscal Year 2002; Project Start 17-SEP-2001; Project End 31-AUG-2004

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Summary: (provided by applicant): Social Phobia is a prevalent and debilitating condition, with a lifetime prevalence rate to be 13.3 percent. Socially phobic patients have been found to be functionally impaired in the areas of education, employment and social relationships, to have poorer quality of life, and increased suicidal ideation and psychiatric comorbidity. Double-blind studies have found benzodiazepines, selective and non-selective MAOI inhibitors, several SSRIs, and the anticonvulsants pregabalin and gabapentin to be effective. However, side effects with these compounds suggests the need for better tolerated compounds, e.g., in the paroxetine multi-center trial (the only drug with an FDA approved indication), 27 percent reported somnolence, 26 percent nausea, and 37 percent of males reported delayed ejaculation; 34 percent of patients discontinued the trial early. There has been considerable worldwide interest in St. John's Wort (SJW) (Hypericum perforatum) as a treatment of mild to moderate depression. There have been 23 randomized trials suggesting SJW is more effective than placebo for the treatment of outpatients with mild to moderate depression. SJW is very well tolerated with mild side effects observed in only 2.5 percent of cases in a large (3250 patients) drug monitoring study. Pharmacokinetic studies have found Hypericum to have affinity for serotonin, dopamine and GABA alpha and GABA beta receptors, each of which have been implicated in social phobia, thus there is a suggestion that SJW may be effective for this disorder. This will be a 12-week, double blind, placebo-controlled trial, designed to generate effect size data that will be used to determine sample size needed to power a definitive study. Forty patients will be randomized to either SJW (LI 160) or matching placebo. This will be a flexible-dose design, starting at 300 mg tid to a maximum of 1800 mg total per day. An intent-to-treat analysis will be employed. Subjects will be evaluated weekly for two weeks, then bi-weekly thereafter. The primary outcome measure will be the change from baseline to endpoint on the Liebowitz Social Anxiety Scale. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STUDY OF A CANNABINOID RECEPTOR INTERACTING PROTEIN Principal Investigator & Institution: Niehaus, Jason L.; Pharmacology and Toxicology; Medical College of Georgia 1120 15Th St Augusta, Ga 30912 Timing: Fiscal Year 2003; Project Start 24-SEP-2003; Project End 23-SEP-2005 Summary: (provided by applicant): Marijuana is the most widely abused illegal drug in the United States. Central nervous system responses to the active compound in marijuana include beneficial therapeutic effects, such as analgesia, appetite stimulation, and reduction of nausea and vomiting, while undesired effects include short-term memory and motor impairment, dysphoria, and sedation. The endogenous function of the cannabinoid receptor and the mechanism by which these effects are produced remains ill-defined. The goal of this project is to investigate the role of an uncharacterized cannabinoid receptor interacting protein on the signaling and function of the receptor. The proposed studies will use patch clamp recording of primary neurons to identify the effects of the interacting protein on ion channel modulation and receptor function. A yeast two-hybrid assay will identify the protein-protein interaction domains and confocal microscopy will be used to determine the effect of the novel protein on receptor expression and localization. The results of these studies will increase the knowledge of cannabinoid receptor signaling pathways and function, which is important to facilitate the design of new therapeutic strategies utilizing cannabinoid compounds to select for desired effects, while excluding side-effects. In addition, further insight into the cannabinoid system may lead to a better understanding of marijuana abuse, tolerance and dependence.

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Nausea

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

Project Title: SYMPTOM CLUSTERS IN CANCER PATIENTS UNDERGOING TREATMENT Principal Investigator & Institution: Barsevick, Andrea M.; Associate Members; Fox Chase Cancer Center Philadelphia, Pa 19111 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2005 Summary: (provided by applicant): The specific aims of the proposed pilot research are to: 1) systematically examine the relationships between and among a group of physical symptoms (fatigue, insomnia, pain, and nausea/vomiting) typically experienced during cancer chemotherapy to determine whether or not they form one or more clusters; and, 2) test alternative models of the impact of these symptoms (and/or symptom clusters) on psychological and functional well-being. The overall goal of this research is to generate hypotheses for future research about the characteristics and effects of symptom clusters during cancer treatment. Indicators of a symptom cluster include two or more symptoms with a common predictor (or cause), pattern, or effect on another symptom(s). A longitudinal descriptive design will be used to examine symptoms and quality of life during one cycle of chemotherapy. Measures will be taken at three data points: 1) day 1 of cycle prior to receiving chemotherapy; 2) day 4 of cycle; 3) last day of cycle. Administering measures at these data points will allow us to track the pattern of symptoms from baseline before treatment to a known symptom high point (day 4) for fatigue, insomnia, and delayed nausea/vomiting to a known symptom low point (last day). The use of repeated measures will enable us to examine symptom patterns as well as temporal patterns by which symptoms could influence other symptoms over time. This design also will allow us to examine relationships between symptoms and other quality of life dimensions at each data point as well as changes over time. For aim #1, five research questions will be examined independently using correlation, multiple regressions, and/or repeated measures ANOVA. The result of each analysis will provide one indication of the presence or absence of a symptom cluster. The number of indicators and the nature of the relationships described will be used to decide whether or not the symptoms under investigation form a cluster. For aim #2, two hypotheses will be examined using multiple regression techniques to test whether functional well-being is a mediator between individual symptoms (or symptom clusters) and psychological well-being. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: THC AND MARIJUANA--EFFECTS IN INDIVIDUALS WITH HIV/AIDS Principal Investigator & Institution: Haney, Margaret; Assistant Professor; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 30-JUN-2004 Summary: (adapted from the applicant's abstract): The purpose of the proposed laboratory studies is to assess the effects of smoked marijuana (MJ) and oral delta-9 THC (the primary psychoactive component of smoked MJ) in individuals who have the human immunodeficiency virus infection (HIV+) with unintended weight loss (<90 percent body cell mass/height). In addition to a detailed analysis of food intake and body composition, we will measure mood, physical symptoms (e.g., nausea, stomach pain), psychomotor task performance, and sleep in order to determine the specificity of drug effects on food intake in relation to other behaviors. Experiment 1 will directly

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compare the short-term effects of smoked MJ and oral THC in the same HIV+ individuals. Little is known about the efficacy and tolerability of oral THC versus smoked MJ in a clinically relevant population. Hypotheses include: 1) both smoked MJ and oral THC will increase food intake; 2) both smoked MJ and oral THC will be well tolerated because all participants will be current MJ smokers; and 3) oral THC will produce greater increases in food intake with repeated administration. Experiment 2 will determine whether maintenance on oral THC administration is well tolerated and increases body weight compared to maintenance on placebo in 2 groups of HIV+ individuals: those who currently smoke MJ and those who have smoked MJ but currently do not. It is not clear how THC's effects vary as a function of (1) the duration of treatment, or (2) the individual's current patterns of smoked MJ use. Hypotheses include: 1) THC will be well tolerated in both groups because the dose regimen will be adjusted to current MJ use; 2) THC administration will produce dose-dependent increases in body weight compared to placebo; and 3) tolerance will develop to THC's subjective effects, but not to THC's positive effects on food intake and body weight. The proposed studies will provide a much-needed experimental database on the behavioral, subjective and appetite-enhancing effects of oral THC and smoked MJ in HIV+ individuals with weight loss, and will contribute empirical data to the current policy debates occurring throughout the United States regarding the efficacy and safety of cannabinoids for medical use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE EFFECTS OF MUSIC THERAPY-BASED STRESS REDUCTION ON * Principal Investigator & Institution: Sahler, Olle J.; Pediatrics; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2002; Project Start 15-JUL-2001; Project End 30-JUN-2003 Summary: (provided by applicant): The regimen-related toxicities associated with bone marrow transplantation (BMT) can be severe and even life threatening. The overall goal of this randomized controlled pilot study in BMT patients is to determine the effect of relaxation/.stress reduction strategies on: (1) the frequency/severity of toxic side effects of marrow ablative chemotherapy, and (2) the timing of immune reconstitution. A substantial literature indicates that music therapy-based interventions are effective in inducing relaxation and also affect immune function by modulating circulating and salivary levels of such agents as cortisol, immunoglobulin A, interleukin-1, natural killer cells, and a variety of other immune system-related substances. Over the past two years, we have provided music therapy-based stress reduction/relaxation interventions to a convenience sample of patients undergoing BMT. Preliminary findings from this pilot feasibility study demonstrate that patients report significantly decreased pain (p<.004) and sense of nausea (p <.001) following an intervention. Average time-to-engraftment was 13.5 (+/- 2.85) days as compared to 15.5 (+/- 4.40) days (p <.O1) for a group of historical controls matched on diagnosis, type of transplant, conditioning regimen, date of transplant, age, and gender. Although highly promising, our data are limited by lack of randomization, an appropriate control condition, measurement of psychologic factors known to influence outcome in BMT, and systematic monitoring of early phase markers of immune reconstitution that could help explain the phenomena we have observed. This proposal corrects these shortcomings and especially highlights the potential mediational effect of cytokine release on regimen-related toxicities and the timing of immune reconstitution. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TNF BLOCKADE IN PANCREATIC CANCER PATIENTS Principal Investigator & Institution: Villalona, Miguel A.; Associate Professor; Internal Medicine; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2005 Summary: (provided by applicant): The poor prognosis of patients with advanced pancreatic adenocarcinoma, with a median survival of less than 12 months, indicates an obvious need for more effective treatments. In addition, patients with pancreatic carcinoma are frequently debilitated by cachexia, anorexia, nausea/vomiting and abdominal pain. Pro-inflammatory cytokines like tumor necrosis factor (TNF) alpha, interleukin 6 (IL-6) and interleukin 1 (IL-1) have all been found to be elevated in pancreatic cancer patients and have been implicated in causing many of these symptoms, in addition to the possibility of directly promoting tumor progression. One potential target for anticancer therapy is blocking the effects of TNF. We hypothesize that TNF blockade should make chemotherapy more tolerable, should improve quality of life and should retard the time to tumor progression. In the current proposal, we seek to combine standard chemotherapy (gemcitabine) and TNF blockade with soluble TNF receptor molecules (etanercept) in a pilot trial in patients with metastatic or recurrent pancreatic cancer. We will evaluate if TNF blockade can improve the clinical benefit response, quality of life and the rate of cancer progression-free survival at six months obtained with chemotherapy. In addition, serial levels of TNF and other inflammatory cytokines, as well as the transcription factor NF-kappaB, a candidate pathway through which TNF stimulates tumor growth, will be obtained from peripheral blood mononuclear cells lysates. Quality of life and levels of the cytokines and NF-kappaB will also be measured in a control group of 10 patients receiving gemcitabine as a single agent. The observation of benefits in either quality of life or progression-free survival in patients undergoing TNF blockade would encourage evaluation of this novel strategy in properly powered randomized clinical trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TNF, VAGAL TONE AND GASTRIC MOTILITY Principal Investigator & Institution: Rogers, Richard C.; Professor; None; Lsu Pennington Biomedical Research Ctr 6400 Perkins Rd Baton Rouge, La 70808 Timing: Fiscal Year 2002; Project Start 15-JAN-1997; Project End 31-AUG-2007 Summary: (provided by applicant): Cytokine production by immune effector cells forms part of the host response to antigenic challenge, trauma or irradiation. Protection of the host relies on cytokine release to stimulate: immune attack on pathogens, wound healing, tissue remodeling and energy mobilization. However, elevation of the proinflammatory cytokine, tumor necrosis factor-alpha (TNF], following these insults is also associated with the onset of gastric stasis, nausea, vomiting and anorexia. Degradation of the control of gastrointestinal, fluid and nutritional homeostasis causes significant morbidity and mortality apart from that caused by the primary disease process.Our work has shown that: a) initiation of gastric inhibition by peripheral immune challenge is dependent on TNF synthesis, b) peripherally generated cytokines suppress CNS-commanded, vagally mediated increases in gastric motility and c) TNF can operate directly on neurons of the dorsal vagal complex [DVC] of the brainstem to produce profound gastroinhibition. These results satisfied the initial goals of the project, i.e., the unambiguous demonstration of a role for the dorsal medulla and vagal control circuitry in TNF-mediated gastric stasis.Now we wish to investigate the physiological mechanisms by which TNF dramatically alters vagal control of the stomach. The present

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proposal focuses on three Specific Aims: 1) which vagal efferent pathway(s) are invoked by central TNF action, 2) the specific phenotype of brainstem neuron(s) activated by TNF and 3) the cellular mechanisms activated within the DVC by TNF. We expect that TNF suppresses gastric motility by acting at several sites within vago-vagal reflex circuits in the medulla. We predict that: 1) TNF enhances glutamate neurotransmission between vagal afferents and the solitary nucleus, 2) TNF directly affects the excitability of specific phenotypes of solitary neurons which control the activity of vagal efferent [DMN] neurons, and 3) these DMN neurons (which ultimately control gastric motility) are also likely to be under the direct influence of TNF. Perhaps TNF produces its profound and prolonged inhibition of gastric motility, (and, perhaps, the generation of nausea, emesis and suppression of feeding) by acting at several points in the DVC simultaneously. These hypotheses will be tested using a combination of in vivo and in vitro neurophysiological methods. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TREATING ACUPRESSURE

CHEMOTHERAPY

INDUCED

NAUSEA

WITH

Principal Investigator & Institution: Dibble, Suzanne L.; Professor; Institute for Health and Aging; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 02-AUG-2001; Project End 31-MAR-2004 Summary: Although the newer antiemetic agents have controlled a notable portion of the vomiting associated with chemotherapy administration, nausea continues to be a significant problem. Therefore, the specific aims of this [randomized clinical trial] are to compare differences in the nausea experience and intensity among three groups (Total N=237) undergoing doxorubicin hydrochloride (Addamycin ) and cyclophosphamide with or without fluorouracil chemotherapy for breast cancer. The groups are those receiving a) usual nausea care plus "Active Acupressure" via finger pressure on the nei guan point (P6), b) usual nausea care plus placebo acupressure and c) usual nausea care. Secondarily, the differences in quality of life, anxiety, and functional status among these group participants will be explored. Using eight oncology settings, participants will be recruited who had experienced nausea with their previous chemotherapy treatment. They will be randomly assigned to treatment groups. Stratification criteria will include regimen and site. The interventions will be conducted by carefully trained research assistants. All participants will be followed on a daily basis for two cycles of chemotherapy (a cycle is usually 21- 28 days). Analyses will be done using repeated measures analysis of variance and analysis of covariance, when baseline data is an appropriate covariate. A strength of this study is that it does not pit modem Western and Chinese medicine against each other to determine which is more effective. All participants will continue to receive their Western medical care, but the added value of acupressure will be explored. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: VERTIGO

TREATMENTS

FOR

BENIGN

PAROXYSMAL

POSITIONAL

Principal Investigator & Institution: Cohen, Helen S.; Associate Professor; Otorhinolaryn & Communica Scis; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2002; Project Start 01-AUG-1998; Project End 31-JUL-2003

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Summary: (Adapted from the Applicant's Abstract) Benign paroxysmal positional vertigo (BPPV), characterized by episodes of intense vertigo cause nausea, blurred vision, and falls. The most effective treatments have not yet been determined. No studies have systematically compared the accepted treatments to sham treatments while comparing systematic in treatment parameters or the influence of co- morbidity from other medical conditions. The clinical studies detailed in this application examine these accepted treatments and a control treatment to determine the immediate short-and longterm effectiveness of treatments for BPPV. The following specific aims will be addressed: 1) Determine the relative effectiveness of the Eply maneuver, the Semont maneuver, and Brandt-Daroff exercises compared to each other and to sham treatment in reducing the intensity and frequency of vertigo episodes and oculomotor responses to Dix-Hallpike maneuvers, and in increasing independence in activities of daily living; 2) Determine the relative effectiveness of habituation exercises designed to facilitate central habituation of vertigo, exercises designed to remove otoconial matter from the semicircular canals and the sham treatment; 3) Determine the relative contributions of variations on the most effective treatment from Specific Aim 2; 4) Determine the effect of co-morbid conditions on short-and long- term response to treatment. 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 “nausea” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for nausea in the PubMed Central database: •

Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. by Tramer MR, Carroll D, Campbell FA, Reynolds DJ, Moore RA, McQuay HJ.; 2001 Jul 7; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=34325

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Discordance between physical symptoms versus perception of severity by women with nausea and vomiting in pregnancy (NVP). by Chandra K MSc, Magee L MD, Koren G MD.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=117801

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Impact of Nausea and Vomiting on Quality of Life in Cancer Patients During Chemotherapy. by Ballatori E, Roila F.; 2003; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=212194

3 4

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

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print.

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The use of CAM by women suffering from nausea and vomiting during pregnancy. by Hollyer T, Boon H, Georgousis A, Smith M, Einarson A.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=113747

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Treatment of established postoperative nausea and vomiting: a quantitative systematic review. by Kazemi-Kjellberg F, Henzi I, Tramer MR.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=60651

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

A 15-year-old with blurred vision, nausea, back pain, and abdominal pain. Author(s): Kuensting LL. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2003 April; 29(2): 171-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12660705

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A comparison of cyclizine, ondansetron and placebo as prophylaxis against postoperative nausea and vomiting in children. Author(s): O'Brien CM, Titley G, Whitehurst P. Source: Anaesthesia. 2003 July; 58(7): 707-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12886917

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A comparison of granisetron, droperidol, and metoclopramide in the treatment of established nausea and vomiting after breast surgery: a double-blind, randomized, controlled trial. Author(s): Fujii Y, Tanaka H, Kawasaki T. Source: Clinical Therapeutics. 2003 April; 25(4): 1142-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12809962

6

PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A comparison of intravenous ketoprofen versus pethidine on peri-operative analgesia and post-operative nausea and vomiting in paediatric vitreoretinal surgery. Author(s): Subramaniam R, Ghai B, Khetarpal M, Subramanyam MS. Source: Journal of Postgraduate Medicine. 2003 April-June; 49(2): 123-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12867686

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A comparison of the effects of droperidol and the combination of droperidol and ondansetron on postoperative nausea and vomiting for patients undergoing laparoscopic cholecystectomy. Author(s): Awad IT, Murphy D, Stack D, Swanton BJ, Meeke RI, Shorten GD. Source: Journal of Clinical Anesthesia. 2002 November; 14(7): 481-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477581

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A comparison of three antiemetic combinations for the prevention of postoperative nausea and vomiting. Author(s): Sanchez-Ledesma MJ, Lopez-Olaondo L, Pueyo FJ, Carrascosa F, Ortega A. Source: Anesthesia and Analgesia. 2002 December; 95(6): 1590-5, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12456422

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A comparison of total intravenous with balanced anaesthesia for middle ear surgery: effects on postoperative nausea and vomiting, pain, and conditions of surgery. Author(s): Mukherjee K, Seavell C, Rawlings E, Weiss A. Source: Anaesthesia. 2003 February; 58(2): 176-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12622108

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A prospective study of incidence of postoperative nausea and vomiting in a tertiary care hospital in Oman. Author(s): Maddali MM, Mathew J, Fahr J, Zarroug AW. Source: Middle East J Anesthesiol. 2003 February; 17(1): 131-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12754778

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A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. Author(s): Sripramote M, Lekhyananda N. Source: J Med Assoc Thai. 2003 September; 86(9): 846-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14649969

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A randomized controlled trial of nerve stimulation for relief of nausea and vomiting in pregnancy. Author(s): Rosen T, de Veciana M, Miller HS, Stewart L, Rebarber A, Slotnick RN. Source: Obstetrics and Gynecology. 2003 July; 102(1): 129-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12850618

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A response to 'A comparison of cyclizine, ondansetron and placebo as prophylaxis against postoperative nausea and vomiting in children' O'Brien CM, Titley G, Whitehurst P, Anaesthesia 2003; 58: 707-11. Author(s): Oldman M, Youngs P, Johnson A. Source: Anaesthesia. 2003 November; 58(11): 1151. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616647

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A systematic approach to the management of postoperative nausea and vomiting. Author(s): Golembiewski JA, O'Brien D. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2002 December; 17(6): 364-76. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12476402

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Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer blind trial. Author(s): Streitberger K, Diefenbacher M, Bauer A, Conradi R, Bardenheuer H, Martin E, Schneider A, Unnebrink K. Source: Anaesthesia. 2004 February; 59(2): 142-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14725517

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Acupuncture to reduce nausea during chemotherapy treatment of rheumatic diseases. Author(s): Josefson A, Kreuter M. Source: Rheumatology (Oxford, England). 2003 October; 42(10): 1149-54. Epub 2003 May 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12777644

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Adding droperidol to morphine patient-controlled analgesia: effect on nausea and vomiting. Author(s): Sanansilp V, Soontarinka S, Kantigal P, Visalyaputra S, Deesawat J, Phadermwongsa P, Parakkamodom S, Vudhikamraksa S. Source: J Med Assoc Thai. 2002 September; 85 Suppl 3: S923-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12452231

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Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America. Author(s): Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, Julie Ma G, Eldridge K, Hipple A, Evans JK, Horgan KJ, Lawson F; Aprepitant Protocol 054 Study Group. Source: Cancer. 2003 June 15; 97(12): 3090-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12784346

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Addition of the oral NK1 antagonist aprepitant to standard antiemetics provides protection against nausea and vomiting during multiple cycles of cisplatin-based chemotherapy. Author(s): de Wit R, Herrstedt J, Rapoport B, Carides AD, Carides G, Elmer M, Schmidt C, Evans JK, Horgan KJ. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 November 15; 21(22): 4105-11. Epub 2003 October 14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14559891

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Advice on postop nausea and vomiting. Author(s): Ninger L. Source: Or Manager. 2003 November; 19(11): 25-6, 28. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14639792

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An audit of post-operative nausea and vomiting, following cardiac surgery: scope of the problem. Author(s): Mace L. Source: Nursing in Critical Care. 2003 September-October; 8(5): 187-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14653525

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Are health states 'timeless'? A case study of an acute condition: post-chemotherapy nausea and vomiting. Author(s): Franic DM, Pathak DS, Gafni A. Source: Journal of Evaluation in Clinical Practice. 2003 February; 9(1): 69-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12558704

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Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea. Author(s): Anderson LA, Gross JB. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2004 February; 19(1): 29-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14770380

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Arterial hypotension during induction of anesthesia may not be a risk factor for postoperative nausea and vomiting. Author(s): Kranke P, Roewer N, Rusch D, Piper SN. Source: Anesthesia and Analgesia. 2003 January; 96(1): 302-3; Author Reply 303. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12505973

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Assessing the impact of chemotherapy-induced nausea and vomiting on patients' daily lives: a modified version of the Functional Living Index-Emesis (FLIE) with 5day recall. Author(s): Martin AR, Pearson JD, Cai B, Elmer M, Horgan K, Lindley C. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 2003 August; 11(8): 522-7. Epub 2003 June 25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12827483

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Atrial fibrillation after ondansetron for the prevention and treatment of postoperative nausea and vomiting: a case report. Author(s): Kasinath NS, Malak O, Tetzlaff J. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 March; 50(3): 229-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12620943

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Benefits and risks of newer treatments for chemotherapy-induced and postoperative nausea and vomiting. Author(s): Kovac AL. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 2003; 26(4): 227-59. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12608887

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Changes in family relationships affect the development of chemotherapy-related nausea symptoms. Author(s): Kim Y, Morrow GR. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 2003 March; 11(3): 171-7. Epub 2003 January 25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12618927

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Chemotherapy-induced nausea and vomiting: the importance of acute antiemetic control. Author(s): Schnell FM. Source: The Oncologist. 2003; 8(2): 187-98. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12697943

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Clinical comparison of the selective serotonin3 antagonists ramosetron and granisetron in treating acute chemotherapy-induced emesis, nausea and anorexia. Author(s): Feng F, Zhang P, He Y, Li Y, Zhou M, Chen G, Li L. Source: Chinese Medical Sciences Journal = Chung-Kuo I Hsueh K'o Hsueh Tsa Chih / Chinese Academy of Medical Sciences. 2002 September; 17(3): 168-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12901541

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Comparative study of low-dose oral granisetron plus dexamethasone and high-dose metoclopramide plus dexamethasone in prevention of nausea and vomiting induced by CHOP-therapy in young patients with non-Hodgkin's lymphoma. Author(s): Numbenjapon T, Sriswasdi C, Mongkonsritragoon W, Leelasiri A, Prayoonwiwat W. Source: J Med Assoc Thai. 2002 November; 85(11): 1156-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12546311

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Comparison of acupressure bands and droperidol for reducing post-operative nausea and vomiting in gynecologic surgery patients. Author(s): Schultz AA, Andrews AL, Goran SF, Mathew T, Sturdevant N. Source: Applied Nursing Research : Anr. 2003 November; 16(4): 256-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14608559

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Comparison of acustimulation and ondansetron for the treatment of established postoperative nausea and vomiting. Author(s): Coloma M, White PF, Ogunnaike BO, Markowitz SD, Brown PM, Lee AQ, Berrisford SB, Wakefield CA, Issioui T, Jones SB, Jones DB. Source: Anesthesiology. 2002 December; 97(6): 1387-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12459663

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Comparison of granisetron and granisetron plus dexamethasone for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy. Author(s): Biswas BN, Rudra A. Source: Acta Anaesthesiologica Scandinavica. 2003 January; 47(1): 79-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12492802

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Comparison of granisetron with granisetron plus droperidol combination prophylaxis in post-operative nausea and vomiting after laparoscopic cholecystectomy. Author(s): Ozmen S, Yavuz L, Ceylan BG, Tarhan O, Aydin C. Source: J Int Med Res. 2002 September-October; 30(5): 520-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12449522

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Comparison of inhaled isopropyl alcohol and intravenous ondansetron for treatment of postoperative nausea. Author(s): Winston AW, Rinehart RS, Riley GP, Vacchiano CA, Pellegrini JE. Source: Aana Journal. 2003 April; 71(2): 127-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12776641

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Comparison of three outpatient regimens in the management of nausea and vomiting in pregnancy. Author(s): Bsat FA, Hoffman DE, Seubert DE. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2003 October; 23(7): 531-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566347

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Consensus guidelines for managing postoperative nausea and vomiting. Author(s): Gan TJ, Meyer T, Apfel CC, Chung F, Davis PJ, Eubanks S, Kovac A, Philip BK, Sessler DI, Temo J, Tramer MR, Watcha M; Department of Anesthesiology, Duke University Medical Center. Source: Anesthesia and Analgesia. 2003 July; 97(1): 62-71, Table of Contents. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12818945

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Consensus guidelines for managing postoperative nausea and vomiting: is there a conflict of interest? Author(s): White PF. Source: Anesthesia and Analgesia. 2004 February; 98(2): 550; Author Reply 550-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14742406

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Continuous PC6 wristband acupressure for relief of nausea and vomiting associated with acute myocardial infarction: a partially randomised, placebo-controlled trial. Author(s): Dent HE, Dewhurst NG, Mills SY, Willoughby M. Source: Complementary Therapies in Medicine. 2003 June; 11(2): 72-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12801491

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Corticosteroids underemployment in delayed chemotherapy-induced nausea and emesis with poor adherence to American Society of Clinical Oncology guidelines: is this a reasonable clinical choice for the elderly? Author(s): Gridelli C, Maione P, Rossi A. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 November 1; 21(21): 4066-7; Author Reply 4067-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14581432

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Cost-effectiveness of three combinations of antiemetics in the prevention of postoperative nausea and vomiting. Author(s): Pueyo FJ, Lopez-Olaondo L, Sanchez-Ledesma MJ, Ortega A, Carrascosa F. Source: British Journal of Anaesthesia. 2003 October; 91(4): 589-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14504165

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Delayed chemotherapy-induced nausea in women treated for breast cancer. Author(s): Dibble SL, Isreal J, Nussey B, Casey K, Luce J. Source: Oncology Nursing Forum. 2003 March-April; 30(2): E40-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12692669

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Development of an instrument to measure nausea and vomiting in pregnancy. Author(s): Swallow BL, Lindow SW, Masson EA, Hay DM. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2002 September; 22(5): 481-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12521412

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Dexamethasone 8 mg in combination with ondansetron 4 mg appears to be the optimal dose for the prevention of nausea and vomiting after laparoscopic cholecystectomy. Author(s): Elhakim M, Nafie M, Mahmoud K, Atef A. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 November; 49(9): 922-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12419717

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Dexamethasone is as effective as ondansetron for the prevention of postoperative nausea and vomiting following breast surgery. Author(s): Wattwil M, Thorn SE, Lovqvist A, Wattwil L, Gupta A, Liljegren G. Source: Acta Anaesthesiologica Scandinavica. 2003 August; 47(7): 823-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12859302

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Dexamethasone prevents postoperative nausea and vomiting more effectively in women with motion sickness. Author(s): Lee Y, Lai HY, Lin PC, Huang SJ, Lin YS. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 March; 50(3): 232-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12620944

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Diclectin therapy for nausea and vomiting of pregnancy: effects of optimal dosing. Author(s): Boskovic R, Einarson A, Maltepe C, Wolpin J, Koren G. Source: J Obstet Gynaecol Can. 2003 October; 25(10): 830-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14532951

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Difference in risk factors for postoperative nausea and vomiting. Author(s): Stadler M, Bardiau F, Seidel L, Albert A, Boogaerts JG. Source: Anesthesiology. 2003 January; 98(1): 46-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12502978

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Does meta-analysis increase our knowledge in the management of postoperative nausea and vomiting? Author(s): Tramer MR. Source: International Anesthesiology Clinics. 2003 Fall; 41(4): 33-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574213

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Does the routine prophylactic use of antiemetics affect the incidence of postdischarge nausea and vomiting following ambulatory surgery?: A systematic review of randomized controlled trials. Author(s): Gupta A, Wu CL, Elkassabany N, Krug CE, Parker SD, Fleisher LA. Source: Anesthesiology. 2003 August; 99(2): 488-95. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12883424

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Dolasetron prophylaxis reduces nausea and postanaesthesia recovery time after remifentanil infusion during monitored anaesthesia care for extracorporeal shock wave lithotripsy. Author(s): Burmeister MA, Standl TG, Wintruff M, Brauer P, Blanc I, Schulte am Esch J. Source: British Journal of Anaesthesia. 2003 February; 90(2): 194-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12538377

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Dolasetron, but not metoclopramide prevents nausea and vomiting in patients undergoing laparoscopic cholecystectomy. Author(s): Piper SN, Suttner SW, Rohm KD, Maleck WH, Larbig E, Boldt J. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 December; 49(10): 1021-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477671

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Effect of a ginger extract on pregnancy-induced nausea: a randomised controlled trial. Author(s): Willetts KE, Ekangaki A, Eden JA. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 2003 April; 43(2): 139-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14712970

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Effect of acupressure on postoperative nausea and vomiting in laparoscopic cholecystectomy. Author(s): Samad K, Afshan G, Kamal R. Source: J Pak Med Assoc. 2003 February; 53(2): 68-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12705488

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Effect of drainage on postoperative nausea, vomiting, and pain after laparoscopic cholecystectomy. Author(s): Nursal TZ, Yildirim S, Tarim A, Noyan T, Poyraz P, Tuna N, Haberal M. Source: Langenbeck's Archives of Surgery / Deutsche Gesellschaft Fur Chirurgie. 2003 April; 388(2): 95-100. Epub 2003 April 02. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12684804

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Effect of gabapentin on nausea induced by chemotherapy in patients with breast cancer. Author(s): Guttuso T Jr, Roscoe J, Griggs J. Source: Lancet. 2003 May 17; 361(9370): 1703-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12767738

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Effect of supplemental pre-operative fluid on postoperative nausea and vomiting. Author(s): Ali SZ, Taguchi A, Holtmann B, Kurz A. Source: Anaesthesia. 2003 August; 58(8): 780-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12859471

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Effectiveness of Gorei-san (TJ-17) for treatment of SSRI-induced nausea and dyspepsia: preliminary observations. Author(s): Yamada K, Yagi G, Kanba S. Source: Clinical Neuropharmacology. 2003 May-June; 26(3): 112-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782911

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Establishing the dose of the oral NK1 antagonist aprepitant for the prevention of chemotherapy-induced nausea and vomiting. Author(s): Chawla SP, Grunberg SM, Gralla RJ, Hesketh PJ, Rittenberg C, Elmer ME, Schmidt C, Taylor A, Carides AD, Evans JK, Horgan KJ. Source: Cancer. 2003 May 1; 97(9): 2290-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12712486

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Expectations of chemotherapy-related nausea: emotional and experiential predictors. Author(s): Montgomery GH, Bovbjerg DH. Source: Annals of Behavioral Medicine : a Publication of the Society of Behavioral Medicine. 2003 Winter; 25(1): 48-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12581936

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Ginger does not prevent postoperative nausea and vomiting after laparoscopic surgery. Author(s): Eberhart LH, Mayer R, Betz O, Tsolakidis S, Hilpert W, Morin AM, Geldner G, Wulf H, Seeling W. Source: Anesthesia and Analgesia. 2003 April; 96(4): 995-8, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12651648

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Granisetron in the control of nausea and vomiting associated with bone marrow transplantation: a review of its efficacy and tolerability. Author(s): Prentice HG. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 2003 August; 11(8): 501-8. Epub 2003 July 05. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12845514

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Granisetron versus granisetron/dexamethasone combination for the treatment of nausea, retching, and vomiting after major gynecologic surgery: a randomized, double-blind study. Author(s): Fujii Y, Tanaka H. Source: Clinical Therapeutics. 2003 February; 25(2): 507-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12749510

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Granisetron: is there a dose-response effect on nausea and vomiting? Author(s): Minami M. Source: Cancer Chemotherapy and Pharmacology. 2003 August; 52(2): 89-98. Epub 2003 May 29. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12783208

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Granisetron: new insights into its use for the treatment of chemotherapy-induced nausea and vomiting. Author(s): Tan M. Source: Expert Opinion on Pharmacotherapy. 2003 September; 4(9): 1563-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12943486

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Guidelines outline strategies to reduce post-operative nausea and vomiting. Author(s): Rollins G. Source: Rep Med Guidel Outcomes Res. 2002 April 19; 13(8): 9-10, 12. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12467270

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Higher plasma 5-hydroxyindoleacetic acid levels are associated with SSRI-induced nausea. Author(s): Ueda N, Yoshimura R, Shinkai K, Sakata Y, Nakamura J. Source: Neuropsychobiology. 2003; 48(1): 31-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12886038

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History of postoperative nausea and vomiting. Author(s): Raeder J. Source: International Anesthesiology Clinics. 2003 Fall; 41(4): 1-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574211

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Immediate-release versus controlled-release formulations: pharmacokinetics of newer antidepressants in relation to nausea. Author(s): DeVane CL. Source: The Journal of Clinical Psychiatry. 2003; 64 Suppl 18: 14-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14700450

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Improved prevention of moderately emetogenic chemotherapy-induced nausea and vomiting with palonosetron, a pharmacologically novel 5-HT3 receptor antagonist: results of a phase III, single-dose trial versus dolasetron. Author(s): Eisenberg P, Figueroa-Vadillo J, Zamora R, Charu V, Hajdenberg J, Cartmell A, Macciocchi A, Grunberg S; 99-04 Palonosetron Study Group. Source: Cancer. 2003 December 1; 98(11): 2473-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14635083

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Improving the care of patients with regard to chemotherapy-induced nausea and emesis: the effect of feedback to clinicians on adherence to antiemetic prescribing guidelines. Author(s): Mertens WC, Higby DJ, Brown D, Parisi R, Fitzgerald J, Benjamin EM, Lindenauer PK. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 April 1; 21(7): 1373-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12663729

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Incidence of postoperative nausea and vomiting in paediatric ambulatory surgery. Author(s): Villeret I, Laffon M, Duchalais A, Blond MH, Lecuyer AI, Mercier C. Source: Paediatric Anaesthesia. 2002 October; 12(8): 712-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12472709

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Increased incidence of postoperative nausea and vomiting without additional analgesic effects when a low dose of intravenous fentanyl is combined with a caudal block. Author(s): Kokinsky E, Nilsson K, Larsson LE. Source: Paediatric Anaesthesia. 2003 May; 13(4): 334-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12753447

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Intraoperative colloid administration reduces postoperative nausea and vomiting and improves postoperative outcomes compared with crystalloid administration. Author(s): Moretti EW, Robertson KM, El-Moalem H, Gan TJ. Source: Anesthesia and Analgesia. 2003 February; 96(2): 611-7, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12538221

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Intravenous fluid loading with or without supplementary dextrose does not prevent nausea, vomiting and pain after laparoscopy. Author(s): McCaul C, Moran C, O'Cronin D, Naughton F, Geary M, Carton E, Gardiner J. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 May; 50(5): 440-4. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12734150

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Is there rationale to use an antiemetic in the same class for the treatment of patients who experience postoperative nausea and vomiting despite prophylaxis? Author(s): Kovac AL. Source: Anesthesia and Analgesia. 2003 December; 97(6): 1857. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14633582

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Local active warming: an effective treatment for pain, anxiety and nausea caused by renal colic. Author(s): Kober A, Dobrovits M, Djavan B, Marberger M, Barker R, Bertalanffy P, Scheck T, Gustorff B, Hoerauf K. Source: The Journal of Urology. 2003 September; 170(3): 741-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12913687

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Low incidence of nausea and vomiting with intravenous opiate analgesia in the ED. Author(s): Paoloni R, Talbot-Stern J. Source: The American Journal of Emergency Medicine. 2002 November; 20(7): 604-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12442238

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Management of postoperative nausea and vomiting in ambulatory surgery. Author(s): Cameron D, Gan TJ. Source: Anesthesiology Clinics of North America. 2003 June; 21(2): 347-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12812400

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Managing nausea and vomiting. Current strategies. Author(s): Garrett K, Tsuruta K, Walker S, Jackson S, Sweat M. Source: Critical Care Nurse. 2003 February; 23(1): 31-50; Quiz 51-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12640958

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Measuring chemotherapy-induced nausea and emesis. Author(s): Martin CG, Rubenstein EB, Elting LS, Kim YJ, Osoba D. Source: Cancer. 2003 August 1; 98(3): 645-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12879484

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Metoclopramide pretreatment attenuates emergency contraceptive-associated nausea. Author(s): Ragan RE, Rock RW, Buck HW. Source: American Journal of Obstetrics and Gynecology. 2003 February; 188(2): 330-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12592235

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Monoamine oxidase A gene polymorphism, 5-HT 2A receptor gene polymorphism and incidence of nausea induced by fluvoxamine. Author(s): Yoshida K, Naito S, Takahashi H, Sato K, Ito K, Kamata M, Higuchi H, Shimizu T, Itoh K, Inoue K, Suzuki T, Ohkubo T. Source: Neuropsychobiology. 2003; 48(1): 10-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12886034

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Nausea and emesis remain significant problems of chemotherapy despite prophylaxis with 5-hydroxytryptamine-3 antiemetics: a University of Rochester James P. Wilmot Cancer Center Community Clinical Oncology Program Study of 360 cancer patients treated in the community. Author(s): Hickok JT, Roscoe JA, Morrow GR, King DK, Atkins JN, Fitch TR. Source: Cancer. 2003 June 1; 97(11): 2880-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12767103

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Nausea and vomiting after fast-track cardiac anaesthesia. Author(s): Kogan A, Eidelman LA, Raanani E, Orlov B, Shenkin O, Vidne BA. Source: British Journal of Anaesthesia. 2003 August; 91(2): 214-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12878620

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Nausea and vomiting after phacoemulsification using topical or retrobulbar anesthesia. Author(s): Chan JC, Lai JS, Lam DS. Source: Journal of Cataract and Refractive Surgery. 2002 November; 28(11): 1973-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12457672

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Nausea and vomiting associate with increasing maternal androgen levels in otherwise uncomplicated pregnancies. Author(s): Carlsen SM, Vanky E, Jacobsen G. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 March; 82(3): 225-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12694117

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Nausea and vomiting during pregnancy. Author(s): Koch KL, Frissora CL. Source: Gastroenterology Clinics of North America. 2003 March; 32(1): 201-34, Vi. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12635417

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Nausea and vomiting in early pregnancy. Author(s): Jewell D. Source: American Family Physician. 2003 July 1; 68(1): 143-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887120

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Nausea and vomiting in pregnancy in relation to prolactin, estrogens, and progesterone: a prospective study. Author(s): Lagiou P, Tamimi R, Mucci LA, Trichopoulos D, Adami HO, Hsieh CC. Source: Obstetrics and Gynecology. 2003 April; 101(4): 639-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12681864

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Nausea and vomiting in pregnancy: results of a survey that identified interventions used by women to alleviate their symptoms. Author(s): Chandra K, Magee L, Einarson A, Koren G. Source: Journal of Psychosomatic Obstetrics and Gynaecology. 2003 June; 24(2): 71-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854391

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Nausea and vomiting in pregnancy: safety and efficacy of self-administered complementary therapies. Author(s): Tiran D. Source: Complementary Therapies in Nursing & Midwifery. 2002 November; 8(4): 191-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12463608

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Nausea and vomiting of pregnancy. Author(s): Quinla JD, Hill DA. Source: American Family Physician. 2003 July 1; 68(1): 121-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887118

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Nausea and vomiting. Author(s): Hasler WL, Chey WD. Source: Gastroenterology. 2003 December; 125(6): 1860-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14724837

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Olanzapine as an antiemetic in refractory nausea and vomiting in advanced cancer. Author(s): Srivastava M, Brito-Dellan N, Davis MP, Leach M, Lagman R. Source: Journal of Pain and Symptom Management. 2003 June; 25(6): 578-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782438

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Olanzapine for intractable nausea in palliative care patients. Author(s): Jackson WC, Tavernier L. Source: Journal of Palliative Medicine. 2003 April; 6(2): 251-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854942

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Olfactory modulation of nausea during early pregnancy? Author(s): Hummel T, von Mering R, Huch R, Kolble N. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2002 December; 109(12): 1394-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12504977

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Oncology Patient Evidence-Based Notes (OPEN): antiemetics for chemotherapyinduced nausea and vomiting. Author(s): Cope D. Source: Clinical Journal of Oncology Nursing. 2003 July-August; 7(4): 461-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12929282

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Ondansetron disintegrating tablets of 8 mg twice a day for 3 days did not reduce the incidence of nausea or vomiting after laparoscopic surgery. Author(s): Thagaard KS, Steine S, Raeder J. Source: European Journal of Anaesthesiology. 2003 February; 20(2): 153-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12622501

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Ondansetron for prevention of intrathecal opioids-induced pruritus, nausea and vomiting after cesarean delivery. Author(s): Yazigi A, Chalhoub V, Madi-Jebara S, Haddad F. Source: Anesthesia and Analgesia. 2004 January; 98(1): 264; Author Reply 264. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14693635

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Ondansetron for the prevention and treatment of nausea and vomiting following pediatric strabismus surgery. Author(s): Caron E, Bussieres JF, Lebel D, Mathews S, Milot J, Jacob JL, Moride Y, Lortie L. Source: Can J Ophthalmol. 2003 April; 38(3): 214-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12733689

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Options for the prevention and management of acute chemotherapy-induced nausea and vomiting in children. Author(s): Dupuis LL, Nathan PC. Source: Paediatric Drugs. 2003; 5(9): 597-613. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956617

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P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women. Author(s): Alkaissi A, Evertsson K, Johnsson VA, Ofenbartl L, Kalman S. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 December; 49(10): 1034-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477673

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Pain, nausea, vomiting and ocular complications delay discharge following ambulatory microdiscectomy. Author(s): Shaikh S, Chung F, Imarengiaye C, Yung D, Bernstein M. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2003 May; 50(5): 514-8. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12734164

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Palonosetron improves prevention of chemotherapy-induced nausea and vomiting following moderately emetogenic chemotherapy: results of a double-blind randomized phase III trial comparing single doses of palonosetron with ondansetron. Author(s): Gralla R, Lichinitser M, Van Der Vegt S, Sleeboom H, Mezger J, Peschel C, Tonini G, Labianca R, Macciocchi A, Aapro M. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2003 October; 14(10): 1570-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14504060

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Pediatric orbital floor fractures: nausea/vomiting as signs of entrapment. Author(s): Cohen SM, Garrett CG. Source: Otolaryngology and Head and Neck Surgery. 2003 July; 129(1): 43-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12869915

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Peroral tramadol premedication increases postoperative nausea and delays homereadiness in day-case knee arthroscopy patients. Author(s): Liukkonen K, Santanen U, Pere P, Erkola O, Rautoma P. Source: Scand J Surg. 2002; 91(4): 365-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12558088

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Pharmacotherapy of postoperative nausea and vomiting. Author(s): Habib AS, Gan TJ. Source: Expert Opinion on Pharmacotherapy. 2003 April; 4(4): 457-73. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12667109

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Postoperative nausea and vomiting and outcome. Author(s): Scuderi PE, Conlay LA. Source: International Anesthesiology Clinics. 2003 Fall; 41(4): 165-74. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574220

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Postoperative nausea and vomiting in children and adolescents undergoing radiofrequency catheter ablation: a randomized comparison of propofol- and isoflurane-based anesthetics. Author(s): Erb TO, Hall JM, Ing RJ, Kanter RJ, Kern FH, Schulman SR, Gan TJ. Source: Anesthesia and Analgesia. 2002 December; 95(6): 1577-81, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12456419

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Postoperative nausea and vomiting in diagnostic gynaecological laparoscopic procedures: comparison of the efficacy of the combination of dexamethasone and metoclopramide with that of dexamethasone and ondansetron. Author(s): Maddali MM, Mathew J, Fahr J, Zarroug AW. Source: Journal of Postgraduate Medicine. 2003 October-December; 49(4): 302-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14699226

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Postoperative nausea and vomiting in regional anesthesia: a review. Author(s): Borgeat A, Ekatodramis G, Schenker CA. Source: Anesthesiology. 2003 February; 98(2): 530-47. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12552215

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Postoperative nausea and vomiting: a review of current literature. Author(s): Ku CM, Ong BC. Source: Singapore Med J. 2003 July; 44(7): 366-74. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14620731

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Pregnancy outcome following women's participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy. Author(s): Smith C, Crowther C, Beilby J. Source: Complementary Therapies in Medicine. 2002 June; 10(2): 78-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12481955

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Prevention of postoperative nausea and vomiting after spinal morphine for Caesarean section: comparison of cyclizine, dexamethasone and placebo. Author(s): Nortcliffe SA, Shah J, Buggy DJ. Source: British Journal of Anaesthesia. 2003 May; 90(5): 665-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12697596

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Prevention of postoperative nausea and vomiting. Author(s): Norred CL. Source: Aana Journal. 2002 October; 70(5): 343-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12425121

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Prophylaxis of nausea and vomiting after laparoscopic cholecystectomy with ramosetron: randomised controlled trial. Author(s): Fujii Y, Uemura A, Tanaka H. Source: The European Journal of Surgery = Acta Chirurgica. 2002; 168(11): 583-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12699092

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Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Author(s): Portnoi G, Chng LA, Karimi-Tabesh L, Koren G, Tan MP, Einarson A. Source: American Journal of Obstetrics and Gynecology. 2003 November; 189(5): 1374-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14634571

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Psychological health in early pregnancy: relationship with nausea and vomiting. Author(s): Swallow BL, Lindow SW, Masson EA, Hay DM. Source: Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology. 2004 January; 24(1): 28-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14675977

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Psychosocial factors related to nausea, vomiting, and fatigue in early pregnancy. Author(s): Chou FH, Lin LL, Cooney AT, Walker LO, Riggs MW. Source: Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau. 2003; 35(2): 119-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854291

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Ramosetron, a 5-HT3 receptor antagonist for the control of nausea and vomiting. Author(s): Rabasseda X. Source: Drugs Today (Barc). 2002 February; 38(2): 75-89. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12532186

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Randomized, double-blind trial of dolasetron versus droperidol for prophylaxis of postoperative nausea and vomiting in patients undergoing TRAM flap breast reconstruction surgery. Author(s): Loewen P, Lamb S, Clugston P. Source: Annals of Plastic Surgery. 2003 November; 51(5): 472-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14595183

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Randomized, double-blinded comparison of tropisetron and placebo for prevention of postoperative nausea and vomiting after supratentorial craniotomy. Author(s): Madenoglu H, Yildiz K, Dogru K, Kurtsoy A, Guler G, Boyaci A. Source: Journal of Neurosurgical Anesthesiology. 2003 April; 15(2): 82-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12657991

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Relationship between anxiety/depression and nausea: causal or associative? Author(s): Jagadisha D. Source: General Hospital Psychiatry. 2003 January-February; 25(1): 52; Author Reply 53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12583930

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Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy. Author(s): Kallen B, Lundberg G, Aberg A. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 October; 82(10): 916-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956841

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Reporting of clinical details in randomized controlled trials of acupuncture for the treatment of migraine/headaches and nausea/vomiting. Author(s): Elorriaga Claraco A, Hanna SE, Fargas-Babjak A. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2003 February; 9(1): 151-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12676043

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Risk assessment of postoperative nausea and vomiting. Author(s): Apfel CC, Roewer N. Source: International Anesthesiology Clinics. 2003 Fall; 41(4): 13-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574212

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Small dose of propofol for preventing nausea and vomiting after third molar extraction. Author(s): Fujii Y, Uemura A, Nakano M. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 2002 November; 60(11): 1246-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12420256

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Strategies to reduce postoperative nausea and vomiting: does metoclopramide have a role? Author(s): Beattie WS. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 December; 49(10): 1009-15. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477669

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Study of postoperative nausea and vomiting: recommending risk models for group comparisons. Author(s): Apfel CC, Koivuranta M, Sweeney B. Source: Anaesthesia. 2003 May; 58(5): 492-3; Author Reply 493. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12694019

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Supplemental oxygen does not reduce postoperative nausea and vomiting after thyroidectomy. Author(s): Joris JL, Poth NJ, Djamadar AM, Sessler DI, Hamoir EE, Defechereux TR, Meurisse MR, Lamy ML. Source: British Journal of Anaesthesia. 2003 December; 91(6): 857-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14633758

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Supplemental oxygen does not reduce the incidence of postoperative nausea and vomiting after ambulatory gynecologic laparoscopy. Author(s): Purhonen S, Turunen M, Ruohoaho UM, Niskanen M, Hynynen M. Source: Anesthesia and Analgesia. 2003 January; 96(1): 91-6, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12505931

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Supplemental oxygen for prevention of nausea and vomiting after breast surgery. Author(s): Purhonen S, Niskanen M, Wustefeld M, Mustonen P, Hynynen M. Source: British Journal of Anaesthesia. 2003 August; 91(2): 284-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12878631

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The effect of caffeine consumption and nausea on the risk of miscarriage. Author(s): Giannelli M, Doyle P, Roman E, Pelerin M, Hermon C. Source: Paediatric and Perinatal Epidemiology. 2003 October; 17(4): 316-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14629312

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The effect of craniotomy location on postoperative pain and nausea. Author(s): Irefin SA, Schubert A, Bloomfield EL, DeBoer GE, Mascha EJ, Ebrahim ZY. Source: Journal of Anesthesia. 2003; 17(4): 227-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14625709

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The effect of mandibular nerve block on opioid consumption, nausea and vomiting in bilateral mandibular osteotomies. Author(s): Van Lancker P, Abeloos JV, De Clercq CA, Mommaerts MY. Source: Acta Anaesthesiol Belg. 2003; 54(3): 223-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14598619

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The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. Author(s): Roscoe JA, Morrow GR, Hickok JT, Bushunow P, Pierce HI, Flynn PJ, Kirshner JJ, Moore DF, Atkins JN. Source: Journal of Pain and Symptom Management. 2003 August; 26(2): 731-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12906958

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The efficacy of ginger in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy. Author(s): Pongrojpaw D, Chiamchanya C. Source: J Med Assoc Thai. 2003 March; 86(3): 244-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12757064

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The management of nausea and vomiting of pregnancy. Author(s): Craig WS. Source: J Obstet Gynaecol Can. 2003 March; 25(3): 184; Discussion 184. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12610668

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The management of nausea and vomiting of pregnancy. Author(s): Boyd JJ. Source: J Obstet Gynaecol Can. 2003 January; 25(1): 13; Author Reply 13. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12548318

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The oral neurokinin-1 antagonist aprepitant for the prevention of chemotherapyinduced nausea and vomiting: a multinational, randomized, double-blind, placebocontrolled trial in patients receiving high-dose cisplatin--the Aprepitant Protocol 052 Study Group. Author(s): Hesketh PJ, Grunberg SM, Gralla RJ, Warr DG, Roila F, de Wit R, Chawla SP, Carides AD, Ianus J, Elmer ME, Evans JK, Beck K, Reines S, Horgan KJ; Aprepitant Protocol 052 Study Group. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2003 November 15; 21(22): 4112-9. Epub 2003 October 14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14559886

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The oral NK(1) antagonist, aprepitant, given with standard antiemetics provides protection against nausea and vomiting over multiple cycles of cisplatin-based chemotherapy: a combined analysis of two randomised, placebo-controlled phase III clinical trials. Author(s): de Wit R, Herrstedt J, Rapoport B, Carides AD, Guoguang-Ma J, Elmer M, Schmidt C, Evans JK, Horgan KJ. Source: European Journal of Cancer (Oxford, England : 1990). 2004 February; 40(3): 40310. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14746859

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The placebo response and effect of time in a trial of acupuncture to treat nausea and vomiting in early pregnancy. Author(s): Smith C, Crowther C. Source: Complementary Therapies in Medicine. 2002 December; 10(4): 210-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12594971

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The psychophysiology of nausea. Author(s): Stern RM. Source: Acta Biol Hung. 2002; 53(4): 589-99. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12501940

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The value of risks scores for predicting postoperative nausea and vomiting when used to compare patient group in a randomised controlled trial. Author(s): Thomas R, Jones NA, Strike P. Source: Anaesthesia. 2002 November; 57(11): 1119-28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12428640

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Transderm scopolamine: a painless, noninvasive option for control of postoperative nausea and vomiting. Author(s): Sandlin D. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2002 December; 17(6): 427-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12476411

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Treating nausea and vomiting during pregnancy: case outcome. Author(s): Harker N, Montgomery A, Fahey T. Source: Bmj (Clinical Research Ed.). 2004 February 28; 328(7438): 503; Discussion 504. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14988187

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Treatment of nausea and emesis during cancer chemotherapy. Discrepancies between antiemetic effect and well-being. Author(s): Borjeson S, Hursti TJ, Tishelman C, Peterson C, Steineck G. Source: Journal of Pain and Symptom Management. 2002 September; 24(3): 345-58. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12458116

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Treatment of postoperative nausea and vomiting. Author(s): Tramer MR. Source: Bmj (Clinical Research Ed.). 2003 October 4; 327(7418): 762-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14525850

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Unbalanced middle ear anaesthesia. A response to 'A comparison of total intravenous with balanced anaesthesia for middle ear surgery: effects on postoperative nausea and vomiting, pain and conditions of surgery', Mukherjee K et al., Anaesthesia 2003; 58: 176-9. Author(s): Walsh E. Source: Anaesthesia. 2003 June; 58(6): 620. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12846668

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Using diazepam and atropine before strabismus surgery to prevent postoperative nausea and vomiting: a randomized, controlled study. Author(s): Ozcan AA, Gunes Y, Haciyakupoglu G. Source: J Aapos. 2003 June; 7(3): 210-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12825062

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

Finding Nutrition Studies on Nausea 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 “nausea” (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 is a typical result when searching for recently indexed consumer information on nausea: •

Nausea and vomiting in early pregnancy. Source: Sharman, Ivan. Nutr-Food-Sci. London, Jan/February 1983. (80) page 20-22. charts. 0034-6659

Eng.

:

Forbes

Publications.

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

Are we failing women? Advice for nausea and vomiting in pregnancy. Author(s): Bournemouth University. Source: Allen, R Pract-Midwife. 2001 April; 4(4): 20-2 1461-3123

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Cannabidiol, a non-psychoactive component of cannabis and its synthetic dimethylheptyl homolog suppress nausea in an experimental model with rats. Author(s): Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario N2L 3C5, Canada. Source: Parker, Linda A Mechoulam, Raphael Schlievert, Coralynne Neuroreport. 2002 April 16; 13(5): 567-70 0959-4965

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Chemotherapy-induced nausea and vomiting. Author(s): University of Pittsburgh School of Nursing, 3500 Victoria Street, Room 415, Victoria Building, Pittsburgh, PA 15261, USA. [email protected] Source: Bender, Catherine M McDaniel, Roxanne W Murphy Ende, Kathleen Pickett, Mary Rittenberg, Cynthia N Rogers, Miriam P Schneider, Susan M Schwartz, Rowena N Clin-J-Oncol-Nurs. 2002 Mar-April; 6(2): 94-102 1092-1095

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Ginger for nausea. Source: Anonymous Harv-Womens-Health-Watch. 1999 September; 7(1): 7 1070-910X

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Nausea and vomiting of pregnancy: endocrine basis and contribution to pregnancy outcome. Author(s): Department of Biomedical Sciences, University of Nottinhgham, Queens Medical Centre, United Kingdom. Source: Furneaux, E C Langley Evans, A J Langley Evans, S C Obstet-GynecolSurvolume 2001 December; 56(12): 775-82 0029-7828

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Powerful peppermint calms indigestion, sore throat, and nausea. Source: Ciesinski, T. Org-gard. [Emmaus, PA : Rodale Press, c1988-. May/June 2001. volume 48 (4) page 18. 0897-3792

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Pre-emptive metoclopramide and ondansetron for nausea and vomiting associated with iloprost infusions. Author(s): Royal Devon & Exeter Hospital (Wonford), Barrack Road, Exeter, England EX2 5DW, UK. Source: Roome, C Thompson, J Pharm-World-Sci. 2001 June; 23(3): 122 0928-1231

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The cannabinoids: an overview. Therapeutic implications in vomiting and nausea after cancer chemotherapy, in appetite promotion, in multiple sclerosis and in neuroprotection. Author(s): Hebrew University, Jerusalem, Israel. [email protected] Source: Mechoulam, R Hanu, L Pain-Res-Manag. 2001 Summer; 6(2): 67-73 1203-6765

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The management of post-operative nausea and vomiting. Author(s): In-patient Neuroscience Center, The Medical College of Virginia Hospitals, Virginia Commonwealth University, USA.

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Source: Thompson, H J J-Adv-Nurs. 1999 May; 29(5): 1130-6 0309-2402 •

The use of nalmefene for intrathecal opioid-associated nausea in postpartum patients. Source: Ward, Robyn C Lawrence, Robert L Hawkins, Robert J DiChiara, Steven E Biegner, Andrew R Vacchiano, Charles A AANA-J. 2002 February; 70(1): 57-60 00946354

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Use of reversal agents in day care procedures (with special reference to postoperative nausea and vomiting). Author(s): Department of Anaesthesia and Critical Care, University of the Saarland, D66421 Homburg/Saar, Germany. [email protected] Source: Fuchs Buder, T Mencke, T Eur-J-Anaesthesiol-Suppl. 2001; 23: 53-9 0952-1941

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to nausea; 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 Pyridoxine Source: Integrative Medicine Communications; www.drkoop.com Vitamin A Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10066,00.html Vitamin B Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10067,00.html Vitamin B3 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B6 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B6 (Pyridoxine) Source: Integrative Medicine Communications; www.drkoop.com Vitamin C Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin D Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,905,00.html

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Vitamin E Alternative names: Alpha-Tocopherol, Beta-Tocopherol, D-Alpha-Tocopherol, Delta-Tocopherol, Gamma-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com Vitamin K Source: Prima Communications, Inc.www.personalhealthzone.com •

Minerals Acetyl-l-carnitine Source: Healthnotes, Inc.; www.healthnotes.com Alpha-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Beta-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Biotin Source: Healthnotes, Inc.; www.healthnotes.com Boron Source: Healthnotes, Inc.; www.healthnotes.com Boron Source: Prima Communications, Inc.www.personalhealthzone.com Cisplatin Source: Healthnotes, Inc.; www.healthnotes.com Copper Source: Integrative Medicine Communications; www.drkoop.com Copper Source: Prima Communications, Inc.www.personalhealthzone.com Copper Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,886,00.html D-alpha-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Delta-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Fluoxetine Source: Healthnotes, Inc.; www.healthnotes.com

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Gamma-tocopherol Source: Integrative Medicine Communications; www.drkoop.com Lecithin and Choline Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10040,00.html Lecithin/Phosphatidylcholine/Choline Source: Healthnotes, Inc.; www.healthnotes.com Magnesium Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html Paroxetine Source: Healthnotes, Inc.; www.healthnotes.com Potassium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10086,00.html Retinol Source: Integrative Medicine Communications; www.drkoop.com Selenium Source: Prima Communications, Inc.www.personalhealthzone.com Selenium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10055,00.html Vitamin A (Retinol) Source: Integrative Medicine Communications; www.drkoop.com Zinc Source: Healthnotes, Inc.; www.healthnotes.com Zinc Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10071,00.html

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Food and Diet Artichoke Alternative names: Cynara scolymus Source: Healthnotes, Inc.; www.healthnotes.com Chondroitin Sulfate Source: Healthnotes, Inc.; www.healthnotes.com Fasting Diet Source: Healthnotes, Inc.; www.healthnotes.com Garlic Source: Prima Communications, Inc.www.personalhealthzone.com Garlic Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,786,00.html Nutritional Yeast Alternative names: Brewer's Yeast Source: Integrative Medicine Communications; www.drkoop.com Tyramine-Free Diet Source: Healthnotes, Inc.; www.healthnotes.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND NAUSEA Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to nausea. At the conclusion of this chapter, we will provide additional sources.

The Combined Health Information Database The Combined Health Information Database (CHID) is a bibliographic database produced by health-related agencies of the U.S. federal government (mostly from the National Institutes of Health) that can offer concise information for a targeted search. The CHID database is updated four times a year at the end of January, April, July, and October. Check the titles, summaries, and availability of CAM-related information by using the “Simple Search” option at the following Web site: http://chid.nih.gov/simple/simple.html. In the drop box at the top, select “Complementary and Alternative Medicine.” Then type “nausea” (or synonyms) in the second search box. We recommend that you select 100 “documents per page” and to check the “whole records” options. The following was extracted using this technique: •

Effect of Therapeutic Touch on the Well-Being of Persons With Terminal Cancer Source: Journal of Holistic Nursing. 16(3): 383-398. September 1998. Summary: This journal article describes a study of the effects of therapeutic touch on the well-being of patients with terminal cancer. The participants were 20 inpatients with terminal cancer, ages 38 to 68 years, on the palliative care unit of a university-affiliated Canadian hospital. They were randomly assigned to three treatments with noncontact therapeutic touch (experimental group) or three rest periods (control group) on consecutive days. Both interventions lasted 15 to 20 minutes and took place at approximately the same time of day, 1 hour following a regularly prescribed analgesic. Well-being was assessed before and immediately after the intervention using the WellBeing Scale, a visual analogue scale measuring pain, nausea, depression, anxiety, shortness of breath, activity, appetite, relaxation, and inner peace. The mean well-being score increased significantly in the experimental group compared with the control group over the three intervention sessions. The mean score for the experimental group

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increased progressively that successive treatments, whereas that of the control group decreased slightly over time. The authors discuss factors which might explain the results, and offer suggestions for further research. The article has 1 figure, 6 tables, and 32 references. •

NIH Consensus Conference: Acupuncture Source: JAMA. Journal of the American Medical Association. 280(17): 1518-1524. November 4, 1998. Summary: This journal article presents the findings of the consensus conference on acupuncture, sponsored by the Office of Alternative Medicine and the Office of Medical Applications of Research, National Institutes of Health. The purpose of the conference was to provide clinicians, patients, and the general public with a reliable assessment of the use and effectiveness of acupuncture for a variety of conditions. A multidisciplinary panel evaluated evidence presented by experts and in the scientific literature, and developed a consensus statement addressing five issues: the efficacy of acupuncture compared with placebo or sham acupuncture, the place of acupuncture in clinical practice, the biological effects of acupuncture, the integration of acupuncture into the health care system, and directions for future research. The panel concluded that many of the efficacy studies of acupuncture provide equivocal results because of design, sample size, and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls. However, promising results have emerged showing the efficacy of acupuncture for adult postoperative and chemotherapy nausea and vomiting, and in postoperative dental pain. In other conditions such as addiction, stroke rehabilitation, headache, menstrual cramps, fibromyalgia, myofascial pain, osteoarthritis, tennis elbow, low back pain, carpal tunnel syndrome, and asthma, acupuncture may be useful as an adjunct treatment, an acceptable alternative, or part of a comprehensive management plan. This article has 66 references.

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Complementary Therapies: Overview and State of the Art Source: Cancer Nursing. 22(1): 85-90. February 1999. Summary: This journal article provides an overview of the benefits and potential problems of complementary therapies for cancer. The author distinguishes between alternative and complementary therapies, noting that alternative therapies are used instead of conventional cancer treatment, whereas complementary therapies are used as adjuncts to mainstream care. In the author's opinion, alternative therapies can be dangerous clinically and also because their use may delay patient's receipt of mainstream care. The first part of this article reviews the evidence regarding the seven categories of alternative therapies established by the Office of Alternative Medicine. The second part describes the potential benefits of selected complementary therapies for some of the difficulties associated with cancer diagnosis, treatment, and survival including therapies for stress and anxiety, constipation, depression, diarrhea, and nausea. The third part outlines the risks associated with certain herbal products, including products with potentially harmful effects, products that are ineffective, products that are fake or highly contaminated, products with inaccurate labeling, and products based on unverified evidence. The article has 5 references.

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Acupuncture: A Review of Its History, Theories, and Indications Source: Southern Medical Journal. 91(12): 1121-1125. December 1998.

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Summary: This journal article reviews the literature on the history, techniques, physiology, indications, adverse effects, and limitations of acupuncture. It describes six approaches to acupuncture that commonly are used in the United States: traditional Chinese medicine acupuncture, French energetics, Korean hand acupuncture, five element theory, auricular acupuncture, and myofascially-based acupuncture. It reviews neurophysiologic theories of the action of acupuncture; methodological difficulties in acupuncture research; and studies supporting the efficacy of acupuncture as a treatment for various pain syndromes, nausea, asthma, addiction, and stroke. It also identifies some of the adverse effects related to acupuncture which have been reported, and highlights studies suggesting that acupuncture may have only limited use. Finally, one of the authors describes his own personal and clinical experience with acupuncture. The article has 43 references. •

Acceptance of Some Acupuncture Applications Source: JAMA. Journal of the American Medical Association. 278(21): 1725-1727. December 3, 1997. Summary: This journal article summarizes the findings of the National Institutes of Health consensus panel on acupuncture. After evaluating current evidence for the efficacy of acupuncture, the 12-member panel concluded that there is clear evidence of efficacy in the control of postoperative nausea and vomiting, nausea and vomiting associated with chemotherapy and postoperative dental pain, and probably for nausea in early pregnancy. The panelists also found that the use of acupuncture, by itself or as an adjunct therapy, results in satisfactory treatment for a number of other conditions, although firm evidence of efficacy has not yet been established. The panelists concluded that more research is needed linking the use of acupuncture to physiological changes known to be associated with pain relief, and that more attention should be given to the issues involved in expanding the use of acupuncture into the health care system. In addition, the panelists noted that acupuncture has fewer side effects than many of the drugs or accepted medical procedures used for the same conditions. Finally, the panelists commended the progress the acupuncture educational community has made in establishing training and credentialing programs.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to nausea and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “nausea” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to nausea: •

A pilot study of the use of progressive muscle relaxation training in the management of post-chemotherapy nausea and vomiting. Author(s): Molassiotis A. Source: European Journal of Cancer Care. 2000 December; 9(4): 230-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11829370

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A randomized comparison of ginger and vitamin B6 in the treatment of nausea and vomiting of pregnancy. Author(s): Sripramote M, Lekhyananda N. Source: J Med Assoc Thai. 2003 September; 86(9): 846-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14649969

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A randomized controlled trial of ginger to treat nausea and vomiting in pregnancy. Author(s): Smith C, Crowther C, Willson K, Hotham N, McMillian V. Source: Obstetrics and Gynecology. 2004 April; 103(4): 639-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15051552

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A randomized controlled trial of nerve stimulation for relief of nausea and vomiting in pregnancy. Author(s): Rosen T, de Veciana M, Miller HS, Stewart L, Rebarber A, Slotnick RN. Source: Obstetrics and Gynecology. 2003 July; 102(1): 129-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12850618

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A systematic approach to the management of postoperative nausea and vomiting. Author(s): Golembiewski JA, O'Brien D. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2002 December; 17(6): 364-76. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12476402

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Acupressure and acustimulation bands for control of nausea: a brief review. Author(s): Roscoe JA, Matteson SE. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S244-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011894

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Acupressure and ondansetron for postoperative nausea and vomiting after laparoscopic cholecystectomy. Author(s): Agarwal A, Bose N, Gaur A, Singh U, Gupta MK, Singh D. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 JuneJuly; 49(6): 554-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12067865

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Acupressure wristbands for the prevention of postoperative nausea and vomiting in adults undergoing cardiac surgery. Author(s): Klein AA, Djaiani G, Karski J, Carroll J, Karkouti K, McCluskey S, Poonawala H, Shayan C, Fedorko L, Cheng D.

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Source: Journal of Cardiothoracic and Vascular Anesthesia. 2004 February; 18(1): 68-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14973803 •

Acupuncture and acupressure for the management of chemotherapy-induced nausea and vomiting. Author(s): Collins KB, Thomas DJ. Source: Journal of the American Academy of Nurse Practitioners. 2004 February; 16(2): 76-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15055425

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Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer blind trial. Author(s): Streitberger K, Diefenbacher M, Bauer A, Conradi R, Bardenheuer H, Martin E, Schneider A, Unnebrink K. Source: Anaesthesia. 2004 February; 59(2): 142-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14725517

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Acupuncture for postoperative nausea and vomiting prophylaxis: where's the point? Author(s): Cohn AI. Source: Anesthesiology. 2002 October; 97(4): 1038-9; Author Reply 1039. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12357192

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Acupuncture to reduce nausea during chemotherapy treatment of rheumatic diseases. Author(s): Josefson A, Kreuter M. Source: Rheumatology (Oxford, England). 2003 October; 42(10): 1149-54. Epub 2003 May 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12777644

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Acupuncture to treat nausea and vomiting in early pregnancy: a randomized controlled trial. Author(s): Smith C, Crowther C, Beilby J. Source: Birth (Berkeley, Calif.). 2002 March; 29(1): 1-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11843784

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Acustimulation wristbands for the relief of chemotherapy-induced nausea. Author(s): Roscoe JA, Morrow GR, Bushunow P, Tian L, Matteson S. Source: Alternative Therapies in Health and Medicine. 2002 July-August; 8(4): 56-7, 5963. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12126174

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Are we failing women? Advice for nausea and vomiting in pregnancy. Author(s): Allen R.

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Source: Pract Midwife. 2001 April; 4(4): 20-2. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12026609 •

Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea. Author(s): Anderson LA, Gross JB. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2004 February; 19(1): 29-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14770380

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Cannabidiol, a non-psychoactive component of cannabis and its synthetic dimethylheptyl homolog suppress nausea in an experimental model with rats. Author(s): Parker LA, Mechoulam R, Schlievert C. Source: Neuroreport. 2002 April 16; 13(5): 567-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11973447

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Capsicum plaster at the korean hand acupuncture point reduces postoperative nausea and vomiting after abdominal hysterectomy. Author(s): Kim KS, Koo MS, Jeon JW, Park HS, Seung IS. Source: Anesthesia and Analgesia. 2002 October; 95(4): 1103-7, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12351304

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Chemotherapy-induced nausea and vomiting. Author(s): Bender CM, McDaniel RW, Murphy-Ende K, Pickett M, Rittenberg CN, Rogers MP, Schneider SM, Schwartz RN. Source: Clinical Journal of Oncology Nursing. 2002 March-April; 6(2): 94-102. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11889684

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Chemotherapy-related nausea and vomiting - past reflections, present practice and future management. Author(s): Miller M, Kearney N. Source: European Journal of Cancer Care. 2004 March; 13(1): 71-81. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14961778

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Comparative efficacy of acustimulation (ReliefBand) versus ondansetron (Zofran) in combination with droperidol for preventing nausea and vomiting. Author(s): White PF, Issioui T, Hu J, Jones SB, Coleman JE, Waddle JP, Markowitz SD, Coloma M, Macaluso AR, Ing CH. Source: Anesthesiology. 2002 November; 97(5): 1075-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12411789

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Comparative study of low-dose oral granisetron plus dexamethasone and high-dose metoclopramide plus dexamethasone in prevention of nausea and vomiting induced by CHOP-therapy in young patients with non-Hodgkin's lymphoma. Author(s): Numbenjapon T, Sriswasdi C, Mongkonsritragoon W, Leelasiri A, Prayoonwiwat W. Source: J Med Assoc Thai. 2002 November; 85(11): 1156-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12546311

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Comparison of acupressure bands and droperidol for reducing post-operative nausea and vomiting in gynecologic surgery patients. Author(s): Schultz AA, Andrews AL, Goran SF, Mathew T, Sturdevant N. Source: Applied Nursing Research : Anr. 2003 November; 16(4): 256-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14608559

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Comparison of acustimulation and ondansetron for the treatment of established postoperative nausea and vomiting. Author(s): Coloma M, White PF, Ogunnaike BO, Markowitz SD, Brown PM, Lee AQ, Berrisford SB, Wakefield CA, Issioui T, Jones SB, Jones DB. Source: Anesthesiology. 2002 December; 97(6): 1387-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12459663

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Continuous PC6 wristband acupressure for relief of nausea and vomiting associated with acute myocardial infarction: a partially randomised, placebo-controlled trial. Author(s): Dent HE, Dewhurst NG, Mills SY, Willoughby M. Source: Complementary Therapies in Medicine. 2003 June; 11(2): 72-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12801491

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Effect of a ginger extract on pregnancy-induced nausea: a randomised controlled trial. Author(s): Willetts KE, Ekangaki A, Eden JA. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 2003 April; 43(2): 139-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14712970

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Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study. Author(s): Werntoft E, Dykes AK. Source: J Reprod Med. 2001 September; 46(9): 835-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11584487

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Effect of acupressure on postoperative nausea and vomiting in laparoscopic cholecystectomy. Author(s): Samad K, Afshan G, Kamal R.

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Source: J Pak Med Assoc. 2003 February; 53(2): 68-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12705488 •

Effectiveness of Gorei-san (TJ-17) for treatment of SSRI-induced nausea and dyspepsia: preliminary observations. Author(s): Yamada K, Yagi G, Kanba S. Source: Clinical Neuropharmacology. 2003 May-June; 26(3): 112-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782911

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Electroacupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy. Author(s): Rusy LM, Hoffman GM, Weisman SJ. Source: Anesthesiology. 2002 February; 96(2): 300-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11818760

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Ginger does not prevent postoperative nausea and vomiting after laparoscopic surgery. Author(s): Eberhart LH, Mayer R, Betz O, Tsolakidis S, Hilpert W, Morin AM, Geldner G, Wulf H, Seeling W. Source: Anesthesia and Analgesia. 2003 April; 96(4): 995-8, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12651648

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Guidelines outline strategies to reduce post-operative nausea and vomiting. Author(s): Rollins G. Source: Rep Med Guidel Outcomes Res. 2002 April 19; 13(8): 9-10, 12. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12467270

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Interventions for nausea and vomiting in early pregnancy. Author(s): Jewell D, Young G. Source: Cochrane Database Syst Rev. 2003; (4): Cd000145. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14583914

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Interventions for nausea and vomiting in early pregnancy. Author(s): Jewell D, Young G. Source: Cochrane Database Syst Rev. 2002; (1): Cd000145. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11869567

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Korean hand acupressure reduces postoperative nausea and vomiting after gynecological laparoscopic surgery. Author(s): Boehler M, Mitterschiffthaler G, Schlager A.

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Source: Anesthesia and Analgesia. 2002 April; 94(4): 872-5, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11916788 •

Management of postoperative nausea and vomiting in children. Author(s): De Negri P, Ivani G. Source: Paediatric Drugs. 2002; 4(11): 717-28. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12390043

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Managing nausea and vomiting. Current strategies. Author(s): Garrett K, Tsuruta K, Walker S, Jackson S, Sweat M. Source: Critical Care Nurse. 2003 February; 23(1): 31-50; Quiz 51-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12640958

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Managing nausea, vomiting, and diarrhea. Author(s): Highleyman L. Source: Beta. 2002 Spring; 15(2): 29-39. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12064304

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Medical, social, and legal implications of treating nausea and vomiting of pregnancy. Author(s): Brent R. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S262-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011898

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Nausea and vomiting in early pregnancy. Author(s): Jewell D. Source: American Family Physician. 2003 July 1; 68(1): 143-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887120

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Nausea and vomiting in early pregnancy. Author(s): Jewell D. Source: Clin Evid. 2002 June; (7): 1277-83. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12230746

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Nausea and vomiting in pregnancy: safety and efficacy of self-administered complementary therapies. Author(s): Tiran D. Source: Complementary Therapies in Nursing & Midwifery. 2002 November; 8(4): 191-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12463608

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Nausea and vomiting of pregnancy. Author(s): Quinla JD, Hill DA. Source: American Family Physician. 2003 July 1; 68(1): 121-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12887118

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Nausea as a complication of low-frequency repetitive transcranial magnetic stimulation of the posterior fossa. Author(s): Satow T, Mima T, Hara H, Oga T, Ikeda A, Hashimoto N, Shibasaki H. Source: Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology. 2002 September; 113(9): 1441-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12169326

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Options for the prevention and management of acute chemotherapy-induced nausea and vomiting in children. Author(s): Dupuis LL, Nathan PC. Source: Paediatric Drugs. 2003; 5(9): 597-613. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956617

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Overview of nausea and vomiting of pregnancy with an emphasis on vitamins and ginger. Author(s): Niebyl JR, Goodwin TM. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S253-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011896

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P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children. Author(s): Wang SM, Kain ZN. Source: Anesthesiology. 2002 August; 97(2): 359-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12151925

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P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women. Author(s): Alkaissi A, Evertsson K, Johnsson VA, Ofenbartl L, Kalman S. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2002 December; 49(10): 1034-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12477673

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Postoperative nausea and vomiting--can it be eliminated? Author(s): Gan TJ.

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Source: Jama : the Journal of the American Medical Association. 2002 March 13; 287(10): 1233-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11886298 •

Pregnancy outcome following women's participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy. Author(s): Smith C, Crowther C, Beilby J. Source: Complementary Therapies in Medicine. 2002 June; 10(2): 78-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12481955

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Prospective comparative study of the safety and effectiveness of ginger for the treatment of nausea and vomiting in pregnancy. Author(s): Portnoi G, Chng LA, Karimi-Tabesh L, Koren G, Tan MP, Einarson A. Source: American Journal of Obstetrics and Gynecology. 2003 November; 189(5): 1374-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14634571

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Psychological factors in the etiology and treatment of severe nausea and vomiting in pregnancy. Author(s): Buckwalter JG, Simpson SW. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5 Suppl Understanding): S210-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011888

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Relationship between vitamin use, smoking, and nausea and vomiting of pregnancy. Author(s): Kallen B, Lundberg G, Aberg A. Source: Acta Obstetricia Et Gynecologica Scandinavica. 2003 October; 82(10): 916-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956841

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Reporting of clinical details in randomized controlled trials of acupuncture for the treatment of migraine/headaches and nausea/vomiting. Author(s): Elorriaga Claraco A, Hanna SE, Fargas-Babjak A. Source: Journal of Alternative and Complementary Medicine (New York, N.Y.). 2003 February; 9(1): 151-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12676043

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Safe, successful nausea suppression in early pregnancy with P-6 acustimulation. Author(s): Slotnick RN. Source: J Reprod Med. 2001 September; 46(9): 811-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11584482

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Taking ginger for nausea and vomiting during pregnancy. Author(s): Chandra K, Einarson A, Koren G.

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Source: Can Fam Physician. 2002 September; 48: 1441-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12371300 •

The effectiveness of progressive muscle relaxation training in managing chemotherapy-induced nausea and vomiting in Chinese breast cancer patients: a randomised controlled trial. Author(s): Molassiotis A, Yung HP, Yam BM, Chan FY, Mok TS. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 2002 April; 10(3): 237-46. Epub 2001 December 18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11904789

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The efficacy of acupressure and acustimulation wrist bands for the relief of chemotherapy-induced nausea and vomiting. A University of Rochester Cancer Center Community Clinical Oncology Program multicenter study. Author(s): Roscoe JA, Morrow GR, Hickok JT, Bushunow P, Pierce HI, Flynn PJ, Kirshner JJ, Moore DF, Atkins JN. Source: Journal of Pain and Symptom Management. 2003 August; 26(2): 731-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12906958

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The efficacy of acupressure to prevent nausea and vomiting in post-operative patients. Author(s): Ming JL, Kuo BI, Lin JG, Lin LC. Source: Journal of Advanced Nursing. 2002 August; 39(4): 343-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12139646

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The efficacy of ginger in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy. Author(s): Pongrojpaw D, Chiamchanya C. Source: J Med Assoc Thai. 2003 March; 86(3): 244-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12757064

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The management of nausea and vomiting of pregnancy. Author(s): Arsenault MY, Lane CA, MacKinnon CJ, Bartellas E, Cargill YM, Klein MC, Martel MJ, Sprague AE, Wilson AK. Source: J Obstet Gynaecol Can. 2002 October; 24(10): 817-31; Quiz 832-3. English, French. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12405123

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The placebo response and effect of time in a trial of acupuncture to treat nausea and vomiting in early pregnancy. Author(s): Smith C, Crowther C. Source: Complementary Therapies in Medicine. 2002 December; 10(4): 210-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12594971

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The use of CAM by women suffering from nausea and vomiting during pregnancy. Author(s): Hollyer T, Boon H, Georgousis A, Smith M, Einarson A. Source: Bmc Complementary and Alternative Medicine [electronic Resource]. 2002 May 17; 2(1): 5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12033990

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Transcutaneous acupoint electrical stimulation in preventing and treating nausea and vomiting in patients receiving electroconvulsive therapy. Author(s): Kramer BA, Kadar AG, Clark K. Source: The Journal of Ect. 2003 December; 19(4): 194-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14657771

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Understanding anticipatory nausea. Author(s): Eckert RM. Source: Oncology Nursing Forum. 2001 November-December; 28(10): 1553-8; Quiz 155960. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11759303

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Use of transcutaneous nerve stimulation wristband to treat methotrexate-induced nausea. Author(s): Wilson JK, Phelps KC, Feldman SR. Source: Journal of Cutaneous Medicine and Surgery. 2002 November-December; 6(6): 551-3. Epub 2002 October 31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12404040

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

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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

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

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

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

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

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

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

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

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

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

General Overview Abdominal Wall Inflammation Source: Integrative Medicine Communications; www.drkoop.com AIDS and HIV Source: Integrative Medicine Communications; www.drkoop.com Alcoholism Source: Integrative Medicine Communications; www.drkoop.com Alzheimer's Disease Source: Integrative Medicine Communications; www.drkoop.com Amenorrhea Source: Integrative Medicine Communications; www.drkoop.com Anaphylaxis Source: Integrative Medicine Communications; www.drkoop.com Anxiety Source: Integrative Medicine Communications; www.drkoop.com Appendicitis Source: Integrative Medicine Communications; www.drkoop.com Ascariasis Source: Integrative Medicine Communications; www.drkoop.com Asthma Source: Prima Communications, Inc.www.personalhealthzone.com Athletic Performance Source: Healthnotes, Inc.; www.healthnotes.com Bladder Infection Alternative names: Urinary Tract Infection [UTI] Source: Prima Communications, Inc.www.personalhealthzone.com Bone Loss Source: Integrative Medicine Communications; www.drkoop.com

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Brain Cancer Source: Integrative Medicine Communications; www.drkoop.com Breast Cancer Source: Integrative Medicine Communications; www.drkoop.com Bronchitis Source: Healthnotes, Inc.; www.healthnotes.com Bulimia Nervosa Source: Integrative Medicine Communications; www.drkoop.com Bursitis Source: Integrative Medicine Communications; www.drkoop.com Cancer Prevention (Reducing the Risk) Source: Prima Communications, Inc.www.personalhealthzone.com Chronic Fatigue Syndrome Source: Integrative Medicine Communications; www.drkoop.com Colorectal Cancer Source: Integrative Medicine Communications; www.drkoop.com Congestive Heart Failure Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Integrative Medicine Communications; www.drkoop.com Depression (Mild to Moderate) Source: Prima Communications, Inc.www.personalhealthzone.com Diabetes Mellitus Source: Integrative Medicine Communications; www.drkoop.com Diarrhea Source: Healthnotes, Inc.; www.healthnotes.com Diverticular Disease Source: Healthnotes, Inc.; www.healthnotes.com Diverticular Disease Source: Integrative Medicine Communications; www.drkoop.com Dysmenorrhea Source: Healthnotes, Inc.; www.healthnotes.com Dysmenorrhea Source: Integrative Medicine Communications; www.drkoop.com

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Epilepsy Source: Integrative Medicine Communications; www.drkoop.com Fainting Source: Integrative Medicine Communications; www.drkoop.com Flu Source: Integrative Medicine Communications; www.drkoop.com Food Allergy Source: Integrative Medicine Communications; www.drkoop.com Food Poisoning Source: Integrative Medicine Communications; www.drkoop.com Gallbladder Disease Source: Integrative Medicine Communications; www.drkoop.com Gallstones Source: Healthnotes, Inc.; www.healthnotes.com Gallstones Source: Prima Communications, Inc.www.personalhealthzone.com Gastritis Source: Integrative Medicine Communications; www.drkoop.com Gout Source: Integrative Medicine Communications; www.drkoop.com Guinea Worm Disease Source: Integrative Medicine Communications; www.drkoop.com Heart Attack Source: Healthnotes, Inc.; www.healthnotes.com Heart Attack Source: Integrative Medicine Communications; www.drkoop.com Heat Exhaustion Source: Integrative Medicine Communications; www.drkoop.com Hemorrhoids Source: Integrative Medicine Communications; www.drkoop.com Hepatitis Source: Healthnotes, Inc.; www.healthnotes.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com

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High Cholesterol Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Prima Communications, Inc.www.personalhealthzone.com HIV and AIDS Source: Integrative Medicine Communications; www.drkoop.com Hookworm Source: Integrative Medicine Communications; www.drkoop.com Hypercholesterolemia Source: Integrative Medicine Communications; www.drkoop.com Hyperparathyroidism Source: Integrative Medicine Communications; www.drkoop.com Hypertension Source: Integrative Medicine Communications; www.drkoop.com Hypochondriasis Source: Integrative Medicine Communications; www.drkoop.com Infection Source: Healthnotes, Inc.; www.healthnotes.com Inflammatory Bowel Disease Source: Integrative Medicine Communications; www.drkoop.com Influenza Source: Healthnotes, Inc.; www.healthnotes.com Influenza Source: Integrative Medicine Communications; www.drkoop.com Insect Bites and Stings Source: Integrative Medicine Communications; www.drkoop.com Intestinal Parasites Source: Integrative Medicine Communications; www.drkoop.com Iron-Deficiency Anemia Source: Healthnotes, Inc.; www.healthnotes.com Irritable Bowel Syndrome Alternative names: Spastic Colon Source: Prima Communications, Inc.www.personalhealthzone.com Kidney Stones Source: Integrative Medicine Communications; www.drkoop.com

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Loiasis Source: Integrative Medicine Communications; www.drkoop.com Lupus Source: Integrative Medicine Communications; www.drkoop.com Lymphatic Filariasis Source: Integrative Medicine Communications; www.drkoop.com Ménière's Disease Source: Healthnotes, Inc.; www.healthnotes.com Macular Degeneration Source: Integrative Medicine Communications; www.drkoop.com Menopause Source: Integrative Medicine Communications; www.drkoop.com Menstrual Pain Source: Integrative Medicine Communications; www.drkoop.com Migraine Headache Source: Integrative Medicine Communications; www.drkoop.com Migraine Headaches Source: Healthnotes, Inc.; www.healthnotes.com Migraine Headaches Source: Prima Communications, Inc.www.personalhealthzone.com Morning Sickness Source: Healthnotes, Inc.; www.healthnotes.com Motion Sickness Source: Healthnotes, Inc.; www.healthnotes.com Motion Sickness Source: Integrative Medicine Communications; www.drkoop.com MSG Sensitivity Source: Healthnotes, Inc.; www.healthnotes.com Mumps Source: Integrative Medicine Communications; www.drkoop.com Myocardial Infarction Source: Integrative Medicine Communications; www.drkoop.com Nausea Source: Prima Communications, Inc.www.personalhealthzone.com

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Obesity Source: Integrative Medicine Communications; www.drkoop.com Osteoarthritis Source: Integrative Medicine Communications; www.drkoop.com Osteoporosis Source: Integrative Medicine Communications; www.drkoop.com Pancreatitis Source: Integrative Medicine Communications; www.drkoop.com Parasites Source: Healthnotes, Inc.; www.healthnotes.com Parkinson's Disease Source: Integrative Medicine Communications; www.drkoop.com Peptic Ulcer Source: Healthnotes, Inc.; www.healthnotes.com Peptic Ulcer Source: Integrative Medicine Communications; www.drkoop.com Peritonitis Source: Integrative Medicine Communications; www.drkoop.com Pertussis Source: Integrative Medicine Communications; www.drkoop.com Photodermatitis Source: Integrative Medicine Communications; www.drkoop.com Pinworm Source: Integrative Medicine Communications; www.drkoop.com PMS Source: Integrative Medicine Communications; www.drkoop.com PMS Alternative names: Premenstrual Stress Syndrome Source: Prima Communications, Inc.www.personalhealthzone.com Pregnancy and Postpartum Support Source: Healthnotes, Inc.; www.healthnotes.com Premenstrual Syndrome Source: Integrative Medicine Communications; www.drkoop.com Prostate Cancer Source: Integrative Medicine Communications; www.drkoop.com

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Radiation Damage Source: Integrative Medicine Communications; www.drkoop.com River Blindness Source: Integrative Medicine Communications; www.drkoop.com Roundworms Source: Integrative Medicine Communications; www.drkoop.com Seizure Disorders Source: Integrative Medicine Communications; www.drkoop.com Serum Sickness Source: Integrative Medicine Communications; www.drkoop.com Sickle Cell Anemia Source: Healthnotes, Inc.; www.healthnotes.com Stomach Inflammation Source: Integrative Medicine Communications; www.drkoop.com Sunburn Source: Integrative Medicine Communications; www.drkoop.com Syncope Source: Integrative Medicine Communications; www.drkoop.com Systemic Lupus Erythematosus Source: Healthnotes, Inc.; www.healthnotes.com Systemic Lupus Erythematosus Source: Integrative Medicine Communications; www.drkoop.com Tension Headache Source: Integrative Medicine Communications; www.drkoop.com Threadworm Source: Integrative Medicine Communications; www.drkoop.com Trichinosis Source: Integrative Medicine Communications; www.drkoop.com Ulcerative Colitis Source: Healthnotes, Inc.; www.healthnotes.com Ulcerative Colitis Source: Integrative Medicine Communications; www.drkoop.com Urinary Tract Infection Source: Healthnotes, Inc.; www.healthnotes.com

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Varicose Veins Source: Prima Communications, Inc.www.personalhealthzone.com Vertigo Source: Healthnotes, Inc.; www.healthnotes.com Visceral Larva Migrans Source: Integrative Medicine Communications; www.drkoop.com Whipworm Source: Integrative Medicine Communications; www.drkoop.com Whooping Cough Source: Integrative Medicine Communications; www.drkoop.com •

Alternative Therapy Acupressure Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,662,00.html Acupuncture Source: Integrative Medicine Communications; www.drkoop.com Acupuncture Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,663,00.html Aromatherapy Source: Integrative Medicine Communications; www.drkoop.com Aromatherapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,664,00.html Colon Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,682,00.html Fasting Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,694,00.html Guided Imagery Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,699,00.html

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Shiatsu Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,733,00.html Testing for Stomach Acidity Source: Healthnotes, Inc.; www.healthnotes.com Therapeutic Touch Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,739,00.html Traditional Chinese Medicine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10085,00.html •

Chinese Medicine Baifuzi Alternative names: Giant Typhonium Rhizome; Rhizoma Typhonii Source: Chinese Materia Medica Banxia Alternative names: Pinellia Tuber; Rhizoma Pinelliae Source: Chinese Materia Medica Bichengqie Alternative names: Mountain Spicy Fruit; Fructus Litseae Source: Chinese Materia Medica Biwen San Alternative names: Biwen Powder Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Caodoukou Alternative names: Katsumada Galangal Seed; Semen Alpiniae Katsumadai Source: Chinese Materia Medica Doukou Alternative names: Round Cardamon Fruit; Fructus Amomi Rotundus Source: Chinese Materia Medica Erchen Wan Alternative names: rchen; Erchen Wan (Er Chen Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China

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Fuzi Alternative names: Beivedere Fruit; Difuzi; Fructus Kochiae Source: Chinese Materia Medica Hongling San Alternative names: Hongling Powder Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Huajuhong Alternative names: Pummelo Peel; Exocarpium Citri Grandis Source: Chinese Materia Medica Huanglian Alternative names: Golden Thread; Rhizoma Coptidis Source: Chinese Materia Medica Huangqi Alternative names: Milkvetch; Radix Astragali Source: Chinese Materia Medica Huangqin Alternative names: Baical Skullcap Root; Radix Scutellariae Source: Chinese Materia Medica Jianpi Wan Alternative names: Jianpi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Juhong Alternative names: Pummelo Peel; Huajuhong; Exocarpium Citri Grandis Source: Chinese Materia Medica Liuhe Dingzhong Wan Alternative names: Liuhe Dingzhong Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Meiguihua Alternative names: Rose Flower; Flos Rosae Rugosae Source: Chinese Materia Medica Muxiang Fenqi Wan Alternative names: Muxiang Fenqi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Peilan Alternative names: Fortune Eupatorium Herb; Herba Eupatorii Source: Chinese Materia Medica

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Renshen Jianpi Wan Alternative names: enshen Jianpi Pills; Renshen Jianpi Wan(Ren Shen Jian Pi Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shedan Chenpi San Alternative names: hedan Chenpi Powder; Shedan Chenpi San (She Dan Chen Pi San Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shihu Alternative names: Dendrobium; Herba Dendrobii Source: Chinese Materia Medica Sizheng Wan Alternative names: izheng Pills; Sizheng Wan (Si Zheng Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Xuanfuhua Alternative names: Inula Flower; Flos Inulae Source: Chinese Materia Medica Zisuye Alternative names: Perilla Leaf; Folium Perillae Source: Chinese Materia Medica •

Herbs and Supplements 5-HTP Source: Integrative Medicine Communications; www.drkoop.com 5-Hydroxytryptophan Source: Healthnotes, Inc.; www.healthnotes.com 5-Hydroxytryptophan (5-HTP) Source: Integrative Medicine Communications; www.drkoop.com Activated Charcoal Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,832,00.html Adrenal Extract Source: Healthnotes, Inc.; www.healthnotes.com Aloe Alternative names: Aloe vera L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org

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Amino Acids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10003,00.html Aminoglycosides Source: Integrative Medicine Communications; www.drkoop.com Ananas Comosus Source: Integrative Medicine Communications; www.drkoop.com Antioxidants Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10004,00.html Arctostaphylos Alternative names: Bearberry; Arctostaphylos uva-ursi (L.) Spreng. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Ava Source: Integrative Medicine Communications; www.drkoop.com Bismuth Subsalicylate Source: Healthnotes, Inc.; www.healthnotes.com Black Cohosh Alternative names: Cimicifuga racemosa Source: Healthnotes, Inc.; www.healthnotes.com Black Cohosh Alternative names: Cimicifuga racemosa (actea), Black Snakeroot Source: Integrative Medicine Communications; www.drkoop.com Black Snakeroot Source: Integrative Medicine Communications; www.drkoop.com Blackberry Alternative names: Rubus fructicosus Source: Healthnotes, Inc.; www.healthnotes.com Bloodroot Alternative names: Sanguinaria canadensis Source: Healthnotes, Inc.; www.healthnotes.com Bloodroot Source: Prima Communications, Inc.www.personalhealthzone.com Blue Cohosh Alternative names: Caulophyllum thalictroides Source: Healthnotes, Inc.; www.healthnotes.com

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Blue Flag Alternative names: Iris versicolor Source: Healthnotes, Inc.; www.healthnotes.com Boneset Alternative names: Eupatorium perfoliatum Source: Healthnotes, Inc.; www.healthnotes.com Borago Alternative names: Borage; Borago officinalis Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Boric Acid Source: Healthnotes, Inc.; www.healthnotes.com Boswellia Alternative names: Boswellia serrata Source: Healthnotes, Inc.; www.healthnotes.com Boswellia Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,759,00.html Brahmi Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Brewer's Yeast Alternative names: Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com Bromelain Alternative names: Ananas comosus, Bromelainum Source: Integrative Medicine Communications; www.drkoop.com Bromelain Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,760,00.html Bromelainum Source: Integrative Medicine Communications; www.drkoop.com Butcher’s Broom Alternative names: Ruscus aculeatus Source: Healthnotes, Inc.; www.healthnotes.com Centella Source: Integrative Medicine Communications; www.drkoop.com

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Centella asiatica Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Chamomile Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,766,00.html Chaparral Alternative names: Larrea tridentata Source: Healthnotes, Inc.; www.healthnotes.com Chemotherapy Source: Healthnotes, Inc.; www.healthnotes.com Chrysanthemum parthenium Source: Integrative Medicine Communications; www.drkoop.com Cimicifuga racemosa (Actea) Source: Integrative Medicine Communications; www.drkoop.com Cinnamomum Alternative names: Cinnamon; Cinnamomum zeylanicum Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Citalopram Source: Healthnotes, Inc.; www.healthnotes.com Coenzyme Q Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,768,00.html Conjugated Linoleic Acid Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10102,00.html Corydalis Alternative names: Corydalis turtschaninovii, Corydalis yanhusuo Source: Healthnotes, Inc.; www.healthnotes.com Cyclophosphamide Source: Healthnotes, Inc.; www.healthnotes.com Cysteine Source: Integrative Medicine Communications; www.drkoop.com

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Dimenhydrinate Source: Healthnotes, Inc.; www.healthnotes.com Dioscorea Villosa Source: Integrative Medicine Communications; www.drkoop.com Docetaxel Source: Healthnotes, Inc.; www.healthnotes.com Elderberry Alternative names: Sambucus nigra Source: Healthnotes, Inc.; www.healthnotes.com Elderberry Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10024,00.html Ephedra Alternative names: Ephedra sinensis, Ma huang Source: Integrative Medicine Communications; www.drkoop.com Ephedra Source: Prima Communications, Inc.www.personalhealthzone.com Ephedra (Ma huang) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,777,00.html Ephedra sinensis Source: Integrative Medicine Communications; www.drkoop.com Eucalyptus Alternative names: Eucalyptus globulus Source: Healthnotes, Inc.; www.healthnotes.com Eucalyptus Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,778,00.html Evening Primrose Alternative names: Oenothera biennis, Sun Drop Source: Integrative Medicine Communications; www.drkoop.com False Unicorn Alternative names: Chamaelirium luteum Source: Healthnotes, Inc.; www.healthnotes.com False Unicorn Root Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com

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Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10075,00.html Fennel Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,849,00.html Fenugreek Alternative names: Trigonella foenum-graecum Source: Healthnotes, Inc.; www.healthnotes.com Feverfew Alternative names: Tanacetum parthenium, Chrysanthemum parthenium Source: Integrative Medicine Communications; www.drkoop.com Feverfew Source: Prima Communications, Inc.www.personalhealthzone.com Feverfew Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,780,00.html Fluorouracil Source: Healthnotes, Inc.; www.healthnotes.com Fluvoxamine Source: Healthnotes, Inc.; www.healthnotes.com GABA Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10027,00.html Gamma-oryzanol Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10028,00.html General Anesthetics Source: Healthnotes, Inc.; www.healthnotes.com Ginger Alternative names: Zingiber officinale Source: Healthnotes, Inc.; www.healthnotes.com Ginger Alternative names: Zingiber officinale Source: Integrative Medicine Communications; www.drkoop.com

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Ginger Source: Prima Communications, Inc.www.personalhealthzone.com Ginger Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,787,00.html Ginkgo Biloba Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,788,00.html Ginseng Source: Prima Communications, Inc.www.personalhealthzone.com Glucosamine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,790,00.html Goldenseal Alternative names: Hydrastis canadensis Source: Integrative Medicine Communications; www.drkoop.com Goldenseal Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,791,00.html Gotu Kola Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com Gotu Kola Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10031,00.html Greater Celandine Alternative names: Chelidonium majus Source: Healthnotes, Inc.; www.healthnotes.com Green-lipped Mussel Source: Healthnotes, Inc.; www.healthnotes.com Gugulipid Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10033,00.html

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Hawthorn Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10035,00.html Horse Chestnut Alternative names: Aesculus hippocastanum Source: Healthnotes, Inc.; www.healthnotes.com Horse Chestnut Source: Prima Communications, Inc.www.personalhealthzone.com Huperzia Source: Healthnotes, Inc.; www.healthnotes.com Huperzine A Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10038,00.html Hydrastis Canadensis Source: Integrative Medicine Communications; www.drkoop.com Hydrocotyle Source: Integrative Medicine Communications; www.drkoop.com Hypericum Perforatum Source: Integrative Medicine Communications; www.drkoop.com Indapamide Source: Healthnotes, Inc.; www.healthnotes.com Indian Pennywort Source: Integrative Medicine Communications; www.drkoop.com Indian Tobacco Source: Integrative Medicine Communications; www.drkoop.com Ipecac Alternative names: Cephaelis ipecacuanha Source: Healthnotes, Inc.; www.healthnotes.com Ivy Leaf Alternative names: Hedera helix Source: Healthnotes, Inc.; www.healthnotes.com Jamaica Dogwood Alternative names: Piscidia erythrina, Piscidia piscipula Source: Integrative Medicine Communications; www.drkoop.com

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Kava Kava Alternative names: Piper methysticum, Ava Source: Integrative Medicine Communications; www.drkoop.com Ketoprofen Source: Healthnotes, Inc.; www.healthnotes.com Klamathweed Source: Integrative Medicine Communications; www.drkoop.com Lapacho Source: Integrative Medicine Communications; www.drkoop.com Lavender Alternative names: Lavandula officinalis Source: Healthnotes, Inc.; www.healthnotes.com Lecithin Source: Prima Communications, Inc.www.personalhealthzone.com Lobelia Alternative names: Lobelia inflata Source: Healthnotes, Inc.; www.healthnotes.com Lobelia Alternative names: Lobelia inflata, Indian Tobacco Source: Integrative Medicine Communications; www.drkoop.com Lobelia Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Lobelia Inflata Source: Integrative Medicine Communications; www.drkoop.com Lomatium Alternative names: Lomatium dissectum Source: Healthnotes, Inc.; www.healthnotes.com Loop Diuretics Source: Integrative Medicine Communications; www.drkoop.com Ma huang Source: Integrative Medicine Communications; www.drkoop.com Marsh Pennywort Alternative names: Centella asiatica , Centella, March Pennywort, Indian Pennywort, Hydrocotyle, Brahmi (Sanskrit), Luei Gong Gen (Chinese)(Note: Gotu kola should not be confused with kola nut.) Source: Integrative Medicine Communications; www.drkoop.com

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Meadowsweet Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Meclizine Source: Healthnotes, Inc.; www.healthnotes.com Methotrexate Source: Healthnotes, Inc.; www.healthnotes.com Metoclopramide Source: Healthnotes, Inc.; www.healthnotes.com Milk Thistle Alternative names: Silybum marianum, Carduus marianus Source: Healthnotes, Inc.; www.healthnotes.com Milk Thistle Source: Prima Communications, Inc.www.personalhealthzone.com Miscellaneous Preparations Source: Integrative Medicine Communications; www.drkoop.com Mistletoe Alternative names: Viscum album Source: Healthnotes, Inc.; www.healthnotes.com NAC (N-Acetyl Cysteine) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,809,00.html N-Acetyl Cysteine Source: Healthnotes, Inc.; www.healthnotes.com Nitrous Oxide Source: Healthnotes, Inc.; www.healthnotes.com Oenothera Biennis Source: Integrative Medicine Communications; www.drkoop.com Organ Mountain Crape Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca PABA Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10049,00.html Paclitaxel Source: Healthnotes, Inc.; www.healthnotes.com

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Passion Flower Alternative names: Passiflora incarnata Source: Healthnotes, Inc.; www.healthnotes.com Pau D’arco Alternative names: Tabebuia avellanedae, Tabebuia impestiginosa Source: Healthnotes, Inc.; www.healthnotes.com Pau D'arco Alternative names: Tabebuia avellanedae, Lapacho Source: Integrative Medicine Communications; www.drkoop.com Pau D'arco Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,811,00.html Peppermint Source: Prima Communications, Inc.www.personalhealthzone.com Peppermint Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,812,00.html Perphenazine Source: Healthnotes, Inc.; www.healthnotes.com Phenylalanine Source: Healthnotes, Inc.; www.healthnotes.com Phosphatidylserine (PS) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,813,00.html Piper Methysticum Source: Integrative Medicine Communications; www.drkoop.com Piroxicam Source: Healthnotes, Inc.; www.healthnotes.com Piscidia Erythrina Source: Integrative Medicine Communications; www.drkoop.com Piscidia Piscipula Source: Integrative Medicine Communications; www.drkoop.com Prochlorperazine Source: Healthnotes, Inc.; www.healthnotes.com

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Promethazine Source: Healthnotes, Inc.; www.healthnotes.com Pygeum Africanum Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10052,00.html Red Raspberry Alternative names: Rubus idaeus Source: Healthnotes, Inc.; www.healthnotes.com S-Adenosylmethionine (SAMe) Source: Integrative Medicine Communications; www.drkoop.com Salicylates Source: Integrative Medicine Communications; www.drkoop.com SAMe Source: Integrative Medicine Communications; www.drkoop.com SAMe (S-Adenosylmethionine) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,818,00.html Sanguinaria Alternative names: Bloodroot; Sanguinaria canadensis L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Saw Palmetto Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,819,00.html Sertraline Source: Healthnotes, Inc.; www.healthnotes.com Spirulina and Kelp Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10058,00.html St. John's Wort Alternative names: Hypericum perforatum, Klamathweed Source: Integrative Medicine Communications; www.drkoop.com Stimulant Laxatives Source: Integrative Medicine Communications; www.drkoop.com Suma Source: Healthnotes, Inc.; www.healthnotes.com

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Sun Drop Source: Integrative Medicine Communications; www.drkoop.com Tabebuia Avellanedae Source: Integrative Medicine Communications; www.drkoop.com Tanacetum Parthenium Source: Integrative Medicine Communications; www.drkoop.com Thiazide Diuretics Source: Integrative Medicine Communications; www.drkoop.com Trace Minerals Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10061,00.html Tylophora Alternative names: Tylophora indica, Tylophora asthmatica Source: Healthnotes, Inc.; www.healthnotes.com Tyrosine Source: Prima Communications, Inc.www.personalhealthzone.com Uricosuric Agents Source: Integrative Medicine Communications; www.drkoop.com Uva Ursi Alternative names: Arctostaphylos uva-ursi Source: Healthnotes, Inc.; www.healthnotes.com Uva Ursi Source: Prima Communications, Inc.www.personalhealthzone.com Uva Ursi Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10063,00.html Valerian Alternative names: Valeriana officinalis Source: Healthnotes, Inc.; www.healthnotes.com Valerian Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10064,00.html White Willow Bark Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10069,00.html

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Wild Indigo Alternative names: Baptisia tinctoria Source: Healthnotes, Inc.; www.healthnotes.com Wild Yam Alternative names: Dioscorea villosa Source: Healthnotes, Inc.; www.healthnotes.com Wild Yam Alternative names: Dioscorea villosa Source: Integrative Medicine Communications; www.drkoop.com Wild Yam Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10070,00.html Willow Bark Alternative names: There are several species of willow includingSalix alba, Salix nigra, Salix fragilis, Salix purpurea, Salix babylonica, White Willow, European Willow, Black Willow, Pussy Willow, Crack Willow, Purple Willow, Weeping Willow, Liu-zhi Source: Integrative Medicine Communications; www.drkoop.com Wormwood Alternative names: Artemisia absinthium Source: Healthnotes, Inc.; www.healthnotes.com Yohimbe Alternative names: Pausinystalia yohimbe Source: Healthnotes, Inc.; www.healthnotes.com Yohimbe Source: Prima Communications, Inc.www.personalhealthzone.com Yohimbe Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,830,00.html Zingiber Alternative names: Ginger; Zingiber officinale Roscoe Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Zingiber Officinale Source: Integrative Medicine Communications; www.drkoop.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page

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dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON NAUSEA Overview In this chapter, we will give you a bibliography on recent dissertations relating to nausea. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “nausea” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on nausea, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Nausea ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to nausea. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Demons, Nausea and Resistance in the Autobiography of Isabel De Jesus (1611-1682) (Spain) by Velasco, Sherry M., PhD from University of California, Los Angeles, 1992, 293 pages http://wwwlib.umi.com/dissertations/fullcit/9301562

•

Early Pregnancy Associated Nausea and Vomiting: Maternal Risk Factors, Fetal Outcome, and Reproductive Success (Morning Sickness, Biological Fitness, Estrogen Sensitivity, Emetic Center, Multiple Regression) by Weigel, Mary-Margaret, PhD from University of California, Los Angeles, 1985, 200 pages http://wwwlib.umi.com/dissertations/fullcit/8603999

•

The Assessment and Treatment of Nausea and Vomiting Associated with Cancer Chemotherapy by Rosberger, Zeev; PhD from Concordia University (Canada), 1988 http://wwwlib.umi.com/dissertations/fullcit/NL44883

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Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. CLINICAL TRIALS AND NAUSEA Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning nausea.

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

A Randomized Study of Electroacupuncture Treatment for Delayed Chemotherapyinduced Nausea and Vomiting in Patients with Pediatric Sarcomas Condition(s): Sarcoma; Nausea; Vomiting Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM); National Cancer Institute (NCI); National Institute of Dental and Craniofacial Research (NIDCR) Purpose - Excerpt: This study will investigate the efficacy of electroacupuncture to reduce delayed chemotherapy-induced nausea in pediatric and young adult patients with pediatric sarcoma. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034996

•

Acupressure in Treating Nausea in Women Receiving Combination Chemotherapy for Breast Cancer Condition(s): Breast Cancer; nausea and vomiting Study Status: This study is currently recruiting patients.

8

These are listed at www.ClinicalTrials.gov.

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Sponsor(s): M.D. Anderson Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Acupressure may help to reduce or prevent nausea in patients who are undergoing chemotherapy. It is not yet known if acupressure plus standard care for nausea is more effective than standard care for nausea alone in women who are receiving chemotherapy for breast cancer. PURPOSE: Randomizedphase III trial to determine the effectiveness of acupressure in treating nausea in women who are receiving combination chemotherapy for breast cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00046865 •

Acupressure to Treat Nausea and Vomiting in HIV/AIDS Patients Condition(s): HIV Infections Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Nursing Research (NINR) Purpose - Excerpt: The purpose of this study is to see whether acupressure (acupuncture using pressure applied by the hands instead of needles) can help nausea and vomiting in persons with HIV/AIDS. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00017823

•

Comparison of Antiemetic Drugs in Preventing Delayed Nausea After Chemotherapy in Patients With Cancer Condition(s): unspecified adult solid tumor, protocol specific; nausea and vomiting; Quality of Life Study Status: This study is currently recruiting patients. Sponsor(s): James P. Wilmot Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Antiemetic drugs may help to reduce or prevent nausea and vomiting in patients being treated with chemotherapy. PURPOSE: Randomizedphase III trial to compare the effectiveness of different antiemetic drugs in preventing delayed nausea after chemotherapy in patients who have cancer. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00020657

•

Ginger Control of Chemotherapy Induced Nausea and Vomiting Condition(s): Nausea; Vomiting; Chemotherapy Study Status: This study is currently recruiting patients.

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Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: This is a trial to determine the safety and efficacy of ginger in reducing the prevalence and severity of chemotherapy induced nausea and vomiting. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00065221 •

Ginger in Treating Nausea and Vomiting in Patients Receiving Chemotherapy for Cancer Condition(s): nausea and vomiting; unspecified adult solid tumor, protocol specific Study Status: This study is currently recruiting patients. Sponsor(s): University of Michigan Comprehensive Cancer Center; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: The herb ginger may help to reduce or prevent nausea and vomiting in patients receiving chemotherapy for cancer. PURPOSE: Randomizedphase II trial to study the effectiveness of ginger in reducing or preventing nausea and vomiting in patients who are receiving chemotherapy for cancer. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00064272

•

Ginger in Treating Nausea in Patients Receiving Chemotherapy for Cancer Condition(s): nausea and vomiting; unspecified adult solid tumor, protocol specific Study Status: This study is currently recruiting patients. Sponsor(s): University of Rochester; National Cancer Institute (NCI) Purpose - Excerpt: RATIONALE: Ginger may help reduce or prevent nausea. It is not yet known if antiemetic drugs are more effective with or without ginger in treating nausea caused by chemotherapy. PURPOSE: Randomizedphase II/III trial to determine the effectiveness of antiemetic drugs with or without ginger in treating nausea in patients who are receiving chemotherapy for cancer. Phase(s): Phase II; Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00040742

•

Ondansetron With or Without Dexamethasone to Prevent Vomiting in Patients Receiving Radiation Therapy to the Upper Abdomen Condition(s): Endocrine Cancer; female reproductive cancer; Gastrointestinal Cancer; nausea and vomiting; Quality of Life Study Status: This study is currently recruiting patients.

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Sponsor(s): National Cancer Institute of Canada Purpose - Excerpt: RATIONALE: Antiemetic drugs may help to reduce or prevent vomiting in patients treated with radiation therapy. It is not yet known if ondansetron is more effective with or without dexamethasone in preventing vomiting caused by radiation therapy. PURPOSE: Randomizedphase III trial to compare the effectiveness of ondansetron with or without dexamethasone in preventing vomiting in patients with cancer who are receiving radiation therapy to the upper abdomen. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00016380

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “nausea” (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

•

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

•

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

•

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

•

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

•

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

•

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/

•

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

•

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

•

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

•

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

•

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

•

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

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CHAPTER 6. PATENTS ON NAUSEA 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 “nausea” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on nausea, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Nausea By performing a patent search focusing on nausea, 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 nausea: •

.DELTA.9 Tetrahydrocannabinol (.DELTA.9 THC) solution metered dose inhaler Inventor(s): Byron; Peter R. (Richmond, VA), Lichtman; Aron H. (Richmond, VA), Martin; Billy R. (Richmond, VA), Peart; Joanne (Richmond, VA) Assignee(s): Virginia Commonwealth University (richmond, Va) Patent Number: 6,509,005 Date filed: March 22, 1999 Abstract: The present invention provides therapeutic formulations for solutions of.DELTA.sup.9 -tetrahydrocannabinol (.DELTA.sup.9 THC) to be delivered by metered dose inhalers. The formulations, which utilize non-CFC propellants, provide a stable aerosol-deliverable source of.DELTA.sup.9 THC for the treatment of various medical conditions, such as: nausea and vomiting associated with chemotherapy; muscle spasticity; pain; anorexia associated with AIDS wasting syndrome; epilepsy; glaucoma; bronchial asthma; and mood disorders. Excerpt(s): The invention is generally related to the therapeutic use of.DELTA.sup.9 Tetrahydrocannabinol (.DELTA.sup.9 THC). In particular, the invention provides a metered dose inhaler (MDI) for the aerosol administration of.DELTA.sup.9 THC to patients suffering from nausea and vomiting associated with cancer chemotherapy, muscle spasticity, pain, anorexia associated with AIDS wasting syndrome, epilepsy, glaucoma, bronchial asthma, mood disorders, and the like. When marijuana is used illegally as a recreational psychoactive drug, the active ingredient.DELTA.sup.9 THC is usually delivered to the lungs as an impure non-pharmaceutical aerosol in the form of marijuana smoke. Aerosolized.DELTA.sup.9 THC in the inhaled smoke is absorbed within seconds and delivered to the brain efficiently. Table 2 and references 19-20 describe the pharmacokinetics of the administration of.DELTA.sup.9 THC. As can be seen, inhalation is the preferred route of delivery for.DELTA.sup.9 THC. When compared to oral delivery, inhalation provides a more rapid onset of pharmacological action and peak plasma levels. The effects achieved via inhalation are comparable to those achieved when the drug is administered intravenously, but inhalation is a much less invasive technique. Currently, the sources of.DELTA.sup.9 THC for patients who could benefit from the drug are very limited. An oral form of.DELTA.sup.9 THC (MARINOL) is marketed as a treatment for nausea and vomiting related to cancer chemotherapy, and as an appetite stimulant in patients suffering from AIDS wasting syndrome. In MARINOL, pharmaceutical grade.DELTA.sup.9 THC is dissolved in sesame oil, encapsulated in gelatin capsules and delivered orally. However, when the drug is taken orally, the absorption is slower and more variable than when inhaled, with an onset of action between 30 minutes and 2 hours (Table 2). Alternatively, some cancer patients do manage to obtain and smoke marijuana in order to alleviate such conditions as nausea and vomiting due to chemotherapy. This is, however, technically illegal and is thus obviously a less than ideal treatment protocol. There is no currently available pharmaceutically acceptable aerosol form of.DELTA.sup.9 THC. Web site: http://www.delphion.com/details?pn=US06509005__

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2-{4-[4-(4,5-dichloro-2-methylimidazol-1-yl)butyl]-1-piperazinyl}-5-fluorop yrimidine, its preparation and its therapeutic use Inventor(s): Frigola-Constansa; Jordi (Barcelone, ES), Merce-Vidal; Ramon (Barcelone, ES) Assignee(s): Laboratorios Del Dr. Esteve, S.a. (barcelone, Es) Patent Number: 6,303,608 Date filed: February 29, 2000 Abstract: 2-{4-[4-(4,5-dichloro-2-methylimidazol-1-yl)butyl]-1-piperazinyl}-5-fluorop yrimidine, and its physiologically acceptable salts; pharmaceutical compositions containing these compounds, and a method of treating vertigo, travel sickness, nausea, depression, anxiety, gastric acid secretion, obsessive/compulsive disorders, panic attacks or sleep apnea using these compounds are disclosed. Excerpt(s): Patents EP 382,637 and EP 497,659 of the Applicant Company disclosed various pyrimidinylpiperazinylalkylazole derivatives having anxiolytic and/or tranquilizing properties. Although Patent EP 382,637 claims pyrimidinylpiperazinylalkylazole derivatives substituted at the 5-position of the pyrimidine by a halogen atom, only two examples of compounds of this type are disclosed and, in both cases, it is a bromine atom. The Applicant Company has now discovered that the introduction of a fluorine atom as substituent at the 5-position of the pyrimidine, in the special case where the azole is an imidazole trisubstituted by a methyl group at the 2-position and by two chlorine atoms at the 4- and 5-positions, gives rise to the compound which is the subject-matter of the present patent, which compound exhibits some advantageous biological properties which make it of particular use in its application in human and/or veterinary therapeutics. In particular, the compound which is the subject-matter of the present patent is of use as an antiemetic against seasickness (nausea caused by motion), as an antidepressant or anxiolytic, as an inhibitor of gastric acid secretion or obsessive-compulsive disorders, in panic attacks and in sleep apnea in mammals, including man. It is possible to prepare the compound 2-{4-[4-(4,5-dichloro-2-methylimidazol-1-yl)butyl]-1-piperazinyl}-5-fluoro pyrimidine and its physiologically acceptable salts according to the invention by one of the processes shown hereinbelow. Web site: http://www.delphion.com/details?pn=US06303608__

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Acceleration of the rate of digestion of a protein Inventor(s): Ballevre; Olivier (Lausanne, CH), Beaufrere; Bernard (Chamalieres, FR), Dangin; Martial (Clermont-Ferrand, FR), Garcia-Rodenas; Clara Lucia (Mollie-Margot, CH) Assignee(s): Nestec S.a. (vevey, Ch) Patent Number: 6,544,515 Date filed: June 7, 2000 Abstract: The invention thus relates to a method for accelerating the rate of digestion of a protein matter, in which a protein matter is treated with transglutaminase, and it is mixed with anionic polysaccharides. The invention also relates to the use of the rapidly digested protein matter for preparing a food or pharmaceutical composition intended for oral administration to a mammal, to induce a postprandial peak of plasmatic

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increase in amino acids. This composition is intended for modulating the postprandial protein gain, limiting the problems linked to gastrointestinal motility disorders, limiting the postprandial sensations of nausea in pregnant women, and/or limiting the postprandial risks of regurgitation and/or gastro-esophageal reflux. Finally, a subject of the invention is also a food or pharmaceutical composition comprising anionic polysaccharides and a protein matter treated with transglutaminase. Excerpt(s): The subject of the invention.is a method for accelerating the rate of digestion of a protein, and the use of a protein thus modified for preparing a food or pharmaceutical composition for modulating the postprandial plasmatic level of amino acids. In humans, during a nycthemeron, food intake is discontinuous. Postprandial periods, i.e. the phases of nutrient assimilation from the digestive tract, alternate with periods of physiological fast. These diurnal variations in the nutritional status affect the components of protein metabolism, and consequently the protein balance. Thus, the consumption of proteins results in an increase in the plasmatic level of amino acids (Aoki et al., Am. J. Olin. Nutr., 41, 1-18, 1987). Similarly, the elevation of the plasmatic level of amino acids is associated with a decline in proteolysis and a stimulation of the oxidation of amino acids and of protein synthesis (Castellino et al., Am. J. Physiol., 262, 162-176, 1992; Giordano et al., Diabetes, 45, 393-399, 1996; Clugston et al., Olin. Nutr., 36, 57-70, 1982; Motil et al., Am. J. Physiol., 240, E712-721, 1981; Melville et al., Metabolism., 30, 248-255, 1989; Pacy et al., Olin. Sci., 86, 103-118, 1994). Web site: http://www.delphion.com/details?pn=US06544515__ •

Acupressure device Inventor(s): Berger; Allen (Wainscott, NY), Johnson; Chris (Irvine, CA), O'Connell; Drew (Cold Spring Harbor, NY) Assignee(s): Cirrus Air Technologies Llc (locust Valley, Ny) Patent Number: 6,007,503 Date filed: May 14, 1998 Abstract: An acupressure device is especially adapted for use as an anti-nausea prophylactic. The device comprises a substantially flat base having first and second opposing surfaces and a central aperture. A rounded button is disposed within the central aperture, the rounded pressure-applying surface of the button facing in the same direction as the first surface of the base. A pluraliy of spokes extend from the button to the perimeter of the central aperture, thereby supporting the button within the aperture. The first surface of the base has an adhesive coating so that the device may be adhered to the skin with the button contacting a desired acupressure point. Excerpt(s): The present invention relates generally to a device for applying pressure to an acupuncture or acupressure point on the human body. More specifically, the present invention relates to an acupressure device for relieving nausea. The effectiveness of acupuncture and acupressure for relieving pain and for treating certain physical disorders has been known for several thousand years. In acupuncture, fine needles are inserted into the skin at specific locations on the anatomy in order to treat specific disorders. Since it is an invasive procedure, acupuncture should be administered only by a skilled practitioner. Even with normal clinical precautions, there is a danger of infection at acupuncture sites. Due, at least in part, to the disadvantages of acupuncture, acupressure has enjoyed increasing popularity. The same anatomical locations used for acupuncture are also used for acupressure; however, only pressure is applied to the

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location. Pressure alone has proven to be effective for the treatment of certain disorders and for certain symptomatic relief. In particular, it has been found that pressure applied to the interior of the wrist can be effective in relieving nausea due, for example, to motion sickness. Web site: http://www.delphion.com/details?pn=US06007503__ •

Amelioration of apomorphine adverse effects Inventor(s): El-Rashidy; Ragab (Deerfield, IL), Ronsen; Bruce (River Forest, IL) Assignee(s): Pentech Pharmaceuticals, Inc. (buffalo Grove, Il) Patent Number: 5,994,363 Date filed: August 24, 1998 Abstract: Symptoms of Parkinson's disease and psychogenic male erectile dysfunction (MED) can be ameliorated through the use of apomorphine. The adverse side effects of apomorphine administration, such as nausea, vomiting, yawning, and cardiovascular effects, can be significantly reduced by a dose escalating method of acclimatization. An initial dose of apomorphine is administered to the patient, and subsequently increased over a period of time until a final apomorphine dose in excess of a desired therapeutic dose has been received by the patient. Thereafter a therapeutic dose of apomorphine, less than the final apomorphine dose, is administered to the patient with attendant reduced side effects. Excerpt(s): This invention relates to amelioration of the adverse effects, such as nausea, yawning, vomiting, and cardiovascular effects, caused to human patients when taking apomorphine for Parkinson's disease, psychogenic male erectile dysfunction (MED), and female sexual dysfunction, or the like afflictions. Apomorphine has been used to treat Parkinsonian patients. See, for example, Deffond et al., J. Neurology, Neurosurgery, and Psychiatry 56:101-103 (1993) and Durif et al., Clinical Neuropharmacology 16(2):157-166 (1993). Additionally, apomorphine has been considered for the treatment of alcoholism, schizophrenia, dystonia musculorum deformans, hallucinations, migraine headaches, hiccups, Huntington's chorea, tardative dyskinesia, and more recently male erectile dysfunction. Administration of large doses of apomorphine to mammals such as humans, dogs and the like usually results in nausea and vomiting, and is believed to be due to the action of apomorphine on the chemoreceptor trigger zone (CTZ) of the medulla oblongata, a structure of the mammalian central nervous system. It is also believed that additional chemoreceptors triggering emesis are present in the gastrointestinal tract as well. Web site: http://www.delphion.com/details?pn=US05994363__

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Analgesic composition for treatment of migraine headaches Inventor(s): Mauskop; Alexander (17A Lafayette Rd., Larchment, NY 10538) Assignee(s): None Reported Patent Number: 5,914,129 Date filed: July 23, 1996 Abstract: Magnesium-containing analgesic compositions used for the alleviation of pain, in particular, migraine headache pain, and methods for using the same are described

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herein. The compositions consist essentially of an analgesic agent, a magnesium salt, a stimulant, optionally an effervescing agent, and a pharmacetically acceptable carrier or vehicle. The symptoms of migraine headache intended to be alleviated include nausea, unilateral pain, dizziness, pulsatile pain, worsening of pain by light physical activity, photophobia and phonophobia. Excerpt(s): This invention relates to magnesium-based analgesic compositions for treating migraine headaches, and methods for using the same. Analgesic compositions comprising magnesium salts have been used to treat a variety of ailments as well as reduce the gastric irritancy often accompanying the oral administration of such analgesic compositions. U.S. Pat. 2,801,951 to Cooper, Jr. discloses the use of an analgesic composition comprising acetylsalicylic acid, citric acid, p-ethoxyacetanilide, caffeine and MgCO.sub.3 or Mg(OH).sub.2 /Al(OH).sub.3. U.S. Pat. No. 3,865,933 to Mudge teaches the use of a mixture comprising magnesium gluconate, stramonium extract and 3-(2methylphenoxy)-1,2-propanediol to relieve headache pain. U.S. Pat. No. 3,759,980 to Rosen et al. teaches the use of a mixture of magnesium salicylate and choline salicylate as an analgesic, anti-pyretic, anti-inflammatory and anti-rheumatic agent. U.S. Pat. No. 3,385,886 to Nicholson et al. teaches the use of phenylpropionic acid magnesium salts for the relief of pain, fever and inflammation. U.S. Pat. No. 3,359,166 to McClure teaches the use of magnesium 4-thiazolidinecarboxylate as an analgesic agent. U.S. Pat. No. 4,083,951 to Goudie et al. teaches the use of magnesium acetylsalicylate in conjunction with sodium bicarbonate as an analgesic having reduced gastric irritancy properties. U.S. Pat. No. 4,217,340 to Tobert discloses the use of a phenylbenzoic acid compound and magnesium hydroxide for treating pain and inflammation. Such compositions have employed magnesium salts for their solubility, absorption properties and buffering effects. A deficiency of magnesium, i.e., hypomagnesemia, has been suggested to play a role in migraine headaches (B.A. Web site: http://www.delphion.com/details?pn=US05914129__ •

Anandamide inhibitors as analgesic agents Inventor(s): Hill; William Adam (Ashford, CT), Lin; Sonyan (Storrs, CT), Makriyannis; Alexandros (Ashford, CT) Assignee(s): University of Connecticut (farmington, Ct) Patent Number: 6,391,909 Date filed: April 20, 2000 Abstract: Disclosed is a method of inhibiting anandamide amidase in an individual or animal and novel inhibitors of anandamide amidase. The disclosed method can be used to reduce pain in an individual or animal suffering from pain, reducing nausea in an individual undergoing chemotherapy, suppressing appetite in an individual, reducing intraocular pressure in the eye of an individual or animal suffering from glaucoma and suppressing the immune system in an individual with an organ transplant. Excerpt(s): Arachidonyl ethanolamide (anandamide) is a naturally-occurring brain constituent that acts as a CB1 and CB2 agonist and exhibits pharmacological activity in mice comparable to cannabinoids (Fride and Mechoulam (1993), Crawley et al. (1993) and Smith et al. (1994)). Anandamide is cleaved in vivo by anandamide amidase. Thus, inhibitors of anandamide amidase have the effect of indirectly stimulating the CB1 and CB2 receptors by increasing in vivo levels of anandamide. In addition to acting at the CB1 and CB2 receptors, cannabinoids also affect cellular membranes, thereby producing

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undesirable side effects such as drowsiness, impairment of monoamide oxidase function and impairment of non-receptor mediated brain function. The addictive and psychotropic properties of cannabinoids also limit their therapeutic value. Inhibitors of anandamide amidase are not expected to have the undesired membrane-related sideeffects produced by cannabinoids. By providing an alternate mechanism for stimulating the CB1 and CB2 receptor, anandamide inhibitors might not have the addictive and psychotropic properties of cannabinoids. However, present inhibitors of anandamide amidase have disadvantages. For example, phenylmethylsulfonyl fluoride (PMSF) is toxic to cells. Thus, there is a need for new and more potent inhibitors of anandamide amidase which have reduced toxicity towards cells and which do not significantly interact with the CB1 or CB2 receptor at inhibitory concentrations. It has now been found that long chain fatty acids and aromatic acid analogs of long chain fatty acids with head groups capable of irreversibly binding to a nucleophilic group at an enzyme active site are potent inhibitors of anandamide amidase. For example, palmitylsulfonyl fluoride was found to increase the level of undegraded anandamide 55-fold at 10 nM in intact neuroblastoma cells (Example 1) and is therefore more than 100 fold more potent than phenylmethylsulfonyl fluoride at inhibiting anandamide amidase. At the same time, the inhibitors disclosed herein have a low affinity for the CB1 receptor (Example 3). For example, the binding affinity of palmitylsulfonyl fluoride for the CB1 receptor is about 10 times lower than anandamide. In addition, it has been found that palmitylsulfonyl fluoride causes some of the same pharmacological effects in rats as do compounds which stimulate the CB1 receptor directly, such as.DELTA.sup.9 tetrahydrocannabinol. For example, palmitylsulfonyl fluoride is shown herein to induce analgesia in rats (Example 4). Based on these results, methods of inhibiting anandamide amidase, thereby stimulating the CB1 and CB2 receptors, in an individual or animal are disclosed. Also disclosed are novel compounds which inhibit anandamide amidase. Web site: http://www.delphion.com/details?pn=US06391909__ •

Anti-nausea compositions and methods Inventor(s): Hermelin; Marc S. (Glendale, MO), Kirschner; Mitchell I. (St. Louis, MO), Levinson; R. Saul (Chesterfield, MO) Assignee(s): Drugtech Corporation (wilmington, De) Patent Number: 6,197,329 Date filed: May 3, 1999 Abstract: The present disclosure is directed to novel nutritional anti-nausea compositions, anti-emetic compositions, and methods of using same. The compositions provide improved relief from nausea and/or vomiting. The compositions are particularly useful for pregnant women. Excerpt(s): The present invention is directed to novel nutritional anti-nausea compositions, anti-emetic compositions and methods of using the same to provide relief from nausea and/or vomiting. The present compositions are also nonteratogenic and are therefore highly useful to pregnant women. Nausea and vomiting are two of the most common symptoms of illness and are also commonly experienced as side effects of numerous medical treatments. Both nausea and vomiting are also commonly experienced as a result of various external factors (e.g., travel) and during various conditions (e.g., pregnancy). Nausea and vomiting can occur individually or in conjunction with one another. A common cause of nausea and vomiting is motion sickness. Motion sickness typically occurs when humans are subjected to long-lasting

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external movement or transportation accompanied by unusual movements such as shaking, waving, atmospheric changes (e.g., flying in an airplane), great acceleration, and uneven road conditions, etc. Motion sickness is not viewed as a disease but as a physiological symptom complex wherein the symptoms experienced, of which nausea and vomiting are common, depend on the individual in question. When the individual experiences motion sickness in a work environment, i.e., truck drivers, air pilots, air craft staff members and the like, the potential for a disadvantageous and dangerous condition result. Such individuals are often required to exhibit high level concentration and intellect, and the presence of motion sickness symptoms can severely detract from their ability to do so. Web site: http://www.delphion.com/details?pn=US06197329__ •

Arginine/ascorbic acid mixed powder as an oral supplement Inventor(s): Kimoto; Eiji (Jonan-ku, JP), Morishige; Fukumi (2-10-13, Miyakono, Oamishirasato-machi, Sanbu-gun, Chiba-ken, JP) Assignee(s): Kimoto; Sachiko (jonan-ku, Jp), Morishige; Fukumi (sanbu-gun, Jp) Patent Number: 6,552,074 Date filed: November 13, 2001 Abstract: A mixture obtained by mixing ascorbic acid powder with arginine powder in a weight ratio (ascorbic acid/arginine) of 1/5 to 20, especially 1/5 to 1/4; and a supplement such as a nutrient preparation and a health-care food containing the mixture. Mixing of arginine powder and ascorbic acid powder in the weight ratios eliminates stringent taste specific to arginine and alleviates stringent feeling in the stomach (heartburn, nausea or vomiting) after oral intake thereof. The mixture prevents also peroxidative injuries of cells caused by an administration of a great amount of arginine alone. Further, mixing of arginine powder with ascorbic acid powder prevents browning of the mixture after long-term storage. Excerpt(s): The present invention relates to a method for eliminating the stringent taste and alleviating stringent feeling in the stomach of L-arginine (hereinafter referred to as arginine) by mixing L-ascorbic acid (hereinafter referred to as ascorbic acid) and for alleviating the toxicity of arginine-derived NO radical by arginine-ascorbic acidcombined treatment. From late 1970's to 1980's, a research group of Illinois University reevaluated that dietary arginine is indispensable for optimal health of adult and especially aged humans. (see E. Kimoto, "Nutritional Chemistry of L-Arginine", Kaisei Publishing Co. Ltd., Tokyo, 1999 (Literature 2), page 93). In 1987, it was reported that NO radical participating in a wide variety of physiological functions such as blood pressure control and prevention of infections is derived from arginine as a source. This led to increased attention paid to arginine in the field of amino acid nutrition science (see Literature 2, page 57). Web site: http://www.delphion.com/details?pn=US06552074__

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Compositions containing the nonprescription combination of acetaminophen, aspirin and caffeine to alleviate the pain and symptoms of migraine Inventor(s): Armellino; Joseph (Chester, NJ), Koslo; Randy (West Windsor Township, NJ) Assignee(s): Bristol-myers Squibb Company (new York, Ny) Patent Number: 5,972,916 Date filed: February 10, 1998 Abstract: The invention provides a safe and economical nonprescription combination of acetaminophen, aspirin and caffeine (APAP/ASA/CAF) for use in treating migraine pain and the cluster of symptoms characteristic of migraine attack, such as nausea, photophobia, phonophobia and functional disabilities. The use of the APAP/ASA/CAF combination is also effective in aborting the prodrome phase of a migraine attack. Excerpt(s): The present invention relates generally to compositions and methods used to alleviate the symptoms and pain associated with acute migraine attack. More particularly, the present invention relates to the use of a nonprescription combination of acetaminophen, aspirin and caffeine for treating individuals afflicted with pre-migraine conditions, migraine-associated symptoms and/or migraine pain of mild to severe intensity. An estimated 23 to 25 million Americans--about 18% of women and 6% of men--suffer from migraine pain and migraine-related symptoms.sup.1. Attacks are common, with more than 50% of sufferers experiencing one or more episodes per month.sup.2. Migraine, a heterogeneous disorder, produces a wide spectrum of pain and associated disabilities, both within and among individual sufferers. The spectrum includes mild pain and no disability in approximately 5-15% of migraine attacks, moderate to severe pain and disability in approximately 60-70% of attacks, and incapacitating pain and total disability in the remaining approximately 25-35% of attacks.sup.3,4. Web site: http://www.delphion.com/details?pn=US05972916__

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Derivatives of amide analogs of certain methano bridged quinolizines Inventor(s): Gittos; Maurice W. (Plobsheim, FR) Assignee(s): Merrell Pharmaceuticals, Inc. (cincinnati, Oh) Patent Number: 5,955,470 Date filed: October 29, 1998 Abstract: This invention relates to novel amide derivatives of certain 2,6-methano-2Hquinolizine-type compounds, to the intermediates and processes for their preparation, to their ability to antagonize the effects of serotonin at the 5HT.sub.3 receptors, and to their end-use application in the treatment of chemotherapeutically-induced nausea and vomiting, as anti-anxiety agents, in the symptomatic treatment of pain associated with migraine, as anti-arrhythmic agents, in the treatment of cognitive disorders, in treating hallucinatory endogenous psychoses of the type manifested in patients suffering from schizophrenia, and mania, in the treatment of glaucoma, for stimulating gastric motility, to combat drug abuse, to treat sleep apnea and to treat irritable bowel syndrome. Excerpt(s): This invention relates to novel amide derivatives of certain 2,6-methano-2Hquinolizines-type compounds, to the intermediates and processes for their preparation, to their ability to antagonize the effects of serotonin at the 5HT.sub.3 receptors, and to

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their end-use application in the treatment of chemotherapeutically-induced nausea and vomiting, as anti-anxiety agents, in the symptomatic treatment of pain associated with migraine, as anti-arrhythmic agents, in the treatment of cognitive disorders, in treating hallucinatory endogenous psychoses of the type manifested in patients suffering from schizophrenia, and mania, in the treatment of glaucoma, for stimulating gastric motility, to combat drug abuse, to treat sleep apnea and to treat irritable bowel syndrome. (g) R.sub.2 substituted-1H-benzotriazoles. The pharmaceutically acceptable acid addition salts referred to above can be non-toxic salts with suitable acids such as those with inorganic acids, for example, hydrochloric, hydrobromic, nitric, sulfuric or phosphoric acids; or with organic acids such as organic carboxylic acids, for example, acetic, propionic, glycolic, maleic, hydroxymaleic, malic, tartaric, citric, salicylic, 2acetyloxybenzoic, nicotinic or isonicotinic; or organic sulfonic acids, for example, methanesulfonic, ethanesulfonic, 2-hydroxyethanesulfonic, 4-toluenesulfonic or 2naphthalenesulfonic. Quaternary ammonium salts are formed with alkyl halides such as methyl chloride, methyl bromide, methyl iodide or ethyl bromide; or with sulfate esters such as methyl 4-toluenesulfonate or methyl 2-naphthalenesulfonate. Web site: http://www.delphion.com/details?pn=US05955470__ •

Device and method for decreasing nausea and vomiting Inventor(s): Langevin; Paul B. (Gainesville, FL) Assignee(s): University of Florida (gainesville, Fl) Patent Number: 6,030,631 Date filed: February 18, 1998 Abstract: The subject invention relates to devices that are specifically designed to safely and efficiently administer alcohol vapor for innocuous insufflation or inhalation, and to related methods of administering alcohol in this manner. The subject invention is preferably used to treat a patient suffering from post-operative nausea or vomiting that are side effects that often accompany the use of anesthetics for surgical applications. Excerpt(s): Nausea and emesis are often induced by stimulation of either the chemoreceptor trigger zone or the emesis (or vomiting) center in the central nervous system. Such stimulation can be caused by afferent stimulation (e.g., tactile pharyngeal impulses, labrynthine disturbances, motion, increased intracranial pressure, pain, distention of viscera or psychologic factors) or blood born emetic substances (e.g., as seen during pregnancy, cancer chemotherapy, uremia, radiation therapy, electrolyte and endocrine disturbances, or the presence of chemical emetic substances). Nausea and vomiting are also common post-operative side effects that result from the use of anesthetics. These symptoms are known as post-operative nausea and vomiting (PONV). A series of medication alternatives are currently used to combat PONV. The drugs used most frequently are benzamides (e.g. Metoclopramide),phenothiazines(e.g. Phenergan) and Serotonin inhibitors (e.g. Ondancetron). In order to minimize the side effects, these drugs are most often administered in this sequence. If Metroclopramide fails to produce adequate relief, Phenergan is administered. If sufficient relief is still not experienced, Ondancetron is given to the patient. In efforts to control cost and potential side effects, these medications are usually given in sequence at 30 minute intervals. This methodology can significantly prolong the time the patient remains in the recovery room, an area of the hospital where every additional minute represents enormous expense. The most common side effects of metroclopramide, which are experienced by about 10% of treated patients involve the central nervous system (CNS) and include

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restlessness, fatigue, drowsiness and lassitude. Insomnia, headache and dizziness occur less frequently. Delirium, severe dysphoria, obsessive rumination, mania, depression, and suicidal indication have also been reported. Extrapyramidal effects also result from dopaminergic blockage. This usually presents in the form of akathisia and occurs most often in children and young adults. Dystonic reactions resembling acute dyskinesia occur in less than 1% of young patients receiving low doses of Metroclopramide, but occur as often as in 25% of patients receiving higher doses. Web site: http://www.delphion.com/details?pn=US06030631__ •

Drug-withdrawal-syndrome auricle-therapeutic device Inventor(s): Qingmin; Wu (Room 102, Flat 4, 17# Huaxin Xiang, Nanjing, Jiangsu Province, CN) Assignee(s): None Reported Patent Number: 6,296,652 Date filed: May 26, 1999 Abstract: A device for treating the undesirable symptoms resulting from cessation of habitual drug use, which can include insomnia, anxiety, tremors, loss of appetite, drowsiness, nausea, and sweating, and for reducing the rate of recurrence of drug use following treatment through the use of a programmed series of acupuncture, massage, and/or moxibustion treatments of acupuncture points in a subject's ear(s). The device includes a housing that conforms to the contour of a human ear containing a plurality of acupuncture needles held in an elastomeric structure and connected to a movable elongate member such that the plurality of needles may be brought into intermittent contact with the inner surface of the ear with an approximately equal force. The device further includes a control circuit adapted to automatically control the application of acupuncture stimulating current, moxibustion, and/or massage in a programmable manner. The device allows a user to program a treatment regimen into the device, removably affix the device adjacent at least one of a subject's ears, and provide the programmed acupuncture, moxibustion, and/or massage treatments to a plurality of known acupuncture points on the inner surface of the subject's ear(s). In one embodiment, the acupuncture needles are made of a permanently magnetic material to include an auxiliary magnetic treatment. In an alternative embodiment, the device also includes a vocal and/or musical sound generating component as additional therapy. Excerpt(s): The invention concerns a therapeutic device, particularly, a therapeutic device for treating drug withdrawal syndrome. What is called drug withdrawal syndrome means such serious syndrome as being anger for drug, anxiety, frequently giving yawn, sweating, running with tears, running nose, drowsing, dilated pupil, being goose flesh, tremor, shivering, muscle aching, headache, losing appetite, insomnia, even blood pressure rising, frequency and depth of breath increasing, pulse quickening, restless, nausea, curling, vomiting, diarrhea, spermatorrhea, etc. occurred after stopping drug-taking. Chemotherapy of entire course integrated the three phases addictionremoving, consolidation and rehabilitation is adopted in drug-giving-up treatment now. Body acupuncture and ear acupuncture therapies by hand-needling or electroimpulse output only are used for an auxiliary means. Modern drug-giving-up therapy is a pure chemotherapy. Addiction-removing therapy taking opium acceptor analeptic such as methadone, opium, dihydroetorphine and others or opium acceptor partial analeptic-buprenorphine as alternatives, or addiction-removing taking non-opium clonidine, existing preserving treatment taking naltrexone or methadone in consolidation therapy.

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The above-mentioned therapies, generally speaking, have many advantages such as reliable efficiency, fast addiction-removing action and relative safety. While there exist problems with them. These include more undesirable reaction, heavier toxic side effects, undetermined effect in giving up abuse of many drugs due to addiction to narcotic drug, trend of some medicines producing dependence, consequently treating medicines having been turned new narcotic drugs and leading new addiction to them. After addiction-removed by modern drug-giving-up treatment, some procrastinated withdrawal syndromes still exists at different extents with sufferers, even though taking naltrexone to consolidate effect, 90.about.95% drug-retaking rate still occurs during six months after addiction-removing treatment using different giving-up medicines in modern drug-giving-up therapy, in result, the vicious circle of habituation--addictionremoving--Addiction-recovering--addiction-re-removi ng almost can not be broken. The existing acupuncture or ear acupuncture therapy and electronics designed based the principle of science of acupuncture and moxibustion is a pure physical therapy, and is only used as an auxiliary means. Hand-needling treatment is not easy to master exactly and may cause pain and infection due to improper operation. Drug-giving-up effect may be unsatisfactory and unsteady when design of the devices is unreasonable, or the devices are not convenient to use due to their low automatic degree. Consequently, popularization of the treatment method in the drug-giving-up field is blocked. Web site: http://www.delphion.com/details?pn=US06296652__ •

Electro-acupuncture device with stimulation electrode assembly Inventor(s): Duffy; Robert J. (Carlsbad, CA), Grey; Thomas L. (Carlsbad, CA), Gruzdowich; Gregory J. (Carlsbad, CA), Mann; Thomas L. (Carlsbad, CA), Tait; Hogar (Carlsbad, CA) Assignee(s): Woodside Biomedical, Inc. (carlsbad, Ca) Patent Number: 6,567,695 Date filed: November 24, 2000 Abstract: An electro-acupuncture device for controlling nausea. The device includes a base unit which is includes a wrist-watch like housing, circuitry for generating electroacupuncture stimulus disposed within the housing, and a strap for securing the housing to the wrist. The base unit has a standardized construction. The device also includes a releasably attachable electrode assembly. The electrode assembly attaches to the base unit of the device. The electrode assembly includes a pair of electrodes and connectors for connecting the electrodes to the circuitry of the base unit. The output of the device is dependent upon the circuitry of the electrode assembly. Thus various electrode assemblies can be made. The circuitry of the base unit modifies the output of the device depending upon which electrode assembly is attached to the base unit. Excerpt(s): The methods and devices described below relate to the field of electroacupuncture and non-invasive stimulation of nerves. We have developed an electroacupuncture device which has proven effective for the control of nausea and vomiting. The device, marketed under the trademark Relief-Band.RTM., is worn on the wrist like a wristwatch, with a watch-like housing which is positioned on the underside of the wrist. The housing has two electrodes on the inside face (the face in contact with the wrist when secured to the wrist), a battery and circuitry inside the housing, and control buttons on the outer face. A patient suffering from nausea or vomiting (from seasickness, morning sickness, chemotherapy, or anesthesia) can strap the device onto their wrist and turn it on. When turned on, the device emits an electrical stimulation

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pulse over the P6 acupuncture point (corresponding to the superficial course of the meridian nerve through the wrist). Within several minutes, most patients experience a substantial relief of nausea. The device uses non-invasive nerve stimulation whereby electricity is passed through two electrodes to stimulate nerves located on the ventral side of the wrist (this anatomical position is sometimes referred to as the palmar side of the wrist). The treatment provided by the device is sometimes referred to as electroacupuncture, which is a form of acupuncture, and the ventral site of application is referred to in the acupuncture art as the P6 point, pericardium 6 point, or master point of the pericardium meridian (sometimes referred to as the vascular meridian). A primary object of the invention is to provide a non-chemical, non-invasive, painless and inexpensive method of alleviating nausea. It is also portable, self-contained and convenient to the patient. Electrical pulse repetition rate of approximately 70 pulses per second and a pulse width of 80 microseconds has been found to provide effective relief of nausea in a patient. Our currently preferred electrical pulse pattern comprises about 350 microsecond pulse width at about 31 pulses per second at power levels of about 1035 milli-amps peak pulse height. Thus a wide range of pulse patterns may be used in non-invasive nerve stimulation devices. The device is described in Bertolucci, Nausea Control Device, U.S. Pat. No. 4,981,146 (Jan. 1, 1991). Previously, we have provided devices in several models, each providing a different strength of stimulation deemed appropriate for particular patients and indications. We have also marketed a version of the device which included circuitry and operator controls which allowed the patient to select from a wide range of power setting and stimulation patterns. Currently, we are marketing over-the-counter devices and prescription devices. Both the over-the-counter device and the prescription are provided in embodiments in which the device is disposable (the batteries cannot be replaced after depletion) and in which the device is reusable, (the batteries may be replaced indefinitely). In each of these versions, we have provided complete circuitry, power supply, and electrodes in each device manufactured. Thus, for each version of the device, different circuitry had to be provided. The devices and methods described below provide for easier manufacturing of a line of devices with different characteristics. Web site: http://www.delphion.com/details?pn=US06567695__ •

Extended release formulation of venlafaxine hydrochloride Inventor(s): Clark; John C. (Peru, NY), Lamer; John U. (St. Albans, VT), Sherman; Deborah M. (Plattsburgh, NY), White; Steven A. (Champlain, NY) Assignee(s): American Home Products Corporation (madison, Nj) Patent Number: 6,274,171 Date filed: January 20, 2000 Abstract: This invention relates to a 24 hour extended release dosage formulation and unit dosage form thereof of venlafaxine hydrochloride, an antidepressant, which provides better control of blood plasma levels than conventional tablet formulations which must be administered two or more times a day and further provides a lower incidence of nausea and vomiting than the conventional tablets. More particularly, the invention comprises an extended release formulation of venlafaxine hydrochloride comprising a therapeutically effective amount of venlafaxine hydrochloride in spheroids comprised of venlafaxine hydrochloride, microcrystalline cellulose and, optionally, hydroxypropylmethylcellulose coated with a mixture of ethyl cellulose and hydroxypropylmethylcellulose.

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Excerpt(s): Extended release drug formulations are conventionally produced as compressed tablets by hydrogel tablet technology. To produce these sustained release tablet drug dosage forms, the active ingredient is conventionally compounded with cellulose ethers such as methyl cellulose, ethyl cellulose or hydroxypropylmethylcellulose with or without other excipients and the resulting mixture is pressed into tablets. When the tablets are orally administered, the cellulose ethers in the tablets swell upon hydration from moisture in the digestive system, thereby limiting exposure of the active ingredient to moisture. As the cellulose ethers are gradually leached away by moisture, water more deeply penetrates the gel matrix and the active ingredient slowly dissolves and diffuses through the gel, making it available for absorption by the body. An example of such a sustained release dosage form of the analgesic/anti-inflammatory drug etodolac (Lodine.RTM.) appears in U.S. Pat. No. 4,966,768. U.S. Pat. No. 4,389,393 discloses sustained release therapeutic compressed solid unit dose forms of an active ingredient plus a carrier base comprised of a high molecular weight hydroxypropylmethylcellulose, methyl cellulose, sodium carboxymethylcellulose and or other cellulose ether. Where the production of tablets is not feasible, it is conventional in the drug industry to prepare encapsulated drug formulations which provide extended or sustained release properties. In this situation, the extended release capsule dosage forms may be formulated by mixing the drug with one or more binding agents to form a uniform mixture which is then moistened with water or a solvent such as ethanol to form an extrudable plastic mass from which small diameter, typically 1 mm, cylinders of drug/matrix are extruded, broken into appropriate lengths and transformed into spheroids using standard spheronization equipment. The spheroids, after drying, may then be film-coated to retard dissolution. The film-coated spheroids may then be placed in pharmaceutically acceptable capsules, such as starch or gelatin capsules, in the quantity needed to obtain the desired therapeutic effect. Spheroids releasing the drug at different rates may be combined in a capsule to obtain desired release rates and blood levels. U.S. Pat. No. 4,138,475 discloses a sustained release pharmaceutical composition consisting of a hard gelatin capsule filled with film-coated spheroids comprised of propanolol in admixture with microcrystalline cellulose wherein the film coating is composed of ethyl cellulose, optionally, with hydroxypropylmethylcellulose and/or a plasticizer. Venlafaxine, 1-[2dimethylamino)-1-(4-methoxyphenyl)ethyl]cyclohexanol, is an important drug in the neuropharmacological arsenal used for treatment of depression. Venlafaxine and the acid addition salts thereof are disclosed in U.S. Pat. No. 4,535,186. Venlafaxine hydrochloride is presently administered to adults in compressed tablet form in doses ranging from 75 to 350 mg/day, in divided doses two or three times a day. In therapeutic dosing with venlafaxine hydrochloride tablets, rapid dissolution results in a rapid increase in blood plasma levels of the active compound shortly after administration followed by a decrease in blood plasma levels over several hours as the active compound is eliminated or metabolized, until subtherapeutic plasma levels are approached after about twelve hours following administration, thus requiring additional dosing with the drug. With the plural daily dosing regimen, the most common side effect is nausea, experienced by about forty five percent of patients under treatment with venlafaxine hydrochloride. Vomiting also occurs in about seventeen percent of the patients. Web site: http://www.delphion.com/details?pn=US06274171__

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Intravaginal rings with insertable drug-containing core Inventor(s): Bardin; C. Wayne (New York, NY), Harmon; Troy (Lansdale, PA), Nash; Harold A. (Harrington Park, NJ), Saleh; Saleh Ismail (Assuit, EG) Assignee(s): The Population Council, Inc. (new York, Ny) Patent Number: 5,972,372 Date filed: May 2, 1997 Abstract: Disclosed is a vaginal ring intended for the release of at least one drug over a prolonged time period. The vaginal ring contains a ring body made of a first polymeric material having at least one hollow internal channel defining an opening to the exterior of the ring body and which channel is adapted to receive a, drug-containing core through the opening, and an intravaginally administerable drug-containing core disposed in the channel. The core is positioned in the vaginal ring body suitably prior to use in order to substantially avoid initial bursts of drug into the tissues of the subject and resultant side effects such as nausea and vomiting. The core contains a pharmaceutically effective amount of at least one intravaginally administerable drug dispersed in a second polymeric material. The first and second polymeric materials may be the same or different. Representative drugs include contraceptive agents and other steroidal substances for use in hormone replacement therapy. Also disclosed are methods for preparing the vaginal rings, kits for assembling the vaginal rings, and methods of using the vaginal rings to achieve intravaginal delivery of drugs to a female. Excerpt(s): The present invention is directed to intravaginal drug delivery devices and methods for the intravaginal administration of drugs, and more particularly, the intravaginal administration of contraceptive agents and agents for hormone replacement therapy. Vaginal rings are torous shaped devices designed to deliver a relatively constant dose of drug to the vagina usually over a period of weeks to months. Typically, they are made of a silicone elastomer and contain a drug released by diffusion though the elastomer. The most common commercial applications have been to deliver low doses of steroids for post-menopausal vaginal conditions. They have also been under development for use in contraception and hormone replacement therapy. Vaginal rings have also been used to administer spermicides, as well as a variety of locally or systematically active medicaments. Vaginal rings have provided several advantages in that their use is controlled by the female; they allow for a better regulated dose of drug without attention by the user; and they avoid the destruction (by the intestine and by first pass through the liver) of an appreciable portion of the daily dosage of some steroids compared to their orally delivered counterparts. The use of a vaginal ring to deliver drugs requires a ring design that regulates the release rate so as to provide the user with the appropriate daily dose. Among the important factors governing release are the solubility of the drug in the ring elastomer, the surface area of the drug reservoir, the distance the drug must diffuse through the ring body to reach its surface and the molecular weight of the drug. If very high release rates are desired, they can be attained by a drug load at the ring surface as is characteristic of the homogeneous matrix ring design. This design, however, suffers from rapidly declining release rates as the distance the drug must travel to reach the ring surface increases as the drug load near the surface is depleted. If moderately high release rates are needed to provide the appropriate dose, a design which modulates release rate by imposing a layer of drug-free elastomer between the drug reservoir and the ring exterior is appropriate. This may be attained by coating a homogeneous ring, or to conserve drug, by incorporating a drug-free core, a shell design may be used. If an even lower release rate is desired, the drug may be confined to a small diameter at the center of the ring ("core ring"). Finally, the drug-

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loaded core may not encircle the ring but instead be of short length. Numerous types of vaginal rings have been described in the patent and non-patent literature alike. See, e.g., U.S. Pat. Nos. 4,012,496 and 4,155,991 (both to Schopflin et al.), 4,292,965 (Nash), 3,545,439 (Duncan), 3,920,805 (Roseman), 3,991,760 and 3,995,634 (both to Drobish et al.), 3,995,633 (Gougen), 4,250,611 and 4,286,587 (both to Wong), 4,596,576 (de Nijs); W095/00199 (Lehtinen et al.), NL 8500-470-A; and Apter et al., Contraception 42:285-295 (1990), Burton et al., Contraception 17:221-230 (1978), Burton et al., contraception 19:507516 (1979), Jackanicz, Contraception 24:323-339 (1981), Sivin et al., Contraception 24:341358 (1981), Timmer et al., Contraception 43:629-642 (1990), and Toivonen, Contraception 20:511-518 (1979). Web site: http://www.delphion.com/details?pn=US05972372__ •

Medicaments for gastrointestinal disorders Inventor(s): Challoner; Teresa Elizabeth (Regents Park, GB), Tyers; Michael Brian (Welwyn, GB) Assignee(s): Glaxo Group Limited (brentford, Gb) Patent Number: 6,544,550 Date filed: November 24, 1993 Abstract: The invention relates to the co-administration in human or veterinary medicine of 1,2,3,9-tetrahydro-9-methyl-3-[(2-methyl-1H-imidazol-1-yl)methyl]-4Hcarba zol-4-one or a physiologically acceptable salt or solvate thereof and dexamethasone or a physiologically acceptable salt or ester thereof. The two active ingredients, which may be administered separately either simultaneously or sequentially, or may be combined in a single pharmaceutical preparation, are useful in the relief and/or prevention of nausea and vomiting. Excerpt(s): This invention relates to improvements in the treatment of gastrointestinal disorders. More particularly it relates to the use of a compound having antagonist activity at 5HT.sub.3 receptors and dexamethasone in the treatment of emesis, and to pharmaceutical compositions containing the two compounds. and physiologically acceptable salts, solvates and physiologically acceptable equivalents thereof. In the aforementioned specification the compounds are described as potent and selective antagonists of 5- hydroxytryptamine (5HT) at `neuronal` 5HT receptors of the type located on terminals of primary afferent nerves, and which are also present in the central nervous system. Receptors of this type are now designated 5HT.sub.3 receptors. The compounds are described as being of use in the treatment of a human or animal subject suffering from a condition caused by a disturbance of neuronal 5HT function, for example in the treatment of migraine pain or a psychotic disorder such as schizophrenia. The compounds may also be useful in the treatment of conditions such as anxiety, obesity and mania. Web site: http://www.delphion.com/details?pn=US06544550__

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Method and composition for treatment of headache using magnesium Inventor(s): Altura; Bella T. (Beechhurst, NY), Altura; Burton M. (Beechhurst, NY), Mauskop; Alexander (Larchmont, NY) Assignee(s): Research Foundation of the State University of New York (albany, Ny) Patent Number: 6,218,192 Date filed: February 17, 1995 Abstract: A method of treating headache is provided using a water soluble magnesium salt. Specifically, a method of treating a headache is provided for an individual having a serum ionized magnesium concentration of 0.44 mmoles/L to 0.53 mmoles/L and having at least one headache symptom by administering an amount of a water soluble magnesium salt sufficaent to inhibit at least one headache symptom in the individual within 24 hours and to raise the serum ionized magnesium concentration in the individual to within a normal ionized magnesium concentration range of 0.54 mmoles/L to 0.67 mmoles/L. Headache symptoms which may be inhibited include: pain, aura, photophobia, nausea, unilateral pain and phonophobia. Excerpt(s): Magnesium (Mg) is the second most abundant cation in the body [Altura, B. M. et al., Drugs 28 (Suppl.I):120-142, 1984]. It is cofactor for more than 325 cellular enzymes involved in cellular energy production and storage, protein synthesis, DNA and RNA synthesis, cell growth and reproduction, adenylate cyclase synthesis, maintenance of cellular electrolyte composition, and stabilization of mitochondrial membranes [Altura, B. M. et al, Drugs 28 (Suppl.I):120-142, 1984; Wacker, W. E. C. Magnesium and Man, Harvard Univ. Press, Cambridge, 1980]. As a consequence of these biochemical activities, Mg plays a pivotal role in control of neuronal activity, cardiac excitability, neuromuscular transmission, muscular contraction, and vasomotor tone [Altura, B. M. et al., Drugs 28 (Suppl.I):120-142, 1984; Wacker, W. E. C. Magnesium and Man, Harvard Univ. Press, Cambridge, 1980; Altura, B. M. et al., in: Metal Ions in Biological Systems, ed. by H. Sigel and A. Sigel, Vol 26: Compendium on Magnesium and Its Role in Biology, Nutrition, and Physiology, pp 359-416, Marcel Dekker, Inc. New York, 1990]. Most clinical data of Mg determinations are derived from blood levels of total Mg (Wacker, W. E. C. Magnesium and Man, 1980; Elin, R. J. Clin. Chem. 33:19651970, 1987). Total serum Mg concentrations reflect protein-bound (30-40%), chelated (712%), and free or ionized Mg (Mg.sup.2+) (60-70%) fractions. The exact proportion of these fractions has been extremely difficult to determine precisely, and, moreover, there is no way to rapidly make such determinations. Precise information about Mg activity is pivotal to our understanding of Mg metabolism. The free or ionized form (Mg.sup.2+) is the active form of the mineral (Wacker, W. E. C. Magnesium and Man, 1980; Elin, R. J. Clin. Chem. 33:1965-1970, 1987; Ryan, M. F. Ann. Clin. Biochem. 28:19-26, 1991). Alterations in circulating protein levels (primarily albumin), which are seen in numerous pathophysiologic states, will alter the interpretation of Mg status (very similar to calcium) (Elin, R. J. Clin. Chem. 33:1965-1970, 1987). Although numerous methods are available clinically, to determine total Mg in serum, plasma, urine, cerebral spinal fluid and other body fluids (e.g., atomic absorption spectrophotometry, atomic emission spectrophotometry, colorimetry, fluorometry, compleximetry and chromatograph for quantifying total Mg), none of these can determine ionized or free Mg.sup.2+ (Elin, R. J. Cin. Chem. 33:1965-1970, 1987; Wills, M. R. et al. Magnesium 5:317-327, 1986). Web site: http://www.delphion.com/details?pn=US06218192__

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Method of treating symptoms of hormonal variation, including hot flashes Inventor(s): Guttuso, Jr.; Thomas J. (Rochester, NY) Assignee(s): University of Rochester (rochester, Ny) Patent Number: 6,310,098 Date filed: July 21, 2000 Abstract: One aspect of the present invention relates to a method of treating hot flashes in a patient which is carried out by providing a compound which binds a.alpha.sub.2.delta. subunit of a voltage-gated calcium channel and administering the compound to a patient experiencing hot flashes under conditions effective to treat the hot flashes. Another aspect of the present invention relates to a method for treating a symptom of hormonal variation in a patient which is carried out by providing a compound which binds a.alpha.sub.2.delta. subunit of a voltage-gated calcium channel and administering the compound to a patient experiencing a symptom of hormonal variation under conditions effective to treat the symptom of hormonal variation. Further aspects of the present invention relate to the administration of a compound which binds a.alpha.sub.2.delta. subunit of a voltage-gated calcium channel as an anti-pyretic agent (for treating fever) or as an anti-emetic agent (for treating nausea and emesis). Excerpt(s): The present invention relates generally to methods of treating symptoms of hormonal variation, including hot flashes, treating fever, and treating nausea and emesis. Hot flashes or flushing occur commonly in menopausal women. This is characterized by a sudden onset of warmth in the face and neck and often progressing to the chest. Such an episode generally lasts several minutes and is evidenced by a visible flushing of the skin. Often such episodes are accompanied by sweating, dizziness, nausea, palpitations and diaphoresis. Such symptoms can disrupt sleep and interfere with the quality of life. Although the cause of hot flashes are not completely understood, they are thought to be a disorder of thermoregulation resulting from a transient lowering of the hypothalamic temperature regulatory set point (Kronenberg et al., "Thermoregulatory Physiology of Menopausal Hot Flashes: A Review," Can. J. Physiol. Pharmacol., 65:1312-1324 (1987)). In post-menopausal woman, the cause of such hot flashes is believed to be a consequence of declining estrogen levels. Thus, it is not surprising that hot flashes also occur in a high percentage of women taking the antiestrogen drug tamoxifen. Men may also have hot flashes following androgendeprivation therapy (from bilateral orchiectomy or treatment with a gonadotrophinreleasing-hormone agonist) for metastatic prostate cancer. Web site: http://www.delphion.com/details?pn=US06310098__

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Method of treatment of nausea, vomiting, and other disorders using estrogens Inventor(s): Steele; Joy Ann (14334 Park Drive, Edmonton Alberta, CA) Assignee(s): None Reported Patent Number: 6,239,122 Date filed: January 5, 2000 Abstract: The use of estrone or derivatives of estrone, equilin, or equilenin, including pharmaceutically acceptable salts, as well as pharmaceutical compositions comprising these compounds as a therapeutic agent in humans or in animals is claimed. The

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asserted use is as an antiemetic agent or for the treatment of other disorders that can be ameliorated by noncompetitive antagonism of the 5-hydroxytryptamine type 3 receptor. Excerpt(s): Not applicable. Web site: http://www.delphion.com/details?pn=US06239122__ •

Methods and compositions involving opioids and antagonists thereof Inventor(s): Farrar; John J. (Chester Springs, PA) Assignee(s): Adolor Corporation (exton, Pa) Patent Number: 6,451,806 Date filed: November 29, 2000 Abstract: Novel methods and compositions comprising opioids In preferred embodiments, the methods and compositions peripheral mu opioid antagonist compounds. The methods particularly suitable for treating and/or preventing side effects including, for example, constipation, vomiting and/or nausea.

and opioid antagonists. comprise opioids and and compositions are associated with opioids

Excerpt(s): The present invention relates to novel methods and compositions comprising opioids and opioid antagonists. More particularly, the present invention relates to novel methods and compositions comprising opioids and peripheral mu opioid antagonist compounds. It is well known that opioid drugs target three types of endogenous opioid receptors (i.e., mu, delta and kappa receptors) in biological systems. Most opioids, such as morphine, are mu opioid agonists that are often used as analgesics for the treatment of severe pain due to their activation of mu opioid receptors in the brain and central nervous system (CNS). Opioid receptors are, however, not limited to the CNS, and may be found in other tissues throughout the body. A number of side effects of opioid drugs may be caused by activation of these peripheral receptors. Administration of mu opioid agonists often results in intestinal dysfunction due to the large number of receptors in the wall of the gut (Wittert, G., Hope, P. and Pyle, D., Biochemical and Biophysical Research Communications 1996, 218, 877-881; Bagnol, D., Mansour, A., Akil, A. and Watson, S. J., Neuroscience 1997, 81, 579-591). Specifically, opioids are generally known to cause nausea and vomiting as well as inhibition of normal propulsive gastrointestinal function in animals and man (Reisine, T., and Pasternak, G., Goodman & Gilman's The Pharmacological Basis of Therapeutics Ninth Edition 1996, 521-555) resulting in side effects such as, for example, constipation. It has been reported that acute nausea or vomiting may occur in up to about 33% of patients who receive oral narcotic analgesics and in up to about 80% of patients who receive injectable narcotics following surgery or trauma. This is due, at least in part, to direct effects of narcotics on the gastrointestinal (GI) tract. Opioid-induced side effects, such as nausea, vomiting, and inhibited gastrointestinal propulsive activity remain serious problems for patients being administered opioid analgesics for both short term and long term pain management. Opioid antagonist compounds that do not readily cross the blood-brain barrier (peripherally acting drugs) have been tested for use in curbing opioid-induced side effects. For instance, the peripheral mu opioid antagonist compound methylnaltrexone and related compounds have been suggested for use in curbing opioid-induced side effects in patients. U.S. Pat. Nos. 5,972,954, 5,102,887, 4,861,781, and 4,719,215 disclose the use of methylnaltrexone and related compounds in controlling opioid-induced pruritus, nausea, and/or vomiting. Additionally, methylnaltrexone has been shown to effectively reduce the incidence of opioid-induced nausea and pruritus as disclosed by

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Yuan, C. -S. et al. Drug and Alcohol Dependence 1998, 52, 161. Similarly, U.S. Pat. Nos. 5,250,542, 5,434,171, 5,159,081, and 5,270,328, disclose peripherally selective piperidineN-alkylcarboxylate opioid antagonists as being useful for the treatment of the opioid side effects constipation, nausea or vomiting, as well as irritable bowel syndrome and idiopathic constipation. Web site: http://www.delphion.com/details?pn=US06451806__ •

Methods for treating behavioral and other disorders using optically pure R(+) ondansetron Inventor(s): Young; James W. (Still River, MA) Assignee(s): Sepracor Inc. (marlborough, Ma) Patent Number: 5,962,494 Date filed: January 23, 1998 Abstract: Methods and compositions are disclosed utilizing the optically pure R(+) isomer of ondansetron. This compound is a potent drug for the treatment of nausea and vomiting associated with chemotherapy and radiation therapy, while avoiding the concomitant liability of adverse effects associated with the racemic mixture of ondansetron. The R(+) isomer of ondansetron is also useful for the treatment of behavioral disorders such as mood anxiety and schizophrenia, and such other conditions as may be related to R(+) ondansetron's activity as a competitive antagonist of serotonin receptor subtype 5-HT.sub.3 such as disorders of gastrointestinal motility, depression, migraine, and as an aid for alcohol withdrawal, nicotine withdrawal, and drug (benzodiazepine et al.) withdrawal, without the concomitant liability of adverse effects associated with the racemic mixture of ondansetron. Furthermore, the R(+) isomer of ondansetron is also useful for the treatment of cognitive disorders such as dementia or age-associated memory impairment, while avoiding the concomitant liability of adverse effects associated with the racemic mixture of ondansetron. Excerpt(s): This invention relates to novel compositions of matter containing optically pure R(+) ondansetron. These novel compositions have potent antiemetic activity and are useful in ameliorating the nausea and vomiting otherwise induced by cancer chemotherapeutic agents and higher dose radiotherapeutic treatment procedures while avoiding adverse effects including but not limited to headache, constipation and increases in transaminase levels, which are associated with the administration of the racemic mixture of ondansetron. Additionally, these novel compositions of matter containing optically pure R(+) ondansetron are useful in treating behavioral disorders such as mood anxiety and schizophrenia, and such other conditions as may relate to R(+) ondansetron's activity as a competitive antagonist of serotonin receptor subtype 5HT.sub.3, including but not limited to disorders of gastrointestinal motility,-depression, migraine, alcohol, nicotine or drug (benzodiazepine et al.) withdrawal, while avoiding adverse effects associated with the administration of the racemic mixture of ondansetron. Furthermore, these novel compositions of matter containing optically pure R(+) ondansetron are useful in treating cognitive disorders such as dementia and ageassociated memory impairment, while avoiding the adverse effects associated with the administration of the racemic mixture of ondansetron. Also disclosed are methods for treating the above described conditions in a human while avoiding the adverse effects that are associated with the racemic mixture of ondansetron, by administering the R(+) isomer of ondansetron to said human. The active compound of this composition, and method is an optical isomer of the compound, ondansetron which is described in U.S.

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Pat. No. 4,695,578. Chemically, the active compound is the R(+) isomer of 1,2,3,9tetrahydro-9-methyl-3-›(2-methyl-1H-imidazol-1-yl)methyl!-4H-carba zol-4-one. This isomer will hereinafter be referred to as R(+) ondansetron. Many organic compounds exist in optically active forms, i.e., they have-the ability to rotate the plane of planepolarized light. In describing an optically active compound, the prefixes D and L or R and S are used to denote the absolute configuration of the molecule about its chiral center(s). The prefixes (+) and (-) or d and 1 are employed to designate the sign of rotation of plane-polarized light by the compound, with (-) or 1 meaning that the compound is levorotatory. A compound prefixed with (+) or d is dextrorotatory. For a given chemical structure, these compounds, called stereoisomers, are identical except that they are mirror images of one another. A specific stereoisomer may also be referred to as an enantiomer, and a mixture of such isomers is often called an enantiomeric or racemic mixture. Web site: http://www.delphion.com/details?pn=US05962494__ •

Migraine medicine and method for treating same Inventor(s): Imanzahrai; Ashkan (1642 Nord La., San Jose, CA 95125) Assignee(s): None Reported Patent Number: 6,642,243 Date filed: June 14, 2000 Abstract: This invention is a safe and effective composition and method for treating acute migraine attacks using pseudoephedrine, acetaminophen, and other agents in an orally administrated form to alleviate the pain and cluster of symptoms characteristic of migraine attacks such as nausea, photophobia, phonophobia, and functional disabilities as well as the prodrome phase of a migraine attack. Excerpt(s): The present invention relates generally to compositions and methods used to alleviate the symptoms and pain associated with an acute migraine attack. Many migraine sufferers use single-agent nonprescription analgesics such as acetaminophen, or aspirin, or non-steroidal anti-inflammatory agents to treat their attacks. (Lipton R B, Newman L C, Solomon S. Over-the-counter medication and the treatment of migraine. Headache 1994; 34:547-548.) In other countries, a number of nonprescription drugs are specifically approved for migraine pain. (Lipton R B, Newman L C, Solomon S. Overthe-counter medication and the treatment of migraine. Headache 1994; 34:547-548.) The effectiveness of self-treatment of a migraine and the effectiveness of most such nonprescription drugs in relieving or aborting migraine pain and/or the characteristic symptoms of a migraine has not been adequately studied in well-controlled clinical trials. (Lipton R B, Newman L C, Solomon S. Over-the-counter medication and the treatment of migraine. Headache 1994; 34:547-548.) Acetaminophen, aspirin, and caffeine are approved for relief of nonspecific headaches and tension headaches (Migliardi J R, Armellino J J, Friedman M, Gillings D B, Beaver W T. Caffeine as an analgesic adjuvant in tension headache. Clin Pharmacol Ther 1994; 56:576-586), which are clinical and physiologically distinct from a migraine. Caffeine is widely consumed and has also been indicated for use to treat asthma, drowsiness, fatigue, lumbar puncture headache, and neonatal apnea. [(Reents S. Clinical Pharmacology. Gold Standard Multimedia, Inc. (www.gsm.com) 1999. Available from URL:https://home.po.com.)] Caffeine is also an analgesic adjuvant for a variety of pain conditions and has been included in combination with other analgesics, ergot alkaloids, and barbiturates in prescription formulations for a migraine. (Laska E M, Sunshine A,

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Mueller F, Elvers W B, Siegel C, Rubin A. Caffeine as an analgesic adjuvant. JAMA 1984; 251:1711-1718; Olesen J. A review of current drugs for migraine. J Neurology 1991; 238 Suppl 1:S23-S27; Solomon G D. Therapeutic advances in migraine. J Clin Pharmacol 1993; 33:200-209; and Sawynok J. Pharmacological rationale for the clinical use of Caffeine. Drugs 1995; 49:37-50.) Caffeine itself may act to relieve a migraine. Caffeine has shown to reduce cerebral blood flow in humans and to be a nonselective adenosine receptor antagonist. Reduction of cerebral blood flow may be due to caffeine inhibition of the adenosine A2 receptor. (Sawynok J. Pharmacological rationale for the clinical use of Caffeine. Drugs 1995; 49:37-50.) A2 receptors are on cerebral vascular muscles, and act to cause vasodilation. Hence, their inhibition would have the effect of vasoconstriction similar to other medications used to abort the migraine headache. Web site: http://www.delphion.com/details?pn=US06642243__ •

Motion sickness/vertigo prevention device and method Inventor(s): Butnaru; Hanan (1 Somerville Ct., San Antonio, TX 78257) Assignee(s): None Reported Patent Number: 5,966,680 Date filed: February 13, 1997 Abstract: A device and method which operates as an artificial labyrinth to eliminate sensory mismatch between the natural labyrinth/vestibular system and the vision system of an individual. The present invention provides an alternative means for the user to determine the true orientation of his body with respect to the surrounding environment. The method can be effected by means of a device which senses true body orientation and displays corresponding visual orientation cues that the brain can use to confirm other visual position information. The display can be projected into space in front of the user, directly onto the user's retina, or effected by pictorial scene averaging. The device is particularly useful in the rehabilitation treatment of persons suffering from vestibular nervous system defect or damage, and in providing relief to those suffering from the symptoms of nausea and/or vertigo which are often experienced as a result of the aforementioned sensory mismatch. Excerpt(s): The present invention relates generally to a device for the relief of nausea, disorientation, and other disabling symptoms resulting from sensory mismatch and, more particularly, to an artificial labyrinth which provides the user an alternate means of determining his actual, physical orientation with respect to the surrounding environment. Motion sickness does not discriminate. It can attack anyone, at any time. It is always disabling, to a greater or lesser degree, depending on the person. It is known from research that certain types of sensory mismatch are the leading cause of motion sickness. This mismatch occurs when the brain perceives that the body is in motion (through signals originating in the labyrinth and transmitted to the brain by the vestibular nerve system), but the motion sensed does not match what the eye can see and verify. The reverse is also true (i.e. sensory mismatch may also occur when the eye perceives motion, but the labyrinth does not provide confirming signals to the brain). There are many causes of this mismatch, including: time delay between the arrival of labyrinth motion signals and visual confirmation signals within the brain, or conflict between these signals when they do manage to arrive at the same time. In addition, the labyrinth's signals may be corrupted by various physical defects, conflict with each other within the labyrinth, or be missing entirely, as is the case when a person has the vestibular system disconnected (via operation, accident, or birth defect). All causes of

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this type of sensory mismatch are not precisely known, but it is well-established that such conditions can drastically affect an individual's quality of life and performance of everyday tasks. One example of sensory mismatch is vertigo, which is the sensation the brain encounters when it perceives that the body is in motion (when in fact there is no motion), and it attempts to correct bodily posture to counteract the perceived physical sensation. Another example of sensory mismatch occurs when the eye perceives motion, but no motion actually occurs. This can be described as a type of "virtual reality" sickness, which is normally experienced users of video games or flight simulators. The reverse situation, when the body feels motion but there are no visual cues, is a much more common occurrence. Examples include: passengers in an airplane with no access to a window, sailors in a submarine, and ship passengers that cannot see the horizon. Such persons sense actual changes in body position, but have nothing in the environment which allows their eye to confirm the motion they perceive. Web site: http://www.delphion.com/details?pn=US05966680__ •

Pharmaceutical compositions containing granisetron and dexamethasone Inventor(s): Dott; Christopher Stuart (Redhill, GB), Sanger; Gareth John (Sawbridgeworth, GB) Assignee(s): Smithkline Beecham P.l.c. (brentford, Gb) Patent Number: 5,929,059 Date filed: July 28, 1997 Abstract: A method of treatment of nausea and vomiting is disclosed which comprises administering to a human or animal subject granisetron and an antiemetic corticosteroid. Excerpt(s): This invention relates to a method of treatment and/or prophylaxis of nausea and vomiting, comprising the administration of a compound having 5-HT.sub.3 receptor antagonist activity. The anti-emetic properties of granisetron are potentially enhanced by administering the compound in conjunction with systemic corticosteroids, such as dexamethasone. Dexamethasone is a systemic anti-inflammatory corticosteroid, which is known to have anti-emetic properties and to be useful in the treatment of emesis resulting from chemotherapy, especially cancer chemotherapy involving the use of, for example, cisplatin. Accordingly, the present invention provides a pharmaceutical product comprising granisetron and steroid such as dexamethasone as a combined preparation for simultaneous, separate or sequential use in the treatment and/or prevention of nausea and vomiting. Web site: http://www.delphion.com/details?pn=US05929059__

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Phosphatidic acid-comprising compositions Inventor(s): Shenfeld; Avner (Rehovot, IL), Shinitzky; Meir (Shmariyahu, IL) Assignee(s): Modus Biological Membranes Ltd. (rehovot, Il) Patent Number: 6,051,564 Date filed: February 24, 1999

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Abstract: The invention is to a method for the treatment of withdrawal symptoms selected from the group consisting of nausea, sweating, shaking, substance craving and hot flushes. Excerpt(s): The present invention concerns lipid-based compositions and use of such compositions in the treatment of withdrawal syndromes or cancer. Withdrawal syndromes can occur during rehabilitation from addiction to drugs, alcohol, cigarettes and from an abrupt decline in the level of various hormones such as that occurring in menopause women. It is expressed in symptoms of seizures, sweat, tremor, nausea, depression, increase in rate of heart beat and in blood pressure, and others. Typically such addiction is treated by a "wash out" period in which the dependency is gradually removed with or without drug intervention. This process is painful and tedious and candidates are thus very often discouraged from entering it. There is thus a strong need for a solution that can ease the difficult period of withdrawal and that would allow people to return to normal life without much complications. A basic biochemical phenomenon shared by most of the withdrawal syndromes is a change in the composition and in the structure of neuronal cell membranes which is expressed in membrane "fluidity" (Hannan, Am. Rev. Respir. Dis., 140 (1989), 1668-73; Crews, Psycho-pharmacology, 81 (1983), 208-13; Harris, Life Sci., 35 (1984), 2601-8; Heron et al., Eur. J. Pharmacol., 83 (1982), 253-261). These changes can at times be counteracted by administration of special natural preparations, resulting in the reduction of the symptoms related to the withdrawal processes (Heron et al., Eur. J. Pharmacol, 83 (1982) 253-261; Shinitzky, Physiology of membrane fluidity, (1984), Vol I, Chapt. 1). Web site: http://www.delphion.com/details?pn=US06051564__ •

Pillow for an individual and the method for producing a pillow for an individual Inventor(s): Takashima; Hisato (5-18, Kasuga-cho, Takatsuki-shi, Osaka-fu, 569-0053, JP) Assignee(s): None Reported Patent Number: 6,151,733 Date filed: January 25, 1999 Abstract: The object of the present invention is to provide a pillow which has the pillow user's most comfortable height and shape and which he can have a comfortable sleep with a relaxed posture and in which he is not prevented from turning in bed and in which is free from headache or nausea from receiving pressure on his neck. The method for producing a pillow which can have the most comfortable height and shape which differs in accord with body shape and sleeping posture is shown and described. Furthermore, a pillow is disclosed for an individual having a flat pad and a cushion having a convex portion as its basic components, and in which necessary numbers of pads used for adjusting height as well as pads for adjusting pressure on cervical vertebra can be added into a flat pad and said cushion having a convex portion and insertable into a cover. The flat pad, the cushion having a convex portion, the pad for adjusting a height and the pad for adjusting pressure on cervical vertebra are then prepared and a bottom of the cushion having a convex portion is flat and the upper surface of it is curved for fitting a shape of a portion along from a pillow user's head to neck. Excerpt(s): A pillow has a great influence in a comfortable sleep and is believed to determine whether people can sleep comfortably. The most important factor is the use of the most comfortable pillow for each person for a comfortable sleep. Although at first

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thought, the factors as a condition of comfortable sleep might seem to be pillow height, hardness, material, size, fragrance, color and sound fitting the individual taste of a pillow user, other conditions include, non-stuffiness conditions relating to the head's ventilation, absorption of humidity and moisture vaporization, especially since it is advantageous to superior to naturally absorb and release sweat during sleep. Further, heat insulation and the ability to naturally turn in bed are also considered as elements of the most comfortable pillow. Recently, it has been found that having a structure to support the cervical vertebra properly in order to avoid prevention of blood running to the nervous system and tissue near the a cervical vertebra, and thus this is also considered as one of elements of a most comfortable pillow. Currently there are many kinds of pillow shapes produced for supporting cervical vertebra. For example, there are a pillows having a concave portion for supporting the head between two apex shapes which act as a support for a portion of the cervical vertebra, and is referred to as a concave shaped pillow or a doughnut-shaped pillow. This pillow has a portion touching the neck which is high, and a portion touching the head is low. A center portion has a hollow shape. The present invention was produced to solve the aforementioned problems. The present in invention relating to the claims is a pillow, for an individual, having a flat pad and a cushion having a convex portion as a basic component, and wherein necessary numbers of pads for adjusting height and pads for adjusting pressure on cervical vertebra are added into the flat pad and cushion having a convex portion to be inserted into a cover, and further comprising that the flat pad, the cushion having a convex portion, the pad for adjusting a height and the pad for adjusting pressure on cervical vertebra are pre-prepared. In addition a bottom of the cushion having a convex portion is flat and an upper surface of the cushion having a convex portion is curved for fitting a shape of a portion of a user's anatomy to conform to a pillow user's head and cervical vertebra. Web site: http://www.delphion.com/details?pn=US06151733__ •

Therapeutic use and formulation Inventor(s): Huckle; Richard Michael (Cambridge, GB) Assignee(s): Darwin Discovery, Ltd. (gb) Patent Number: 6,297,286 Date filed: November 8, 2000 Abstract: Substantially single-enantiomer(-)-tramadol, and its metabolites and structural and/or functional analogues, are useful for the prevention and/or treatment of one or more symptoms selected from nausea, vomiting, dizziness, blurred vision, drowsiness, somnolence, hallucinations, respiratory depression, constipation and euphoria. In particular, substantially single enantiomer (-)-tramadol, and its o-desmethyl metabolite, have been found to be potent anti-emetics. Excerpt(s): This invention relates to new therapeutic uses of tramadol and its structural and/or functional analogues, and to new formulations thereof. Tramadol has the chemical name (+/-)-trans (RR,SS)-2-[(di-methylamino)methyl]-1-(3-methoxyphenyl) cyclohexanol, and which is generally, and erroneously, referred to in literature as the cis(RS,SR) diastereomer, is a centrally acting, binary analgesic that is neither opiatederived, nor is a non-steroidal, anti-inflammatory drug (NSAID). It is used to control moderate pain in chronic pain settings, such as osteoarthritis and postoperative cases, and acute pain, such as dental pain. Used in therapy as a racemic mixture, the (+)enantiomer binds to the.mu.-opioid receptor, and both enantiomers inhibit 5-

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hydroxytryptamine (serotonin) and noradrenaline (norepinephrine) reuptake. Tramadol's major active metabolite, O-desmethyltramadol (M1), shows higher affinity for the.mu.-opioid receptor and has at least twice the analgesic potency of the parent drug. Web site: http://www.delphion.com/details?pn=US06297286__ •

Use of granisetron for the treatment of postoperative nausea and vomiting Inventor(s): Davey; Philip Timothy (Bishop's Stortford, GB), Dott; Christopher Stuart (Reigate, GB), Sanger; Gareth John (Sawbridgeworth, GB) Assignee(s): Smithkline Beecham P.l.c. (brentford, Gb) Patent Number: 5,952,340 Date filed: May 23, 1996 Abstract: The present invention is directed to a method for the treatment of postoperative nausea and vomiting wherein granisetron is administered to a patient in need thereof. Excerpt(s): This invention relates to prevention and treatment of post-operative nausea and vomiting (PONV), and pharmaceutical compositions therefor. Thus from the point of view of patients and clinicians, the control of PONV is essential. Financially, the control of PONV is also important. In regions such as the U.S.A., a lot of surgery is done in the day-care setting and the importance of being able to send patients home without an overnight stay is financially attractive. In other countries the popularity of day-care surgery is increasing and it may reach to over 50% in 5-10 years time. Web site: http://www.delphion.com/details?pn=US05952340__

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Use of orexin receptor antagonists Inventor(s): Irving; Elaine Alison (Bengeo, GB), Sanger; Gareth John (Sawbridgeworth, GB) Assignee(s): Smithkline Beecham P.l.c. (brentford, Gb) Patent Number: 6,506,774 Date filed: November 30, 2001 Abstract: The use of orexin receptor antagonists as neuroprotectants, and in the treatment of nausea and vomiting, irritable bowel syndrome and other conditions associated with visceral pain. Excerpt(s): The present invention relates to the use of orexin receptor antagonists as neuroprotectants, and in the treatment of nausea and vomiting, irritable bowel syndrome and other conditions associated with visceral pain. Many medically significant biological processes are mediated by proteins participating in signal transduction pathways that involve G-proteins and/or second messengers. Polypeptides and polynucleotides encoding the human 7-transmembrane G-protein coupled neuropeptide receptor, orexin-1 (HFGAN72), have been identified and are disclosed in U.S. Pat. Nos. 5,935,814, 6,020,157 and 6,410,701. Polypeptides and polynucleotides encoding a second human orexin receptor, orexin-2 (HFGANP), have been identified and are disclosed in U.S. Pat. No. 6,166,193.

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Web site: http://www.delphion.com/details?pn=US06506774__

Patent Applications on Nausea 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 nausea: •

3-azabicyclo[3.1.0]hexane derivatives useful in therapy Inventor(s): Banks, Bernard Joseph; (Kent, GB), Critcher, Douglas James; (Kent, GB), Fenwick, Ashley Edward; (Kent, GB), Gethin, David Morris; (Kent, GB), Gibson, Stephen Paul; (Kent, GB) Correspondence: Paul H. Ginsburg; Pfizer Inc; 20th Floor; 235 East 42nd Street; New York; NY; 10017-5755; US Patent Application Number: 20020025948 Date filed: June 18, 2001 Abstract: Compounds of formula I, 1where the substituents are as defined herein, and the pharmaceutically or veterinarily acceptable derivatives or prodrugs thereof, are pharmaceutically and veterinarily useful, in particular they bind to opiate receptors (e.g. mu, kappa and delta opioid receptors). They are likely to be useful in the treatment of diseases or conditions modulated by opiate receptors, for example irritable bowel syndrome; constipation; nausea; vomiting; pruritic dermatoses, such as allergic dermatitis and atopy; eating disorders; opiate overdoses; depression; smoking and alcohol addiction; sexual dysfunction; shock; stroke; spinal damage; and head trauma. Excerpt(s): This invention relates to pharmaceutically useful compounds, in particular compounds that bind to opiate receptors (e.g. mu, kappa and delta opioid receptors). Compounds that bind to such receptors are likely to be useful in the treatment of diseases modulated by opiate receptors, for example irritable bowel syndrome; constipation; nausea; vomiting; and pruritic dermatoses, such as allergic dermatitis and atopy in animals and humans. Compounds that bind to opiate receptors have also been indicated in the treatment of eating disorders, opiate overdoses, depression, smoking and alcohol addiction, sexual dysfunction, shock, stroke, spinal damage and head trauma. There is a particular need for an improved treatment of itching. Itching, or pruritus, is a common dermatological symptom that can give rise to considerable distress in both humans and animals. Pruritus is often associated with inflammatory skin diseases which may be caused by hypersensitivity reactions, including reactions to insect bites, such as flea bites, and to environmental allergens, such as house dust mite or pollen; by bacterial and fungal infections of the skin; or by ectoparasite infections. Existing treatments that have been employed in the treatment of pruritus include the use of corticosteroids and antihistamines. However, both of these treatments are known to have undesirable side effects. Other therapies that have been employed include the use of essential fatty acid dietary supplements, though these have the disadvantages of being slow to act, and of offering only limited efficacy against allergic dermatitis. A variety of emollients such as soft paraffin, glycerine and lanolin are also employed, but with limited success.

10

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

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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Amines that inhibit a mammalian anandamide transporter, and methods of use thereof Inventor(s): Aquila, Brian M.; (Marlborough, MA), Hopkins, Seth C.; (Clinton, MA), Lockshin, Curtis A.; (Lexington, MA), Wang, Fengjiang; (Northborough, MA) Correspondence: Foley Hoag, Llp; Patent Group, World Trade Center West; 155 Seaport Blvd; Boston; MA; 02110; US Patent Application Number: 20040048907 Date filed: May 15, 2003 Abstract: One aspect of the present invention relates to amines. A second aspect of the present invention relates to the use of the amines as inhibitors of a mammalian anandamide transporter. The compounds of the present invention will also find use in the treatment of numerous ailments, conditions and diseases which afflict mammals, including but not limited to asthma, neuropathic pain, persistent pain, inflammatory pain, hyperactivity, hypertension, brain ischemia, Parkinson's disease, spasticity, Tourette's syndrome, schizophrenia, hemorrhagic shock, septic shock, cardiac shock, migrane, Horton's headache, multiple sclerosis, anorexia, AIDS wasting syndrome, organ rejection, autoimmune diseases, allergy, arthritis, Crohn's disease, malignant gliomas, neurodegenerative diseases, Huntington's chorea, glaucoma, nausea, anxiety, psychosis, attention deficit hyperactivity disorder, premature ejaculation, and stroke. Another aspect of the present invention relates to combinatorial libraries of amines, and methods for preparing the libraries. Excerpt(s): This application claims the benefit of priority to U.S. Provisional Patent Application serial No. 60/381,041, filed May 16, 2002. The various elements of the mammalian endogenous cannabinoid system (ECS) constitute a variety of pharmacological targets for the broad group of compounds generally termed as cannabinoids. Included among these elements are two types of G-protein-coupled membrane receptors: the central CB.sub.1 receptors (Matsuda, L. A.; Lolait, S. J.; Brownstein, M. J.; Young, A. C.; Bonner, T. I. Structure of a Cannabinoid Receptor and Functional Expression of the Cloned cDNA. Nature 1990, 346, 561-564); and the peripheral CB.sub.2 receptors (Munro, S.; Thomas, K. L.; Abu-Shaar, M. Molecular Characterization of a Peripheral Receptor for Cannabinoids. Nature 1993, 365, 61-65). Also included among the elements of the ECS are the endogenous ligands anandamide (Devane, W. A.; Hanus, L.; Breuer, A.; Pertwee, R. G.; Stevenson, L. A.; Griffin, G.; Gibson, D.; Mandelbaum, A.; Etinger, A.; Mechoulam, R. Isolation and Structure of a Brain Constituent That Binds to the Cannabinoid Receptor. Science 1992, 258, 19461949), 2-arachidonoylglycerol (Sugiura, T.; Kondo, S.; Sukagawa, A.; Nakane, S.; Shinoda, A.; Itoh, K; Yamashita, A.; Waku, K. 2-Arachidonoylglycerol: a Possible Endogenous Cannabinoid Receptor Ligand in Brain. Biochem. Biophys. Res. Commun. 1995, 215, 89-97), and the recently reported 2-arachidonyl glyceryl ether (Hanus, L.; Abu-Lafi, S.; Fride, E.; Breuer, A.; Vogel, Z.; Shalev, D. E.; Kustanovich, I.; Mechoulam, R. 2-Arachidonyl Glyceryl Ether, an Endogenous Agonist of the Cannabinoid CBI Receptor. Proc. Natl. Acad. Sci. U.S.A. 2001, 98, 3662-3665). A mechanism for the termination of the biological activity of the endogenous ligands has been elucidated, composed of a carrier-mediated transport system (anandamide transporter (AT)) and a hydrolyzing enzyme, named fatty acid amide hydrolase (FAAH). Hillard, C. J.; Edgemond, W. S.; Jarrahian, A; Campbell, W. B. Accumulation of N-

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Arachidonoylehanolamine (Anandamide) into Cerebellar Granule Cells Occurs via Facilitated Diffusion. J. Neurochem. 1997, 69, 631-638; Beltramo, M.; Stella, N.; Calignano, A.; Lin, S. Y.; Makriyannis, A.; Piomelli, D. Functional Role of High-Affinity Anandamide Transport, as Revealed by Selective Inhibition. Science 1997, 277, 10941097; Hillard, C. J.; Jarrahian, A. The Movement of N-arachidonoylethanolamine (Anandamide) across Cellular Membranes. Chem. Phys. Lipids 2000, 108, 123-134; and Ueda, N.; Puffenbarger, R. A.; Yamamoto, S.; Deutsch, D. G. The Fatty Acid Amide Hydrolase (FAAH). Chem. Phys. Lipids 2000, 108, 107-121. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Analgesic and anti-inflammatory compositions comprising domperidone and methods of using same Inventor(s): On, Ninh; (London, GB) Correspondence: Arent Fox Kintner Plotkin & Kahn; 1050 Connecticut Avenue, N.W.; Suite 600; Washington; DC; 20036; US Patent Application Number: 20020025971 Date filed: September 21, 2001 Abstract: The present invention provides a method for eliciting an onset hastened analgesic and anti-inflammatory response and combating nausea in acute migraine attacks. This method comprises administering a pharmaceutical composition comprising more than one active ingredient, wherein said more than one active ingredient consist essentially of:(i) domperidone or an analogue thereof in an amount sufficient to hasten the onset of the analgesic and anti-inflammatory response and to combat nausea in an acute migraine attack, and(ii) a NSAID, a pharmaceutically acceptable salt thereof or a pure (-) or pure (+) optical isomeric form thereof in an analgesically and antiinflammatory effective amount, wherein said NSAID is selected from the group consisting of proprionic acid derivatives, acetic acid derivatives, fenamic acid derivatives, biphenylcarboxylic acid derivatives and oxicams. Excerpt(s): The current means of combating migraine attacks include simple analgesics such as aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDS) and paracetamol, taken at the earliest signs of an attack [1,2,3]. Aspirin, paracetamol and phenacetin have long been among the most commonly used members of the NSAIDS class. Amongst the newer NSAIDS are ibuprofen, ketoprofen, mefenamic acid, diflunisal, naproxen and piroxicam. The most widely used NSAIDS available over the counter that have fewer gastro intestinal side effects than aspirin are paracetamol and ibuprofen. Combined preparations of paracetamol or aspirin with an anti-emetic agent such as buclizine or metoclopramide, have been used to alleviate the nausea symptoms that often accompanied a migraine attack. Commercially, they are available as Migraleve Duo.RTM., Paramax.RTM., Migravess.RTM. Narcotic analgesics such as codeine have also been employed together with NSAIDS to obtain synergistic analgesia, for example Migraleve Yellow.RTM., co-codamol. Gastric stasis, commonly present in migraine[4], causes the poor absorption of the analgesics. Dispersible and effervescent formulations have been used in an attempt to overcome this [4]. Metoclopramide, an anti-emetic, also relieves gastric stasis which has been found useful counteracting the reduced analgesic effects of paracetamol in migraine attacks [1,4,5]. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Antiemetic, anti-motion sustained release drug delivery system Inventor(s): Drizen, Alan; (Downsview, CA), Nath, Gary M.; (Bethesda, MD) Correspondence: Nath & Associates Pllc; 6th Floor; 1030th 15th Street, N.W.; Washington; DC; 20005; US Patent Application Number: 20020172712 Date filed: March 19, 2001 Abstract: This invention relates to a stable, sterilized, purified composition having a polymer matrix and a therapeutically effective amount of a drug, wherein the drug can be used to prevent or treat drug-induced, alcohol-induced, biologically-induced, trauma-induced or pain-induced nausea, vomiting, dizziness and other adverse effects arising from but not limited to motion sickness, cancer therapy, and pregnancy. In particular, the polymer matrix may be conformable to topical application on animal skin. Excerpt(s): This invention relates to a dermal dressing for conformable topical application and sustained release of a polymer matrix containing a drug or combinations of drugs to animal skin. The drug can be any pharmaceutically effective amount useful for preventing and treating nausea, vomiting, dizziness and other adverse effects arising from but not limited to motion sickness, cancer therapy, and pregnancy in an animal. Over the years, methods have been developed to achieve the efficient delivery of a therapeutic drug to a mammalian body part requiring pharmaceutical treatment. Intravenous delivery and oral ingestion are two examples of current delivery techniques. While these techniques are generally effective, they suffer from several pharmacokinetic limitations and often result in substantial non-compliance by patients. For example, the therapeutic benefit from conventional methods often wear off within several hours after the initial dosing while the pain and discomfort associated with injections and intravenous lines often lead to difficulties in administration and maintenance of intravenous lines. Even oral administration can be ineffective where a patient cannot ingest due to nausea and/or vomiting. Topical administration of a pharmaceutically effective agent may avoid the problems associated with known drug delivery methods. One known method of topical administration uses an aqueous liquid that is applied at room temperature but forms a semi-solid gel when warmed to body temperature. This technique has the reported benefit of being easier to use and improving drug retention at the treatment site. For example, U.S. Pat. No. 4,188,373 uses PLURONIC.RTM. polyols in aqueous compositions to thermally gel aqueous systems. A sol-gel transition temperature is adjusted by varying the concentration of the polyols. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Anti-nausea and anti-vomiting activity of cannabidiol compounds Inventor(s): Breuer, Aviva; (Jerusalem, IL), Mechoulam, Raphael; (Jerusalem, IL), Parker, Linda; (Waterloo, CA) Correspondence: John R. Van Amsterdam, PH.D., ESQ.; 600 Atlantic Avenue; Boston; MA; 02210; US Patent Application Number: 20030225156 Date filed: February 19, 2003

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Abstract: The present invention relates the use of certain cannabidiol derivatives and of their dimethyl heptyl homologs (CBD-DMH) in the treatment of nausea, in particular chemotherapy-induced nausea, and of anti vomiting activity. The present invention relates also to the use of said cannabidiol derivatives being part of a pharmaceutical composition. Excerpt(s): The present invention relates the use of certain cannabidiol derivatives and of their dimethyl heptyl homologs (CBD-DMH) in the treatment of nausea and of anti vomiting activity. c. a group --(CH.sub.2).sub.n--O-alkyl, where n is an integer from 1 to 7 and the alkyl group contains 1 to 5 carbon atoms, are antiiflammatory agents and have analgesic, antianxiety, anticonvulsive, neuroprotective, antipsychotic and anticancer activity. There are known many compounds being present in marihuana which have anti-nausea and anti-vomiting activity. However, many of them are psychoactive which is undesired for this purpose. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Apomorphine-containing dosage form for ameliorating male erectile dysfunction Inventor(s): El-Rashidy, Ragab; (Deerfield, IL), Ronsen, Bruce; (River Forest, IL) Correspondence: Olson & Hierl, LTD.; 36th Floor; 20 North Wacker Drive; Chicago; IL; 60606; US Patent Application Number: 20030073715 Date filed: October 23, 2001 Abstract: Impotence can be ameliorated without substantial undesirable side effects by nasal administration of apomorphine, optionally with an antiemetic agent present in an amount sufficient to substantially reduce nausea symptoms that may be associated with the use of apomorphine. Excerpt(s): This application is a continuation-in-part of our application U.S. Ser. No. 09/606,919, filed on Jun. 29, 2000 and now U.S. Pat. No. 6,306,437, which is a continuation of U.S. Ser. No. 09/102,406, filed on Jun. 22, 1998 and now U.S. Pat. No. 6,121,276, which is a continuation-in-part of U.S. Ser. No. 08/546,498 filed on Oct. 20, 1995 and now U.S. Pat. No. 5,770,606, which in turn is a continuation-in-part of U.S. Ser. No. 08/231,250, filed on Apr. 22, 1994, abandoned. This invention, in one aspect, relates to dosage forms and methods for ameliorating erectile dysfunction in psychogenic male patients. In another aspect this invention relates to diagnosis of erectile dysfunction. More particularly, this invention relates to the use of apomorphine-containing compositions for amelioration of erectile dysfunction in male patients and for diagnostic purposes. A normal erection occurs as a result of a coordinated vascular event in the penis. This is usually triggered neurally and consists of vasodilation and smooth muscle relaxation in the penis and its supplying arterial vessels. Arterial inflow causes enlargement of the substance of the corpora cavernosa. Venous outflow is trapped by this enlargement, permitting sustained high blood pressures in the penis sufficient to cause rigidity. Muscles in the perineum also assist in creating and maintaining penile rigidity. Erection may be induced centrally in the nervous system by sexual thoughts or fantasy, and is usually reinforced locally by reflex mechanisms. Erectile mechanics are substantially similar in the female for the clitoris. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Bisarylimidazolyl fatty acid amide hydrolase inhibitors Inventor(s): Sit, Sing-Yuen; (Meriden, CT), Xie, Kai; (Wallingford, CT) Correspondence: Stephen B. Davis; Bristol-myers Squibb Company; Patent Department; P.O. Box 4000; Princeton; NJ; 08543-4000; US Patent Application Number: 20020188009 Date filed: April 23, 2002 Abstract: The present invention relates to bisarylimidazolyl derivatives and pharmaceutical compositions comprising said compounds inhibiting fatty acid amide hydrolase and useful for the treatment of pain, particularly neuropathic pain, psychomotor disorder, hypertension, cardiovascular disease, eating disorder, nausea, AIDS-related complex, glaucoma, inflammation, psoriasis or multiple sclerosis, and other conditions the treatment of which can be effected by inhibiting fatty acid amide hydrolase. Excerpt(s): This non-provisional application claims priority from provisional application U.S. Serial No. 60/286,827 filed Apr. 27, 2001. The present invention relates to bisarylimidazolyl derivatives and pharmaceutical compositions comprising said derivatives which inhibit fatty acid amide hydrolase and are useful for the treatment of conditions affected by inhibiting fatty acid amide hydrolase. Neuropathic pain is caused by injury to nerves as the result of many factors including physical damage (e.g., trauma, surgery), drugs such as Zidovudine (AZT), Carmustine (BCNU) and disease (e.g., diabetes, herpes zoster). The prevalence in the United States of neuropathies associated with diabetes, herpes and amputation is estimated at 1.5 million. The worldwide prevalence of diabetic neuropathy alone is expected to reach 12 million by 2007. Nerve injury can result in both allodynia and hyperalgesia. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Composition and method for treating the effects of diseases and maladies Inventor(s): Gelber, Daniel; (Woodland Hills, CA), Kleinberger, Richard; (Sherman Oaks, CA) Correspondence: Terry W. Kramer; Kramer & Associates; 2001 JEFF. Davis HWY., Suite 1101; Arlington; VA; 22202; US Patent Application Number: 20020034555 Date filed: January 5, 2001 Abstract: A medicinal composition for treating pain resulting from a migraine headache comprises at least one pain relieving and anti-inflammatory pharmaceutical and at least one nutraceutical in a pharmaceutically acceptable base. The pharmaceutical is preferably acetaminophen or a non-steroidal anti-inflammatory drug (NSAID). The nutraceutical is preferably an antivasospastic agent or a vascular dilator; an anti-nausea agent; or a liver protectant. Methods of using these compositions to treat migraine pain are also disclosed. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/184,351 entitled "Composition and Method For Treating The Effects of A Cold or Flu," filed on Feb. 23, 2000. The present invention relates to the field of medicinal compositions and methods of using said compositions for treating diseases and maladies. In particular, the present invention relates to formulations comprising

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combinations of a pharmaceutical in combination with a nutraceutical, which when administered to a person in need thereof have the effect of increasing the beneficial effects of the pharmaceutical utilized. Beginning in prehistoric times, humans have attempted to treat every known type of illness and malady with naturally occurring products. Such products were initially in their natural state, such as leaves, berries, roots, tree cuttings and extracts. With the advance of science, and greater understanding of chemistry, humans have been able to synthetically produce and extract a great variety of pharmaceuticals which were previously unknown or unidentified. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

COMPOSITION FOR INDUCING SMOKING ALKALOIDS FROM RADIX IPECAUANHAE

CESSATION

COMPRISING

Inventor(s): Ahn, Byung-Zun; (Taejeon, KR), Park, Hwa-Mok; (Seoul, KR) Correspondence: Birch Stewart Kolasch & Birch; PO Box 747; Falls Church; VA; 220400747; US Patent Application Number: 20030054051 Date filed: September 13, 2001 Abstract: This invention relates to a composition for inducing smoking cessation comprising as active ingredient alkaloids from Radix ipecauanhae. In smoking cessation program using the composition, the considerable number of volunteers participated in the program became nausea and thus ultimately to have no craving for smoking. Excerpt(s): This invention relates to a composition for inducing smoking cessation comprising as active ingredient alkaloids from Radix ipecauanhae. More specifically, it relates to a composition comprising as active ingredient basic alkaloid fraction from Radix ipecauanhae or basic emetine, optionally in combination with one or more auxiliary agents selected from Nicotiana tabacum, Fructus Phyllanthus emblica, Herba adenophorae, Herba leonuri, Herba foeniculi, Folia valerianae, Herba centellae or Circii herba. The invention also provides a method for using the same. Nicotiana tabacum contains harmful ingredients to human body such as nicotine, tar, dioxin and the like in large quantities. It is a one's favorite known to increase incidence of diseases related lung and cancers through long-term smoking. Various kinds of smoking cessation medicines or aids have been hitherto developed for smoking cessation. However, they have frequently adverse effects on human body or fail to successfully induce smoking cessation. Accordingly, it is absolutely needed to develop more efficient smoking cessation method or smoking cessation aid. Radix ipecauanhae, as emetic, has been used for detoxification and the treatment of dysentery, and used as expectorant, depending upon its dosage (Deutsches Arzneibuch, British Herbal Pharmacopoeia, Gerhardt Madaus's Lehrbuch der Biologischen Heilmittel, Georg Olms 1976). However, it has never been used for inducing smoking cessation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Compositions and methods for enhancing analgesic potency of tramadol and attenuating its adverse side effects Inventor(s): Barbier, Remi; (San Francisco, CA), Crain, Stanley M.; (State College, PA), Friedmann, Nadav; (Lafayette, CA), Remien, Mary; (San Francisco, CA), Shen, Ke-Fei; (Flushing, NY), Sherman, Barry; (Hillsborough, CA) Correspondence: Mcandrews Held & Malloy, Ltd; 500 West Madison Street; Suite 3400; Chicago; IL; 60661 Patent Application Number: 20030148941 Date filed: March 12, 2002 Abstract: The invention generally relates to compositions and methods with tramadol and an opioid antagonist to enhance analgesic potency and/or attenuate one or more adverse effects of tramadol, including adverse side effect(s) in humans such as nausea, vomiting, dizziness, headache, sedation (somnolence) or pruritis. This invention relates to compositions and methods for selectively enhancing the analgesic potency of tramadol and simultaneously attenuating anti-analgesia, hyperalgesia, hyperexcitability, physical dependence and/or tolerance effects associated with the administration of tramadol. The methods of the present invention comprise administering to a subject an analgesic or subanalgesic amount of tramadol and an amount of excitatory opioid receptor antagonist such as naltrexone or nalmefene effective to enhance the analgesic potency of tramadol and attenuate the anti-analgesia, hyperalgesia, hyperexcitability, physical dependence and/or tolerance effects of tramadol. Excerpt(s): This is a continuation-in-part of co-pending application Ser. No. 09/306,164 filed May 6, 1999, the content of which is hereby incorporated by reference in its entirety. Morphine or other bimodally-acting opioid agonists are administered to relieve severe pain due to the fact that they have analgesic effects mediated by their activation of inhibitory opioid receptors on nociceptive neurons (see North, Trends Neurosci., Vol. 9, pp. 114-117 (1986) and Crain and Shen, Trends Pharmacol. Sci., Vol. 11, pp. 77-81 (1990)). However, morphine and other bimodally-acting opioid agonists also activate opioid excitatory receptors on nociceptive neurons, which attenuate the analgesic potency of the opioids and result in the development of physical dependence and increased tolerance (see Shen and Crain, Brain Res., Vol. 597, pp. 74-83 (1992)), as well as hyperexcitability, hyperalgesia and other undesirable (excitatory) side effects. As a result, a long-standing need has existed to develop a method of both enhancing the analgesic (inhibitory) effects of bimodally-acting opioid agonists and blocking or preventing undesirable (excitatory) side effects caused by such opioid agonists. Tramadol is an orally active, clinically effective, centrally acting analgene compound with opioid and non-opioid activity. This synthetic analgesic has a novel mechanism of action involving a complementary and synergistic interaction between inhibition of neuronal monamine uptake and weak affinity for opioid receptors (Raffa et al., Rev. Contemp. Pharmacother. 6:485-497 (1995)). Tramadol is generally well tolerated, with dizziness, nausea, constipation, headache, somnolence (sedation), vomiting, pruritis, CNS stimulation, sezures, asthenia, dyspepsia, diarrhea, dry mouth and/or sweating as adverse side effects. Respiratory depression is uncommon (Lee et al., Drugs 46: 313-340 (1993); Vickers et al., Anaesthesia 47: 291-296 (1992)). Tramadol is marketed in the United States as ULTRAM.RTM. Data from a double-blind, crossover study suggest that oral tramadol 120 mg is equipotent to oral morphine 30 mg (Wilder et al., Ann. Oncol. 5: 141-146 (1994)). A need thus exists for compositions and methods that could enhance the analgesic potency of tramadol and/or block or prevent its adverse side effects, particularly its principal adverse effects in humans.

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Compositions and Methods for Reducing Respiratory Depression and Attendant SIde Effects of Mu Opioid Compounds Inventor(s): Bishop , Michael J.; ( Durham, NC), Chang , Kwen-Jen; ( Chapel Hill, NC), McNutt , Robert W. Jr.; ( Durham, NC), Pettit , Hugh O.; ( Cary, NC) Correspondence: Steven J. Hultquist; Marianne Fuierer; 6320 Quadrangle, Suite 110; Chapel Hill; NC; 27517; US Patent Application Number: 20020111359 Date filed: October 9, 2001 Abstract: A method of reducing, treating or preventing drug-mediated respiratory depression, muscle rigidity, or nausea/vomiting in an animal, incident to the administration to said animal of a mixed delta/mu opioid agonist or a respiratory depression-mediating drug, comprising administering to the animal receiving said drug an effective amount of a delta receptor agonist compound. Preferred examples of such delta receptor agonist compound include diarylmethyl piperazine compounds and diarylmethyl piperidine compounds, and pharmaceutical compositions thereof, having utility in medical therapy for reducing respiratory depression associated with certain analgesics, such as mu opiates. Excerpt(s): This is a divisional application of United States patent application no. 09/352,308 filed July 12, 1999 and issued October 9, 2001 as U.S. Patent 6,300,332, which claims priority to United States patent application 08/887,312 filed July 3, 1997, which is a continuation-in-part of United States patent application no. 08/658,726, filed June 5, 1996. The disclosures of the following applications are hereby incorporated herein by reference in their entirety: United States patent application no. 08/658,726 filed June 5, 1996; United States patent application no. 08/169,879 filed December 17, 1993; United States patent application no. 08/098,333 filed July 30, 1993; United States patent application no. 08/430,677 filed April 28, 1995; International Patent Application no. PCT/GB93/00216 filed February 2, 1993; Great Britain patent application 9202238.3 filed 3 February 1992; and all applications from which they claim priority, or from which priority is claimed. This invention relates generally to methods for reducing, treating, reversing or preventing drug-mediated respiratory depression, such as may be directly or indirectly caused by use of various bioactive compositions, including anaesthetics, barbiturates, analgesics, etc. The invention further relates to diarylmethyl piperazine compounds and diarylmethyl piperidine compounds, and pharmaceutical compositions thereof, having utility in medical therapy especially for reducing respiratory depression associated with certain analgesics, such as mu opiates. This invention additionally relates to diarylmethyl piperazine compounds and diarylmethyl piperidine compounds having utility in assays for determining the respiratory reducing characteristics of other bioactive compounds, including other diarylmethyl piperazine compounds and other diarylmethyl piperidine compounds. In the study of opioid biochemistry, a variety of endogenous opioid compounds and non-endogenous opioid compounds has been identified. In this effort, significant research has been focused on understanding the mechanism of opioid drug action, particularly as it relates to cellular and differentiated tissue opiate receptors. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Co-therapy for the treatment of migraine comprising anticonvulsant derivatives and anti-migraine agents Inventor(s): Livingstone, Ian R.; (Princeton, NJ) Correspondence: Audley A. Ciamporcero JR.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20030225002 Date filed: February 25, 2003 Abstract: The present invention describes a method for the treatment and/or prevention of migraine and associated symptoms (nausea, vomiting, photophobia, phonophobia, etc.) comprising co-therapy with a therapeutically effective amount of one or more antimigraine agents and one or more anticonvulsant derivatives. Excerpt(s): This application claims the benefit of U.S. Provisional Application 60/359,894, filed on Feb. 26, 2002, which is incorporated by reference herein in its entirety. Migraine is a chronic, episodic and debilitating clinical condition that is diagnosed by the presence of moderate to severe pulsating unilateral headaches lasting between 4 and 72 h. Additionally, the headache is sometimes associated with temporary sensory (photophobia and phonophobia) and/or gastrointestinal (nausea, vomiting) disturbances. Migraine headaches can present without or with aura. Migraine without aura is defined by at least five attacks fulfilling the following criteria: (a) the headache attacks lasting 4-72 hours with the headache having at least two of the following features: unilateral location, pulsating quality, moderate or severe intensity with a direct influence on activities of daily living, and aggravation by walking up stairs or similar routines; (b) during the headache at least one of the following occurs: nausea and/or vomiting, photophobia or phonophobia (Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society. Cephalalgia 1988;8 Suppl 7:1-96). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Delta9 tetrahydrocannabinol (Delta9 THC) solution metered dose inhalers and methods of use Inventor(s): Byron, Peter R.; (Richmond, VA), Lichtman, Aron H.; (Richmond, VA), Martin, Billy R.; (Richmond, VA), Peart, Joanne; (Richmond, VA) Correspondence: Mcguire Woods; Tysons Corner; Suite 1800; 1750 Tysons Boulevard; Mclean; VA; 22102-4215; US Patent Application Number: 20020031480 Date filed: September 4, 2001 Abstract: The present invention provides therapeutic formulations for solutions of.DELTA.sup.9-tetrahydrocannabinol (.DELTA.sup.9 THC) to be delivered by metered dose inhalers. The formulations, which use non-CFC propellants, provide a stable aerosol-deliverable source of.DELTA.sup.9 THC for the treatment of various medical conditions, such as: nausea and vomiting associated with chemotherapy--muscle spasticity; pain; anorexia associated with AIDS wasting syndrome, epilepsy; glaucoma; bronchial asthma; and mood disorders. Excerpt(s): This application is a continuation-in-part of pending U.S. Ser. No. 09/273,766 which claims priority of U.S. provisional application serial No. 60/105,850 filed Oct. 27,

Patents 149

1998, and the complete contents of those applications are incorporated herein by reference. The invention is generally related to the therapeutic use of.DELTA.sup.9 Tetrahydrocarnabinol (.DELTA.sup.9 THC). In particular, the invention provides a metered dose inhaler (MDI) for the aerosol administration of.DELTA.sup.9 THC to patients suffering from nausea and vomiting associated with cancer chemotherapy, muscle spasticity, pain, anorexia associated with AIDS wasting syndrome, epilepsy, glaucoma, bronchial asthma, mood disorders, and the like. In 1997, the National Institutes of Health (NIH) released a review of the scientific data concerning potential therapeutic uses for marijuana. In that review, the NIH found that marijuana may indeed have beneficial medicinal effects and recommended that researchers develop alternative dosage forms for the drug, such as a "smoke free" inhaled delivery system. Workshop on the medical utility of marijuana, National Institutes of Health, August 1997. Studies have documented therapeutically beneficial medicinal uses of the major active component of marijuana,.DELTA.sup.9 tetrahydrocannabinol (.DELTA.sup.9 THC). Beal, J. A., Olson, R., Lefkowitz, L., Laubenstein, L., Bellman, P., Yangco, B., Morales, J. O., Murphy, R., Powderly, W., Plasse, T. F., Mosdell, K. W. and Shepard, K. W., Long-term efficacy and safety of dronabinol for acquired immunodeficiency syndrome-associated anorexia, J Pain. Symptom Manage. 14:7-14 (1997); Beal, J. A., Olson, R., Laubenstein, L., Morales, J. O., Beliman, B., Yangco, B., Lefkowitz, L., Plasse, T. F. and Shepard, K. V. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS, J Pain. Symptom Manage,. 10: 89-97 (1995); McCabe, M., Smith, F. P., MacDonald, J. S., Wooley, P. V., Goldberg, D. and Schein, P. S., Efficacy of tetrahydrocannabinol in patients refractory to standard antiemetic therapy, Invest. New Drugs 6:243-246 (1988); Lucas, V. S. and Laszlo, J.DELTA.sup.9-THC for refractory vomiting induced by cancer chemotherapy, JAMA 243:1241-1243 (1980); Sallan, S. E., Cronin, C., Zelen, M. and Zinberg, N. E., Antiemetics in patients receiving chemotherapy for cancer: a randomized comparison of.DELTA.sup.9 THC and prochlorperazine, N. Engl. J Med., 302:135-138 (1980); Frytak, S., Moertel, C. G., O'Fallon, J R., Rubin, J., Creagan, E. T., O'Connell, M. J., Schutt, A. J. and Schwartau, N. W., Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy: a comparison with prochlorperazine and a placebo, Ann. Inter. Med 91:825-830 (1979); Chang, A. E., Shiling, D. J., Stillman, R. C., Goldgerg, N. H., Seipp, C. A., Barofdky, I., Simon, R. M. and Rosenberg S A,.DELTA.sup.9 THC as an antiemitic in cancer patients receiving high-dose methotrexate. Ann. Internal Med. 91:819-824 (1979); Sallan, S. E., Zinberg, N. E. and Frei, I. E., Antiemetic effect of.DELTA.sup.9 THC in patients receiving cancer chemotherapy, New Engl. J Med. 293:795-797 (1975); Noyes, J R., Brunk, S. F., Baram, D. A. and Canter, A., The analgesic properties of.DELTA.sup.9 THC and codeine. J Clin. Pharmacol 15:139-143 (1975); Noyes, R., Jr., Brunk, S. F., Baram, D. A. and Canter, A., Analgesic effect of.DELTA.sup.9 tetrahydrocannabinol, Clin. Pharmacol & Ther 18:84-89 (1975); Brenneisen, R., Egli, A., Elosohlly, M. A., Henn, V. and Spiess, Y., The effect of orally and rectally administered.DELTA.sup.9 THC on spasticity: a pilot study with 2 patients, Int. J Clin. J Pharmocol Ther. 34:446-452 (1996); Ungerleider, J. T., Andyrsiak, T. F. L., Ellison, G. W. and Myers, L. W.,.DELTA.sup.9 THC in the treatment of spasticity associated with multiple sclerosis, Adv. Alcohol Subst. Abuse 7:39-50 (1987); Clifford, D. B., Tetra-hydrocannabinol for tremor in multiple sclerosis, Ann. Neurol 13:669-171 (1983); Petro, D. J. and Ellenberger, C., Treatment of human spasticity with delta 9-tetrahydrocannabinol, J Clin. Pharmacol 21:413S-416S (1981); Maurer, M., Henn, V., Dittrich, A. and Hofman, A., Delta 9tetrahydrocannabinol shows antispastic and analgesic effects in a single case doubleblind trial, Eur. Arch. Psychiatry Neurol Sci. 240:1-4 (1990); Merrift, J., Crawford, W., Alexander, P., Anduze, A. and Gelbart, S., Effects of marihuana on intra ocular and blood pressure in glaucoma, Opht. 87:222-228 (1980); Cooler, P. and Gregg, J. M., Effect

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of delta 9-.DELTA.sup.9 THC on intra ocular pressure in humans. South. Med J 70:951954 (1977). Table 1 summarizes the findings of these studies. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Efficacious dosage regimen of galantamine that reduces side effects Inventor(s): Parys, Wim Louis Julien; (Gaithersburg, MD), Pontecorvo, Michael; (Lawrenceville, NJ) Correspondence: Audley A. Ciamporcero JR.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20030139391 Date filed: October 3, 2002 Abstract: Galantamine has be used in the treatment of a number of chronic diseases. The use of this drug is associated with side effects such as, nausea or vomiting, and headaches. It has been demonstrated that by slowly introducing the patient to the drug these side effects can be reduced. It has also been shown that this slower titration results in the ability to use a lower effective dose of the drug. Excerpt(s): The present invention relates to a slower titration regimen that results in a safe and effective use of galantamine at from about 16 mg/day to about 24 mg/day for the treatment of galantamine responsive conditions, with improved tolerability of the drug. Galantamine is a reversible cholinesterase inhibitor that can be isolated from a number of different plant sources, including daffodil bulbs. Galantamine interacts competitively with the enzyme, acetylcholinesterase, and demonstrates a 10 to 50 fold selectivity for acetyl vs. butyryl cholinesterase. Galantamine has been used for the treatment of a number of chronic diseases, where life-long treatment may be necessary. Galantamine has been shown to be effective in the treatment of arthritic disorders (Canadian Patent application 2,251,114); fatigue syndromes (Canadian Patent application 2,108,880); mania (Canadian Patent application 2,062,094);schizophrenia (Canadian Patent application 2,108,880); memory dysfunction, including Alzheimer's Disease (U.S. Pat. No. 4,663,318); alcoholism (Canadian Patent 2,039,197); nicotine dependence (Canadian Patent application 2,153,570); disorders of attention (PCT published application WO 99/21561) and jet lag (Canadian Patent application 2,193,473). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Electro-acupuncture device with D-shaped stimulation electrodes Inventor(s): Giuntoli, David M.; (Carlsbad, CA), Grey, Thomas L.; (Carlsbad, CA), Gruzdowich, Gregory J.; (Carlsbad, CA) Correspondence: Crockett &: Crockett; 24012 Calle DE LA Plata, Suite 400; Laguna Hills; CA; 92653; US Patent Application Number: 20030004555 Date filed: June 29, 2001 Abstract: An electro-acupuncture device for controlling nausea. The device includes a wristwatch like housing, circuitry for generating electro-acupuncture stimulus disposed within the housing, and a strap for securing the housing to the wrist. The device also includes a pair of D-shaped electrodes disposed on the bottom outer surface of the

Patents 151

housing. A gasket made of an electrically non-conductive material is applied to the bottom outer surface of the housing. The gasket has apertures which are sized and shaped to receive the D-shaped electrodes. When the device is strapped to a patient's wrist, the electrodes contact the wrist and provide electric stimulation to the wrist. Excerpt(s): The devices described below relate to the field of electro-acupuncture and non-invasive stimulation of nerves. We have developed an electro-acupuncture or nerve stimulation device which has proven effective for the control of nausea and vomiting. The basic device is described in Bertolucci, Nausea Control Device, U.S. Pat. No. 4,981,146 (Jan. 1, 1991). The device, marketed under the trademark Relief-Band.RTM., is worn on the wrist like a wristwatch, with a watch-like housing which is positioned on the underside of the wrist. The housing has two electrodes on the inside face (the face in contact with the wrist when secured to the wrist), a battery and circuitry inside the housing, and control buttons on the outer face. A patient suffering from nausea or vomiting (from motion sickness, morning sickness, chemotherapy, or anesthesia) can strap the device onto their wrist and turn it on. When turned on, the device emits an electrical stimulation pulse over the P6 acupuncture point (corresponding to the superficial course of the meridian nerve through the wrist). Within several minutes, most patients experience a substantial relief of nausea. The device uses non-invasive nerve stimulation whereby electricity is passed through the electrodes to stimulate nerves located on the ventral side of the wrist (this anatomical position is sometimes referred to as the palmar side of the wrist). The treatment provided by the device is sometimes referred to as electro-acupuncture, which is a form of acupuncture, and the ventral site of application is referred to in the acupuncture art as the P6 point, pericardium 6 point, or master point of the pericardium meridian (sometimes referred to as the vascular meridian). It is also portable, self-contained and convenient to the patient. Electrical pulse repetition rate of approximately 70 pulses per second and a pulse width of 80 microseconds have been found to provide effective relief of nausea in a patient. Our currently preferred electrical pulse pattern comprises about 350 microsecond pulse width at about 31 pulses per second at power levels of about 10-35 milliamps peak pulse height. Thus a wide range of pulse patterns may be used in noninvasive nerve stimulation devices. In each of our electro-acupuncture products, the stimulation and effect are greatly enhanced if the patient applies a gel to the skin before strapping the device onto the wrist. This gel serves as an electronic to ionic current conversion layer between the electrodes and the dry outer skin layer. This electrical conduction layer, sometimes referred to as an impedance matching layer, greatly enhances the effect of the device and lowers the power requirements for the device. The patient applies the gel to the skin before strapping the device onto the wrist. The gel may be referred to as a conductivity gel or an electro-medical coupling agent. The users may use too much gel, too little gel, or apply it too infrequently. Some users may omit application of the gel, either through forgetfulness or ignorance of need to use it. Additionally, gel may be removed by water in the environment of use, such as where the device is used for seasickness on a small sail boat while the user is operating the sail boat. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Extended release formulation Inventor(s): Clark, John C.; (Peru, NY), Lamer, John U.; (Albans, VT), Sherman, Deborah M.; (Plattsburg, NY), White, Steven A.; (Champlain, NY) Correspondence: American Home Products Corporation; Five Giralda Farms; Patent Law; Madison; NJ; 07940; US Patent Application Number: 20010055612 Date filed: June 19, 2001 Abstract: This invention relates to a 24 hour extended release dosage formulation and unit dosage form thereof of venlafaxine hydrochloride, an antidepressant, which provides better control of blood plasma levels than conventional tablet formulations which must be administered two or more times a day and further provides a lower incidence of nausea and vomiting than the conventional tablets. More particularly, the invention comprises an extended release formulation of venlafaxine hydrochloride comprising a therapeutically effective amount of venlafaxine hydrochloride in spheroids comprised of venlafaxine hydrochloride, microcrystalline cellulose and, optionally, hydroxypropylmethylcellulose coated with a mixture of ethyl cellulose and hydroxypropylmethylcellulose. Excerpt(s): This application continuation-in-part of application Ser. No. 08/964,328, filed Nov. 5, 1997, which is a continuation-in-part of copending application Ser. No. 08/821,137, filed Mar. 20, 1997, which, in turn, claims priority from Provisional Application No. 60/014,006 filed Mar. 25, 1996. Extended release drug formulations are conventionally produced as compressed tablets by hydrogel tablet technology. To produce these sustained release tablet drug dosage forms, the active ingredient is conventionally compounded with cellulose ethers such as methyl cellulose, ethyl cellulose or hydroxypropylmethylcellulose with or without other excipients and the resulting mixture is pressed into tablets. When the tablets are orally administered, the cellulose ethers in the tablets swell upon hydration from moisture in the digestive system, thereby limiting exposure of the active ingredient to moisture. As the cellulose ethers are gradually leached away by moisture, water more deeply penetrates the gel matrix and the active ingredient slowly dissolves and diffuses through the gel, making it available for absorption by the body. An example of such a sustained release dosage form of the analgesic/anti-inflammatory drug etodolac (Lodine.RTM.) appears in U.S. Pat. No. 4,966,768. U.S. Pat. No. 4,389,393 discloses sustained release therapeutic compressed solid unit dose forms of an active ingredient plus a carrier base comprised of a high molecular weight hydroxypropylmethylcellulose, methyl cellulose, sodium carboxymethylcellulose and or other cellulose ether. Where the production of tablets is not feasible, it is conventional in the drug industry to prepare encapsulated drug formulations which provide extended or sustained release properties. In this situation, the extended release capsule dosage forms may be formulated by mixing the drug with one or more binding agents to form a uniform mixture which is then moistened with water or a solvent such as ethanol to form an extrudable plastic mass from which small diameter, typically 1 mm, cylinders of drug/matrix are extruded, broken into appropriate lengths and transformed into spheroids using standard spheronization equipment. The spheroids, after drying, may then be film-coated to retard dissolution. The film-coated spheroids may then be placed in pharmaceutically acceptable capsules, such as starch or gelatin capsules, in the quantity needed to obtain the desired therapeutic effect. Spheroids releasing the drug at different rates may be combined in a capsule to obtain desired release rates and blood levels. U.S. Pat. No. 4,138,475 discloses a sustained release pharmaceutical composition consisting of a hard gelatin capsule

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filled with film-coated spheroids comprised of propanolol in admixture with microcrystalline cellulose wherein the film coating is composed of ethyl cellulose, optionally, with hydroxypropylmethylcellulose and/or a plasticizer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Fentanyl composition for nasal administration Inventor(s): Grarup, Jesper; (Roskilde, DK), Nielsen, Hanne Wulf; (Svenborg, DK) Correspondence: Wenderoth, Lind & Ponack, L.L.P.; 2033 K Street N. W.; Suite 800; Washington; DC; 20006-1021; US Patent Application Number: 20040034059 Date filed: July 14, 2003 Abstract: The treatment of acute pain with a sufficient dosage by intranasal administration of fentanyl results in a time to onset of action comparable to intravenous administration and a significantly faster onset of action than nasal titration of fentanyl. The nasal administration of a sufficient amount of fentanyl to obtain pain relief has lower maximum plasma concentrations comparable to intravenous administration and results in lower rates of adverse events like respiratory depression, nausea and vomiting. Compositions fur use in the method are also disclosed. Excerpt(s): The present invention relates to a pharmaceutical composition for use in the treatment of acute pain such as breakthrough pain by means of a non-invasive administration of fentanyl or a pharmaceutically acceptable salt thereof, said composition being such that at least 70.mu.g of fentanyl is delivered in a dosage unit. The method comprises administration of a treatment dosage sufficient to treat the acute pain with time to onset of action comparable to intravenous administration. The treatment typically comprises intranasal administration of a relatively concentrated composition of fentanyl citrate. In addition, the invention relates to a pharmaceutical kit comprising a treatment dosage of fentanyl for nasal administration for treatment of acute pain together with a delivery system of an analgesic for a continuous treatment of chronic pain. Fentanyl is a potent narcotic analgesic with pharmacological effects similar to morphine. Fentanyl is 50 to 100 times more potent than morphine on a weight basis. Fentanyl is a mu-receptor agonist acting on receptors distributed in the brain, spinal cord and other tissues. Opioids produce both analgesia and sedation. Opiate agonists appear to prevent the release of beta-endorphin, possibly by altering the patients perceived level of pain and anxiety, although the presence of pain may still be recognised (1). Parenteral fentanyl is indicated for anaesthesia, treating postoperative pain, and as a premedicant. Transdermal fentanyl is used for managing chronic pain in patients requiring opioids. Fentanyl lozenge/sucker (Oralet.RTM.) is indicated to induce anxiolysis and analgesia prior to surgery in pediatric and adult patients. Oral transmucosal fentanyl (Actiq.RTM.) is indicated for the management of breakthrough cancer pain in adults with malignancies who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. Fentanyl Oralet.RTM. is only indicated for use in a hospital setting as an anaesthetic pre-medication in the operating room setting or to induce conscious sedation prior to a diagnostic or therapeutic procedure in other monitored anaesthesia care settings in the hospital. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Galenical preparations of dapsone and related sulphones, and method of therapeutic and preventative treatment of disease Inventor(s): Aberg, A K Gunnar; (Sarasota, FL), Bain, Allen I; (Vancouver, CA), Zolotoy, Alexander; (Richmond, CA) Correspondence: Kevin S Lemack; Neilds & Lemack; 176 E Main Street; Westboro; MA; 01581; US Patent Application Number: 20030092635 Date filed: August 26, 2002 Abstract: Dapsone and related sulfones are known to have therapeutic activity against leprosy, dermatitis herpetiformis, actinomycotic mycetoma, asthma, malaria, rheumatoid arthritis, Kaposis sarcoma, pneumocystis carini (pneumonia), subcorneal pustular dermatosis and cystic acne, in patients in need of such therapy. These sulfones are also known to have therapeutic activity against memory loss in patients in need of such therapy, including patients suffering from Alzheimer's disease and related neurodegenerative disorders. It has now been found that new, modified-release formulations of dapsone and related sulfones may also be used that decrease side effects and increase effectiveness of the drugs. New methods are disclosed utilizing certain formulations of dapsone and related sulfones that improve the therapeutic index of said drugs. Side effects of these drugs are known to those skilled in the art and include, but are not restricted to anorexia, psychosis, agranulocytosis, peripheral neuritis, hemolysis, methemoglobinemia, nausea, vomiting, headache, dizziness, tachycardia, nervousness, insomnia and skin disorders. Modified-release (as defined herein) formulations of dapsone have now been found to avoid some or all of these side effects, and to have more efficacy on potency. Excerpt(s): The object of the present invention pertains to a method of treating or preventing certain diseases in a human being while increasing compliance, reducing side effects and improving efficacy of the active therapeutic ingredient(s) within a large therapeutic range. The method comprises the use of modified-release dosage formulations of sulfone compounds including 4,4'-diaminodiphenylsulfone, its didextrose sulfonate derivative(s), their analogs, metabolites, any enantiomers, any diasteriomers, or mixtures thereof and/or therapeutically acceptable salts thereof. Dapsone is an active substance that is known in the treatment of various infectious diseases and inflammatory conditions. There is a wealth of data and experimental studies regarding the activity of dapsone and related sulfones. In particular, there is a large amount of data regarding the bioavailability and pharmacokinetics of the drug. It is also known in the prior art that dapsone has therapeutic activity against leprosy, dermatitis herpetiformis, actinomycotic mycetoma, asthma, malaria, rheumatoid arthritis, Kaposis sarcoma, pneumocystis carinii (pneumonia), subcorneal pustular dermatosis and cystic acne, in patients in need of such therapy. However, since the acute or chronic toxicity of dapsone is unacceptable at the doses necessary to treat most diseases, it is not possible to use this compound for these indications in the presently available formulation(s). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Intravaginal mucosal or transmucosal delivery of antimigraine and antinausea drugs Inventor(s): Pauletti, Giovanni M.; (Loveland, OH), Ritschel, Wolfgang A.; (Cincinnati, OH), Soderstrom, Richard; (Seattle, WA) Correspondence: Hana Verny; Peters, Verny, Jones & Schmitt, Llp; Suite 6; 385 Sherman Avenue; Palo Alto; CA; 94306; US Patent Application Number: 20040043071 Date filed: June 20, 2003 Abstract: A method, composition and device for intravaginal mucosal or transmucosal delivery of antimigraine and/or antinausea drugs to a female subject for treatment of migraine and other diseases accompanied by or associated with nausea and vomiting. A mucoadhesive composition comprising antimigraine or antinausea drugs, mucoadhesive agent, penetration enhancer or sorption promoter and a hydrophilic or lipophilic carries. An intravaginal device for delivery of antimigraine or antinausea drugs. Excerpt(s): This application is based on and claims priority of the Provisional Application Ser. No. 60/390,748 filed on Jun. 21, 2002. The present invention concerns a method, composition and device for intravaginal mucosal or transmucosal delivery of antimigraine and/or antinausea drugs to a female subject for treatment of migraine and other diseases accompanied by or associated with nausea and vomiting. In particular, the invention concerns a method, composition, and device for mucosal delivery of antimigraine and/or antinausea drugs to the vagina for topical vaginal treatment or for transmucosal delivery of these drugs into the systemic blood circulation for systemic therapy using a mucoadhesive composition comprising these drugs. The composition is administered directly or incorporated into an intravaginal device. The mucoadhesive composition of the invention or intravaginal device incorporated with said composition delivers the antimigraine and/or antinausea drug into the vagina, provides a continuous contact with the vaginal mucosa, releases the therapeutic agent from the formulation in timely fashion and at controllable quantities, and delivers the drugs transmucosally across the vaginal epithelial barrier into the systemic circulation. The mucoadhesive composition adheres to the vaginal mucosa and promotes topical adhesion of the drug released from said composition to the vaginal mucosa and further promotes delivery of the drug transmucosally through the vaginal mucosa and wall to the systemic circulation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Measurement of pain Inventor(s): Laserow, Kay; (Malmo, SE) Correspondence: Oblon Spivak Mcclelland Maier & Neustadt PC; Fourth Floor; 1755 Jefferson Davis Highway; Arlington; VA; 22202; US Patent Application Number: 20010049472 Date filed: August 13, 2001 Abstract: The invention relates to a measuring instrument for the measurement of an existing pain or a feeling of nausea of a patient. The measuring instrument induces pain in an arbitrary body part of said patient, by supplying an electrical current. The measuring instrument provides a current increase into said body part, until said

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induced pain is experienced by the patient as being as great as the existing pain/nausea. The current is supplied from a current source arranged in the measuring instrument via wires (H, I) and electrodes (C, D), said electrodes being applied onto that part of the body in which pain is to be induced. When the pain induced is experienced to be as great as the existing pain/nausea, the body part is removed from the electrodes, whereupon a pain value is registered and shown on a display (F). (FIG. 6). Excerpt(s): The present invention relates to a measuring instrument and a method of measuring, by means of said instrument, an existing pain experienced by a patient. When a person in need of medical treatment first comes into contact with a doctor, a physiotherapist, a nurse etc., this person generally tries to describe his pain verbally, so that the medical staff are at least able to make a primary diagnosis of the patient's condition and suggest a suitable treatment. However, this creates a significant problem for the medical staff, depending upon different persons experiencing, and therefore describing, their pain or symptoms in different ways. One person may e.g. be more resistant to pain than others. Another person may e.g. have become used to his pain after a certain period of time and may therefore describe his/her pain in milder terms than he/she would have done if the pain had arisen recently. The varying descriptions of pain which a diagnostician may be exposed to, complicate a quick and exact diagnosis of a person's ailment or injury. For the sake of simplicity, in the below text the patient is always referred to as being male. It should of course be understood, however, that the same applies to female patients. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for protecting a human being against health impairment by ingestion of a transdermal therapeutic system Inventor(s): Becher, Frank; (Koblenz, DE), Klink, Ann-Katrin; (Waldesch, DE) Correspondence: D. Peter Hochberg CO. L.P.A.; 1940 East 6th Street; Cleveland; OH; 44114; US Patent Application Number: 20020187183 Date filed: May 21, 2002 Abstract: A method for the protection of a human being against any health impairment as a result of the ingestion of the whole or parts of a transdermal therapeutic system containing at least one pharmacologically active ingredient, which is toxic or induces nausea or addiction at oral, but not at transdermal administration is disclosed. The method comprises adding to said transdermal therapeutic system a substance being able to keep off a human being from said ingestion. Excerpt(s): This is a continuation-in-part application of application Ser. No. 09/486,214 filed May 3, 2000. The present invention relates to a method for the protection of a human being against any health impairment as a result of the ingestion of the whole or parts of a transdermal therapeutic system (TTS). More specifically, the present invention relates to a method for the protection of a human being against any health impairments as a result of the ingestion of the whole or parts of a transdermal therapeutic system, comprising at least one pharmacologically active ingredient-containing, especially a pressure-sensitive adhesive layer and at least on active-ingredient-impermeable backing layer, and further comprising a substance, which does not interact with the pharmacologically active ingredient and is able to keep off a human being from said ingestion. A series of transdermal therapeutic systems present an acute danger of

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undesired side effects if administered orally by a human being in order to extract a soluble active agent. This is true whether the system is a new one or a used one. For example, infants have a tendency to stick anything interesting into their mouths and to at least suck or chew on it. This cannot be avoided especially if children happen to attain access to such systems by chance, especially systems with a release liner. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method for treating or preventing depression Inventor(s): Reines, Scott A.; (New Hope, PA), Robichaud, Annette; (Montreal, CA), Tattersall, Frederick D.; (Bishops Stortford, GB) Correspondence: Merck And CO Inc; P O Box 2000; Rahway; NJ; 070650907 Patent Application Number: 20010049368 Date filed: February 27, 2001 Abstract: A neurokinin-1 antagonist or an alpha-2 adrenoreceptor agonist provide an effective therapy in conjunction with a PDE4 inhibitor for the treatment or prevention of depression and/or anxiety. These combinations minimize the side effects of nausea and/or emesis associated with the PDE4 inhibitor and may also provide beneficial antidepressant and/or anti-anxiety effects. Excerpt(s): Depression is characterised by feelings of intense sadness and despair, mental slowing and loss of concentration, pessimistic worry, agitation, and selfdeprecation. Physical changes also occur, especially in severe or "melancholic" depression. These include insomnia or hypersomnia, anorexia and weight loss (or sometimes overeating), decreased energy and libido, and disruption of normal circadian rhythms of activity, body temperature, and many endocrine functions. Treatment regimens commonly include the use of tricyclic antidepressants, monoamine oxidase inhibitors, some psychotropic drugs, lithium carbonate, and electroconvulsive therapy (ECT) (see R. J. Baldessarini in Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Edition, Chapter 19, McGraw-Hill, 1996 for a review). More recently, new classes of antidepressant drugs are being developed including selective serotonin reuptake inhibitors (SSRIs), specific monoamine reuptake inhibitors and 5-HT1A receptor agonists, antagonists and partial agonists. Anxiety is an emotional condition characterised by feelings such as apprehension and fear accompanied by physical sympoms such as tachycardia, increased respiration, sweating and tremor. It is a normal emotion but when it is severe and disabling it becomes pathological. Anxiety disorders are generally treated using benzodiazepine sedative-antianxiety agents. Potent benzodiazepines are effective in panic disorder as well as in generalised anxiety disorder, however, the risks associated with drug dependency may limit their long-term use. 5-HT1A receptor partial agonists also have useful anxiolytic and other psychotropic activity, and less likelihood of sedation and dependance (see R. J. Baldessarini in Goodman & Gilman's The Pharmacological Basis of Therapeutics, 9th Edition, Chapter 18, McGraw-Hill, 1996 for a review). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Migraine medicine and method of treating the same without caffeine Inventor(s): Imanzahrai, Ashkan; (San Jose, CA) Correspondence: Kevin D. Mccarthy, ESQ.; Hodgson Russ Llp; Suite 2000; One M&t Plaza; Buffalo; NY; 14203-2391; US Patent Application Number: 20020091162 Date filed: January 4, 2002 Abstract: This invention is a safe and effective composition and method for treating acute migraine attacks using pseudoephedrine, acetaminophen, and other agents in an orally administrated form to alleviate the pain and cluster of symptoms characteristic of migraine attacks such as nausea, photophobia, phonophobia, and functional disabilities as well as the prodrome phase of a migraine attack. Excerpt(s): This application claims priority as a divisional application of U.S. nonprovisional patent application serial no. 09/593,238 (filed on Jun. 14, 2000) which relies on the priority of provisional patent application Serial Number 60/144,973 which was filed on Jul. 22, 1999. The present invention relates generally to compositions and methods used to alleviate the symptoms and pain associated with an acute migraine attack. Many migraine sufferers use single-agent nonprescription analgesics such as acetaminophen, or aspirin, or non-steroidal anti-inflammatory agents to treat their attacks. (Lipton R B, Newman L C, Solomon S. Over-the-counter medication and the treatment of migraine. Headache 1994; 34:547-548.) In other countries, a number of nonprescription drugs are specifically approved for migraine pain. (Lipton R B, Newman L C, Solomon S. Over-the-counter medication and the treatment of migraine. Headache 1994; 34:547-548.) The effectiveness of self-treatment of a migraine and the effectiveness of most such nonprescription drugs in relieving or aborting migraine pain and/or the characteristic symptoms of a migraine has not been adequately studied in well-controlled clinical trials. (Lipton R B, Newman L C, Solomon S. Over-the-counter medication and the treatment of migraine. Headache 1994; 34:547-548.) Acetaminophen, aspirin, and caffeine are approved for relief of nonspecific headaches and tension headaches (Migliardi J R, Armellino J J, Friedman M, Gillings D B, Beaver W T. Caffeine as an analgesic adjuvant in tension headache. Clin Pharmacol Ther 1994; 56:576-586), which are clinical and physiologically distinct from a migraine. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Novel anandamide amidase inhibitors as analgesic agents Inventor(s): Hill, William Adam; (Ashford, CT), Lin, Sonyan; (Storrs, CT), Makriyannis, Alexandros; (Ashford, CT) Correspondence: Alix Yale & Ristas Llp; 750 Main Street; Suite 600; Hartford; CT; 06103 Patent Application Number: 20020091153 Date filed: February 6, 2002 Abstract: Disclosed is a method of inhibiting anandamide amidase in an individual or animal and novel inhibitors of anandamide amidase. The disclosed method and novel compounds can be used to reduce pain in an individual or animal suffering from pain, reducing nausea in an individual undergoing chemotherapy, for example cancer chemotherapy, suppressing appetite in an individual, reducing intraocular pressure in

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the eye of an individual or animal suffering from glaucoma and suppressing the immune system in an individual with an organ transplant. Excerpt(s):.DELTA.sup.9-Tetrahydrocannabinol, the pyschoactive marijuana derived cannabinoid, binds to the CB1 receptor in the brain and to the CB2 receptor in the spleen. Compounds which stimulate the CB1 receptor have been shown to induce analgesia and sedation, to cause mood elevation, to control nausea and appetite and to lower intraocular pressure (Mechoulam, Cannabinoids as Therapeutic Agents, CRC Press, Boca Raton, Fla. (1986), Fride and Mechoulam, Eur. J. Pharmacol. 231:313 (1993), Crawley et al., Pharmacol. Biochem. Behav. 40:907 (1993) and Smith et al., J. Pharm. Exp. Therap. 270:219 (1994)). Cannabinoids have also been shown to suppress the immune system (Mechoulam, Cannabinoids as Therapeutic Agents, CRC Press, Boca Raton, Fla. (1986). Thus, compounds which stimulate the CB1 or CB2 receptor, directly or indirectly, are potentially useful in treating glaucoma, preventing tissue rejection in organ transplant patients, controlling nausea in patients undergoing chemotherapy, controlling pain and enhancing the appetite and controlling pain in individuals with AIDS Wasting Syndrome. Arachidonyl ethanolamide (anandamide) is a naturallyoccurring brain constituent that acts as a CB1 and CB2 agonist and exhibits pharmacological activity in mice comparable to cannabinoids (Fride and Mechoulam (1993), Crawley et al. (1993) and Smith at al. (1994)). Anandamide is cleaved in vivo by anandamide amidase. Thus, inhibitors of anandamide amidase have the effect of indirectly stimulating the CB1 and CB2 receptors by increasing in vivo levels of anandamide. In addition to acting at the CB1 and CB2 receptors, cannabinoids also affect cellular membranes, thereby producing undesirable side effects such as drowsiness, impairment of monoamine oxidase function and impairment of nonreceptor mediated brain function. The addictive and psychotropic properties of cannabinoids also limit their therapeutic value. Inhibitors of anandamide amidase are not expected to have the undesired membrane-related side-effects produced by cannabinoids. By providing an alternate mechanism for stimulating the CB1 and CB2 receptor, anandamide inhibitors might not have the addictive and psychotropic properties of cannabinoids. However, present inhibitors of anandamide amidase have disadvantages. For example, phenylmethylsulfonyl fluoride (PMSF) is toxic to cells. Thus, there is a need for new and more potent inhibitors of anandamide amidase which have reduced toxicity towards cells and which do not significantly interact with the CB1 or CB2 receptor at inhibitory concentrations. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Novel arginine/ascorbic acid mixed powder as an oral supplement Inventor(s): Kimoto, Eiji; (Jonan-ku, JP), Morishige, Fukumi; (Sanbu-gun, JP) Correspondence: Oliff & Berridge, Plc; P.O. Box 19928; Alexandria; VA; 22320; US Patent Application Number: 20020091156 Date filed: November 13, 2001 Abstract: A mixture obtained by mixing ascorbic acid powder with arginine powder in a weight ratio (ascorbic acid/arginine) of 1/5 to 20, especially 1/5 to 1/4; and a supplement such as a nutrient preparation and a health-care food containing the mixture. Mixing of arginine powder and ascorbic acid powder in the weight ratios eliminates stringent taste specific to arginine and alleviates stringent feeling in the stomach (heartburn, nausea or vomiting) after oral intake thereof. The mixture prevents also peroxidative injuries of cells caused by an administration of a great amount of

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arginine alone. Further, mixing of arginine powder with ascorbic acid powder prevents browning of the mixture after long-term storage. Excerpt(s): The present invention relates to a method for eliminating the stringent taste and alleviating stringent feeling in the stomach of L-arginine (hereinafter referred to as arginine) by mixing L-ascorbic acid (hereinafter referred to as ascorbic acid) and for alleviating the toxicity of arginine-derived NO radical by arginine-ascorbic acidcombined treatment. From late 1970's to 1980's, a research group of Illinois University reevaluated that dietary arginine is indispensable for optimal health of adult and especially aged humans. (see E. Kimoto, "Nutritional Chemistry of L-Arginine", Kaisei Publishing Co. Ltd., Tokyo, 1999 (Literature 2), page 93). In 1987, it was reported that NO radical participating in a wide variety of physiological functions such as blood pressure control and prevention of infections is derived from arginine as a source. This led to increased attention paid to arginine in the field of amino acid nutrition science (see Literature 2, page 57). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Novel crystal forms of ondansetron, processes for their preparation, pharmaceutical compositions containing the novel forms and methods for treating nausea using them Inventor(s): Salyi, Szabolcs; (Debrecen, HU), Szabo, Csaba; (Debrecen, HU), Tamas, Tivadar; (Debrecen, HU), Aronhime, Judith; (Rehovot, IL), Meszaros Sos, Erzsebet; (Debrecen, HU), Molnar, Sandor; (Debrecen, HU) Correspondence: Kenyon & Kenyon; One Broadway; New York; NY; 10004; US Patent Application Number: 20040019093 Date filed: April 29, 2003 Abstract: Ondansetron crystalline Forms A and B are useful in the treatment of nausea and vomiting. Form B has a uniquely high melting point of about 244.degree. C. and both forms are stable against thermally induced polymorphic transition from 30.degree. C. up to their melting points. Excerpt(s): This application claims the benefit under 35 U.S.C.sctn.1.119(e) of Provisional Application Serial No. 60/376,395, filed Apr. 30, 2002, and is incorporated herein by reference. The present invention relates to (.+-.) 1,2,3,9-tetrahydro-9-methyl- -3-[2methyl-1h-imidazol-1-yl)methyl]-4h-carbazol-4-one (ondansetron). More particularly, it relates to a newly discovered high melting crystalline form of ondansetron, to a second newly discovered crystalline form, to processes for producing the new forms, to pharmaceutical compositions containing them and methods of treating nausea and vomiting using them. and formula C.sub.18H.sub.19N.sub.3O is a selective 5-HT.sub.3 receptor antagonist. It is a nitrogen-containing compound capable of existence in free base and salt forms. The free base is known by the generic name ondansetron. Ondansetron is useful for reducing nausea in patients undergoing chemotherapy. Grunberg, S. M.; Hesketh, P.J. "Control of Chemotherapy-Induced Emesis" N. Engl. J. Med. 1993, 329, 1790-96. It is approved by the United States Food and Drug Administration for prophylactic treatment of nausea and vomiting associated with some cancer chemotherapy, radiotherapy and postoperative nausea and/or vomiting. Ondansetron is commercially available in orally disintegrating tablets under the trade name Zofran.RTM. ODT. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Novel methods and compositions involving opioids and antagonists thereof Inventor(s): Farrar, John J.; (Chester Springs, PA) Correspondence: David A. Cherry, Esquire; Woodcock Washburn Kurtz; Mackiewicz & Norris Llp; One Liberty Place-46th Floor; Philadelphia; PA; 19103; US Patent Application Number: 20010047005 Date filed: November 29, 2000 Abstract: Novel methods and compositions comprising opioids In preferred embodiments, the methods and compositions peripheral mu opioid antagonist compounds. The methods particularly suitable for treating and/or preventing side effects including, for example, constipation, vomiting and/or nausea.

and opioid antagonists. comprise opioids and and compositions are associated with opioids

Excerpt(s): The present invention relates to novel methods and compositions comprising opioids and opioid antagonists. More particularly, the present invention relates to novel methods and compositions comprising opioids and peripheral mu opioid antagonist compounds. It is well known that opioid drugs target three types of endogenous opioid receptors (i.e., mu, delta and kappa receptors) in biological systems. Most opioids, such as morphine, are mu opioid agonists that are often used as analgesics for the treatment of severe pain due to their activation of mu opioid receptors in the brain and central nervous system (CNS). Opioid receptors are, however, not limited to the CNS, and may be found in other tissues throughout the body. A number of side effects of opioid drugs may be caused by activation of these peripheral receptors. Administration of mu opioid agonists often results in intestinal dysfunction due to the large number of receptors in the wall of the gut (Wittert, G., Hope, P. and Pyle, D., Biochemical and Biophysical Research Communications 1996, 218, 877-881; Bagnol, D., Mansour, A., Akil, A. and Watson, S. J., Neuroscience 1997, 81, 579-591). Specifically, opioids are generally known to cause nausea and vomiting as well as inhibition of normal propulsive gastrointestinal function in animals and man (Reisine, T., and Pasternak, G., Goodman & Gilman's The Pharmacological Basis of Therapeutics Ninth Edition 1996, 521-555) resulting in side effects such as, for example, constipation. It has been reported that acute nausea or vomiting may occur in up to about 33% of patients who receive oral narcotic analgesics and in up to about 80% of patients who receive injectable narcotics following surgery or trauma. This is due, at least in part, to direct effects of narcotics on the gastrointestinal (GI) tract. Opioid-induced side effects, such as nausea, vomiting, and inhibited gastrointestinal propulsive activity remain serious problems for patients being administered opioid analgesics for both short term and long term pain management. Opioid antagonist compounds that do not readily cross the blood-brain barrier (peripherally acting drugs) have been tested for use in curbing opioid-induced side effects. For instance, the peripheral mu opioid antagonist compound methylnaltrexone and related compounds have been suggested for use in curbing opioid-induced side effects in patients. U.S. Pat. Nos. 5,972,954, 5,102,887, 4,861,781, and 4,719,215 disclose the use of methylnaltrexone and related compounds in controlling opioid-induced pruritus, nausea, and/or vomiting. Additionally, methylnaltrexone has been shown to effectively reduce the incidence of opioid-induced nausea and pruritus as disclosed by Yuan, C. -S. et al. Drug and Alcohol Dependence 1998, 52, 161. Similarly, U.S. Pat. Nos. 5,250,542, 5,434,171, 5,159,081, and 5,270,328, disclose peripherally selective piperidineN-alkylcarboxylate opioid antagonists as being useful for the treatment of the opioid side effects constipation, nausea or vomiting, as well as irritable bowel syndrome and idiopathic constipation.

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Nutritional drink Inventor(s): Bjorkstrom, Jane; (Stockholm, SE), Bodemar, Goran; (Stockholm, SE), Lindewald, Gusta; (Stockholm, SE), Sjoberg, Lars-Borje; (Stockholm, SE) Correspondence: Larson & Taylor, Plc; 1199 North Fairfax Street; Suite 900; Alexandria; VA; 22314; US Patent Application Number: 20030118713 Date filed: September 18, 2002 Abstract: Nutritional drink which can with good tolerance be taken by persons suffering from feeling of nausea, or which are expected to be sick when consuming food or drink, which nutritional drink have an energy value of not more than 85, or preferably 40-60 kcal/100 ml drink, and an osmolality of not more than 600, or preferably 350-400 mOsmol/kg water, and which mainly contains proteins in an amount of 0.5-5.0 g/100 ml drink, carbohydrates in an amount of 6-20 g/100 ml drink, salts and acidifying agents that give a pH-value in the final drink of between 3 and 6, aroma, flavouring agents and vitamins. Excerpt(s): This invention pertains to a nutritional drink which with good tolerance can be ingested by persons suffering from nausea, or which are expected to be sick when consuming food or drink, e.g. persons who are treated with composition which can cause nausea, such as cytostatics, or persons who have become sick after consuming a certain type of food or drink, or persons who have been submitted to some form of surgical operation including anaesthesia, analgesia or narcosis, or persons in general who by different reasons easily get nauseous. It is important that patients get enough nutrition. The drink is clear and contains mainly proteins, carbohydrates, salts, acidifying agents, aroma, flavouring agents and vitamins. At chronic diseases the appetite often decreases, and if you are also nauseous, the nutritional intake is even more difficult. At nausea the nutritional intake from regular food is to small and leads to loss of weight and muscular mass. Malnutrition and loss of muscular strength and thus decreased general well-being, leads to decreased tolerance to treatments, e.g. radiotherapy and treatment with cytotoxic drugs at tumoural diseases, but also the result of the treatment itself is reduced. This is especially obvious after surgical operations if you are malnourished before the operation. Earlier, administration of nutrition by injecting into the blood stream, so called intravenous nutrition, was used to ameliorate the nutritional condition and to increase the muscular strength at severe diseases. Nowadays, it is known that, if nutrition can instead be administered in regular ways or through enteral probe nutrition to the stomach and the intestines, the administration of nutrition is tolerated better and the ability of the body to assimilate the nutrition is facilitated. It is not fully understood which mechanisms lead to nausea and low tolerance towards ingested food. It is however known that at nausea food and drink remain in the stomach a prolonged time, or reversed, that nausea makes food and drink remain in the stomach a prolonged time. When food and drink remain in the stomach a prolonged time often a feeling of uneasiness occurs with nausea as a consequence. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Nutritional formulations Inventor(s): Hermelin, Marc S.; (Glendale, MO), Kirschner, Mitchell I.; (St. Louis, MO), Levinson, R. Saul; (Chesterfield, MO) Correspondence: Gary M. Nath; Nath & Associates Pllc; 6th Floor; 1030 15th Street, N.W.; Washington; DC; 20005; US Patent Application Number: 20020044961 Date filed: October 9, 2001 Abstract: This invention relates to novel dosage formulations for nutritional compositions comprising fatty acids derived from both plant and animal sources and methods for minimizing unpleasant taste, regurgitation, gastroesophageal reflux, dyspepsia, nausea, or difficulty in swallowing or ingesting nutritional agents. The nutritional compositions are intended for use by pregnant or lactating women. Excerpt(s): This invention is directed to novel soft gelatin nutritional supplements, particularly soft gelatin nutritional supplements for pregnant women comprising fatty acids, methods of using said supplements to reduce the unpleasant taste, regurgitation, gastroesophageal reflux, dyspepsia, and nausea associated with the administration of traditional prenatal nutritional supplements, and processes for manufacturing said supplements. Gastrointestinal motility problems are common in women at all stages of pregnancy. Approximately 45% to 85% of women report experiencing digestive disturbances during pregnancy. Olans, et al., "Gastroesophageal reflux in pregnancy", Gastrointest Endosc Clin N Am 4(4):699-712 (1994). Typical symptoms experienced by pregnant women include belching, heartburn, gastroesophageal reflux, dyspepsia, regurgitation, increased sensitivity to unpleasant odors and/or tastes, nausea and vomiting. The Merck Manual, 1850-1866 (16.sup.th Ed. 1992). These symptoms are thought to be brought about, in part, by the physiological changes which occur in the female body during pregnancy. As pregnancy progresses, gastrointestinal motility decreases due to elevated progesterone levels which cause the smooth muscles associated with the digestive tract to relax. Id. The delay in gastric emptying time and relaxation of the sphincter located at the junction of the esophagus and stomach can cause a reflux of gastric fluids into the esophagus, e.g. gastroesophogeal reflux. Id. The relaxation of the diaphragmatic hiatus can exacerbate this condition. Id. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Oral pediatric trimethobenzamide formulations and methods Inventor(s): Bruns, Robert G.; (Johnson City, TN), Cirotta, Dean R.; (Webster, NY), Gregory, Jefferson J.; (Bristol, TN), Pamplin, Charles L. III; (Chapel Hill, NC), Rogers, Thomas K. III; (Bristol, TN) Correspondence: Edwards & Angell, Llp; P.O. Box 9169; Boston; MA; 02209; US Patent Application Number: 20040034102 Date filed: February 6, 2003 Abstract: Oral pediatric trimethobenzamide compositions and methods for treating and controlling nausea and/or vomiting are disclosed in warm blooded animals, especially humans including children. The oral pediatric trimethobenzamide compositions and methods of the present invention are believed to be at least as effective as a 200 mg intramuscular (I.M.) trimethobenzamide HCl injectable formulation when administered

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at a dose of about 100 mg. In addition, an oral pediatric composition containing about 120 mg of trimethobenzamide HCl is believed to be uniquely approximately bioequivalent to a 200 mg intramuscular (I.M.) trimethobenzamide HCl injectable formulation when administered at a dose of about 100 mg. Excerpt(s): This application for U.S. patent is filed as a provisional application under U.S.C., Title 35,.sctn.111(b). The present invention is concerned with oral pediatric trimethobenzamide compositions and methods useful for treating and controlling nausea and/or vomiting or emesis in warm-blooded animals, especially children. The process of nausea and vomiting is regulated by the chemoreceptor trigger zone ("CTZ") which is located in the vomiting center. The vomiting center is located in the medulla. The chemoreceptor trigger zone is the primary trigger for emesis. Because the chemoreceptor trigger zone must first stimulate the vomiting center to induce emesis, the chemoreceptor trigger zone, by itself, cannot induce vomiting. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Orally ingestible preparation of mistletoe lectins and method Inventor(s): Pryme, Ian; (Bergen, NO) Correspondence: Christian D. Abel; Onsagers AS; Postboks 6963 ST. Olavs Plass; Norway; N-0130; NO Patent Application Number: 20040052869 Date filed: September 22, 2003 Abstract: An orally ingestible preparation consisting essentially of Mistletoe lectin I (ML-I), Mistletoe lectin II (ML-II), and Mistletoe lectin III (ML-III), which specifically excludes the nausea-inducing compounds present in mistletoe extracts. The invention also provides for a method of producing said preparation, a method of using said preparation to produce pharmaceutical preparations, and a method for using said preparation in the treatment of patients suffering from cancer and auto immune diseases. Excerpt(s): The present invention relates to medicinally useful preparations derived from mistletoe, methods for making such preparations and treatment methods employing such preparations. More specifically, the invention relates to an orally ingestible preparation of mistletoe lectins useful in the treatment of cancer and other diseases. The cytotoxic cells of the immune system, cytolytic T cells (CTL), natural killer (NK) cells and macrophages, can seek out and ultimately lyse tumor cells either spontaneously or more often after appropriate activation. Spontaneous cytotoxic activity against tumor cells is mainly a result of NK cells. Various cytokines, alone or in combination, have been shown to augment anti-tumor activity : IL-2, IL-7, IL-12 and IFN-.gamma. induce cytotoxic activity in NK and T-cells while IFN-.gamma. and TNF.alpha. are potent activators of macrophages and monocytes. Most of the studies that have demonstrated these effects have been confined to in vitro systems although recently the anti-tumor effect of some of these cytokines has also been demonstrated in vivo in animals and also in humans. Lymphocytes cultured in the presence of high amounts of IL-2 are refered to as lymfokine-activated killer (LAK) cells. LAK cells are characterised by their ability to kill NK-resistant tumor cells without major histocompatibility complex (MHC) restriction. Although both NK and T cells are responsible for LAK activity, the former are responsible for mediating most of the activity. Macrophages and monocytes are known to accumulate around tumors.

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Following the TNF.alpha. and IFN-.gamma. stimulated activation of these cells it is predicted that a local release of cytokines would occur from these activated cells directly into the tumor. This in turn would be expected to induce apoptosis and ultimately cause death of the tumor cells. Besides cytokines, a variety of natural or synthetically produced protein mixtures have been reported to exert immunomodulating properties. The commercially available mistletoe extracts belong to this category of agents. Biochemical analysis has shown that the immunomodulating capacity is due to the presence of mistletoe lectins (ML-I, ML-II and ML-III) in the extracts. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Pharmaceutical composition and method of modulating cholinergic function in a mammal Inventor(s): Coe, Jotham W.; (Niantic, CT), Sands, Steven B.; (Stonington, CT) Correspondence: Pfizer Inc; 150 East 42nd Street; 5th Floor - Stop 49; New York; NY; 10017-5612; US Patent Application Number: 20030008892 Date filed: March 25, 2002 Abstract: A pharmaceutical composition and method of modulating cholinergic function in a mammal comprising administration of a NRPA compound or a pharmaceutically acceptable salt thereof; and an anti-emetic/anti-nausea agent or a pharmaceutically acceptable salt thereof; and a pharmaceutically acceptable carrier. The NRPA compound and the anti-emetic/anti-nausea agent are present in amounts that render the composition effective modulating cholinergic function or in the treatment of a diorder or condition selected from inflammatory bowel disease (including but not limited to ulcerative colitis, pyoderma gangrenosum and Crohn's disease), irritable bowel syndrome, spastic dystonia, chronic pain, acute pain, celiac sprue, pouchitis, vasoconstriction, anxiety, panic disorder, depression, bipolar disorder, autism, sleep disorders, jet lag, amyotrophic lateral sclerosis (ALS), cognitive dysfunction, hypertension, bulimia, anorexia, obesity, cardiac arrythmias, gastric acid hypersecretion, ulcers, pheochromocytoma, progressive supranuclear palsy, chemical dependencies and addictions (e.g., dependencies on, or addictions to nicotine (and/or tobacco products), alcohol, benzodiazepines, barbiturates, opioids or cocaine), headache, migraine, stroke, traumatic brain injury (TBI), obsessive-compulsive disorder (OCD), psychosis, Huntington's chorea, tardive dyskinesia, hyperkinesia, dyslexia, schizophrenia, multiinfarct dementia, age-related cognitive decline, epilepsy, including petit mal absence epilepsy, senile dementia of the Alzheimer's type (AD), Parkinson's disease (PD), attention deficit hyperactivity disorder (ADHD) and Tourette's Syndrome. The method of using these compositions is also disclosed. Excerpt(s): The present invention relates to pharmaceutical compositions for modulating cholinergic function in a mammal comprising a nicotinic receptor partial agonist compound in combination with an anti-emetic/anti-nausea agent and a pharmaceutically acceptable carrier. The nicotinic receptor partial agonists (NRPAs) included herein are aryl fused azapolycyclic compounds. NRPAs are not limited to those described here. The term NRPA refers to all chemical compounds which bind at neuronal nicotinic acetylcholine specific receptor sites in mammalian tissue and elicit a partial agonist response. A partial agonist response is defined here to mean a partial, or incomplete functional effect in a given functional assay. Additionally, a partial agonist will also exhibit some degree of antagonist activity by its ability to block the action of a

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full agonist (Feldman, R. S., Meyer, J. S. & Quenzer, L. F. Principles of Neuropsychopharmacology, 1997; Sinauer Assoc. Inc.). The present invention may be used to treat mammals (e.g. humans) for inflammatory bowel disease (including but not limited to ulcerative colitis, pyoderma gangrenosum and Crohn's disease), irritable bowel syndrome, spastic dystonia, chronic pain, acute pain, celiac sprue, pouchitis, vasoconstriction, anxiety, panic disorder, depression, bipolar disorder, autism, sleep disorders, jet lag, amyotrophic lateral sclerosis (ALS), cognitive dysfunction, hypertension, bulimia, anorexia, obesity, cardiac arrythmias, gastric acid hypersecretion, ulcers, pheochromocytoma, progressive supranuclear palsy, chemical dependencies and addictions (e.g., dependencies on, or addictions to nicotine (and/or tobacco products), alcohol, benzodiazepines, barbiturates, opioids or cocaine), headache, migraine, stroke, traumatic brain injury (TBI), obsessive-compulsive disorder (OCD), psychosis, Huntington's chorea, tardive dyskinesia, hyperkinesia, dyslexia, schizophrenia, multiinfarct dementia, age-related cognitive decline, epilepsy, including petit mal absence epilepsy, senile dementia of the Alzheimer's type (AD), Parkinson's disease (PD), attention deficit hyperactivity disorder (ADHD) and Tourette's Syndrome with a decrease in the incidence and severity of unwanted side effects such as nausea and/or stomach upset. The present invention also relates to the combination use of NRPAs and anti-emetic/anti-nausea agents resulting in modulation of cholinergic function without nausea. The combination will provide an improved treatment paradigm than NRPAs alone. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Pharmaceutical compositions for headache, migraine, nausea and emesis Inventor(s): Barkan, Raphael; (Zion, IL), Mirimsky, Alexander; (Rehovot, IL) Correspondence: Winston & Strawn; Patent Department; 1400 L Street, N.W.; Washington; DC; 20005-3502; US Patent Application Number: 20040006044 Date filed: March 5, 2003 Abstract: S-alkylsiothiouronium derivatives such as S-ethylisothiouronium diethylphosphate are used for the treatment of headaches, in particular, migraines, as well as for the prevention or treatment of nausea and vomiting. The compositions of the invention are also effective in preventing or alleviating emesis associated with migraines or other medical conditions such as chemotherapy or radiotherapy, as well as other symptoms of migraines including phonophobia and photophobia. Excerpt(s): The present invention relates to the use of S-alkylisothiouronium derivatives, including, but not limited to, S-ethylisothiouronium diethylphosphate, for the prevention or treatment of headache, including but not limited to migraine, and for the prevention or treatment of emesis, and more particularly, to the alleviation of migraine symptoms, including but not limited to headache, nausea and vomiting. Headache is a term used to describe a varied set of symptoms, ranging in intensity from mild discomfort to the very severe syndrome known by the name of migraine. While the most severe and debilitating form of headache is migraine headache there are several other types of headaches that warrant consideration in terms of prevalence, including but not limited to premenstrual syndrome (PMS) associated headaches and the condition associated with morning after alcohol consumption, commonly referred to as hangover. Symptoms such as headache, fever, chills, nausea, muscle and nerve pain, lethargy, and others are often manifested during the syndrome known as hangover.

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Pharmaceutical compositions of 5,7,14-triazatetracyclo[10.3.1.02,11.04,9]-- hexadeca-2 (11),3,5,7,9-pentaene Inventor(s): Am Ende, Mary T.; (Waterford, CT), Moses, Sara Kristen; (Mystic, CT), Quan, Ernest S.; (East Lyme, CT), Roy, Michael C.; (Groton, CT), Smith, Scott W.; (San Diego, CA), Waterman, Kenneth C.; (East Lyme, CT) Correspondence: Pfizer Inc; 150 East 42nd Street; 5th Floor - Stop 49; New York; NY; 10017-5612; US Patent Application Number: 20030180360 Date filed: November 20, 2002 Abstract: The present invention is directed to controlled-release (CR) oral pharmaceutical dosage forms of 5,8,14-triazatetracyclo[10.3.1.0.sup.2,11.- 0.sup.4,9]hexadeca-2(11),3,5,7,9-pentaene, 1, and pharmaceutically acceptable salts thereof, and methods of using them to reduce nicotine addiction or aiding in the cessation or lessening of tobacco use while reducing nausea as an adverse effect. The present invention also relates to an immediate-release (IR) low dosage composition having a stable formulation with uniform drug distribution and potency. 1 Excerpt(s): Compound 1, also known as 7,8,9,10-tetrahydro-6,10-methano-6H-pyrazino[2,3-h][3]-benzazepine, binds to neuronal nicotinic acetylcholine specific receptor sites and are useful in modulating cholinergic function. Accordingly, this compound is useful in the treatment of inflammatory bowel disease (including but not limited to ulcerative colitis, pyoderma gangrenosum and Crohn's disease), irritable bowel syndrome, spastic dystonia, chronic pain, acute pain, celiac sprue, pouchitis, vasoconstriction, anxiety, panic disorder, depression, bipolar disorder, autism, sleep disorders, jet lag, amyotrophic lateral sclerosis (ALS), cognitive dysfunction, hypertension, bulimia, anorexia, obesity, cardiac arrhythmias, gastric acid hypersecretion, ulcers, pheochromocytoma, progressive supranuclear palsy, chemical dependencies and addictions (e.g., dependencies on, or addictions to nicotine (and/or tobacco products), alcohol, benzodiazepines, barbiturates, opioids or cocaine), headache, migraine, stroke, traumatic brain injury (TBI), obsessive-compulsive disorder (OCD), psychosis, Huntington's chorea, tardive dyskinesia, hyperkinesia, dyslexia, schizophrenia, multi-infarct dementia, age-related cognitive decline, epilepsy, including petit mal absence epilepsy, senile dementia of the Alzheimer's type (AD), Parkinson's disease (PD), attention deficit hyperactivity disorder (ADHD) and Tourette's Syndrome. Compound 1 and pharmaceutically acceptable acid addition salts thereof are referred to in International Patent Publication WO 99/35131, published Jul. 15, 1999, which is incorporated herein by reference in its entirety. Whereas immediate release (IR) dosage forms of the aforementioned compound, that is, dosage forms designed to provide the drug in a dissolved form upon swallowing in less than about 30 minutes, provide therapeutically useful levels of drug in the blood and brain, it has been observed that there is a significant level of nausea in patients, especially at doses sufficiently high to be therapeutically useful for some patients. Since nausea can lead to poor patient compliance with a dosing regimen, there is a need to provide 1 in a form that reduces the incidence of nausea. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Polymer conjugates of opioid antagonists Inventor(s): Bentley, Michael David; (Huntsville, AL), Cheng, Lin; (Huntsville, AL), Roberts, Michael James; (Williamsburg, VA), Shen, Xiaoming; (Madison, AL) Correspondence: Alston & Bird Llp; Bank OF America Plaza; 101 South Tryon Street, Suite 4000; Charlotte; NC; 28280-4000; US Patent Application Number: 20030124086 Date filed: October 18, 2002 Abstract: The invention provides polymer conjugates of opioid antagonists comprising a polymer, such as poly(ethylene glycol), covalently attached to an opioid antagonist. The linkage between the polymer and the opioid antagonist is preferably hydrolytically stable. The invention also includes a method of treating one or more side effects associated with the use of opioid analgesics, such as constipation, nausea, or pruritus, by administering a polymer conjugate of the invention. Excerpt(s): This application claims the benefit of Provisional Application Serial No. 60/330,400, filed Oct. 18, 2001, which is incorporated herein by reference in its entirety. This invention relates to water-soluble polymer conjugates of biologically active molecules, and in particular, to water-soluble polymer conjugates of opioid antagonists, such as naloxone, and related pharmaceutical compositions and uses thereof. Natural and synthetic alkaloids of opium (i.e., opioids) are useful as analgesics for the treatment of severe pain. Opioids target three types of endogenous opioid receptors:.mu.-,.delta.-, and.kappa.-receptors. Many opioids, such as morphine, are Preceptor agonists that are highly efficacious analgesic compounds due to their activation of opioid receptors in the brain and central nervous system (CNS). Opioid receptors are, however, not only limited to the CNS, but may be found in other tissues throughout the body. These receptors located outside the CNS are referred to as peripheral receptors. A number of side effects associated with opioid use are caused by activation of these peripheral receptors. For example, administration of opioid agonists often results in intestinal dysfunction due to action of the opioid agonist upon the large number of receptors in the intestinal wall. Specifically, opioids are generally known to cause nausea and vomiting as well as inhibition of normal propulsive gastrointestinal function in animals, resulting in side effects such as constipation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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PROKINETIC AGENTS FOR TREATING GASTRIC HYPOMOTILITY AND RELATED DISORDERS Inventor(s): ANDREWS, PAUL L. R.; (LONDON, GB), WATSON, JOHN W.; (LEDYARD, CT), WOODS, ANTHONY J.; (LONDON, GB) Correspondence: Pfizer Inc; 150 East 42nd Street; 5th Floor - Stop 49; New York; NY; 10017-5612; US Patent Application Number: 20030176421 Date filed: December 30, 1999 Abstract: Stasis is treated or prevented in all or any part or parts of the stomach of a patient, especially a human patient, in need of such treatment, where said stasis results from hypomotility in the stomach, particularly gastric hypomotility with delayed emptying of the liquid and/or solid contents of the stomach. Gastric or gastrointestinal

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disorders are also treated which are characterized by one or more symptoms selected from pain, nausea, vomiting, heartburn, postprandial discomfort, indigestion and gastroesophageal reflux. Such treatment or prevention is achieved by administering to the patient a therapeutically effective amount of an inhibitor of phosphodiesterase-4 (PDE4), including isozyme subtypes thereof, sufficient to treat or prevent such hypomotility or gastric or gastrointestinal disorder in said patient. The PDE4 inhibitor comprises a compound of Formula (IA) or (IB): 1where in a preferred embodiment, R is cyclopentyl or cyclohexyl; R.sup.1 is (C.sub.1-C.sub.2) alkyl; one of R.sup.2.sub.a and R.sup.2.sub.b is hydrogen and the other is a substituent of partial Formula (1.0.0) above, where the dashed line represents a single bond, m is 0, R.sup.113 and R.sup.114 are in a cis relationship to each other, R.sup.113 is cyano, R.sup.115 is hydrogen, and R.sup.114 is carboxy, --CH.sub.2OH, or --CH.sub.2C(.dbd.O)NH.sub.2.Pharmaceutical compositions are also described which are useful for carrying out the above-mentioned methods of treatment and prevention, and which are also useful in the treatment of a gastric or gastrointestinal disorder in a patient which comprises with respect to said patient, (i) a sign or concomitant of diabetic neuropathy, anorexia nervosa, achlorhydria, gastrointestinal surgery, post-surgical recovery in the period of emergence from general anesthesia; or the administration of morphine and morphine-like opioids; (ii) a secondary aspect of a primary disease or disorder in said patient which is organic, wherein said disease or disorder involves particularly a gastroenteric or gastroesophageal organ or tissue, or an organ or tissue of the central nervous system of said patient; or (iii) an adverse side effect of a different therapeutic agent administered to said patient in the course of treating another unrelated disease or disorder in said patient. Excerpt(s): The method of treatment of the present invention involves a therapeutic agent having a prokinetic effect on, i.e., that promotes activity with regard to gastric motility. This type of drug is useful in treating gastric hypomotility with delayed gastric emptying of liquid and/or solid contents of the antrum (stomach), which is a component of a number of gastric or gastrointestinal disorders. The symptoms of such gastric or gastrointestinal disorders can be quite serious and include pain, nausea, vomiting, heartburn, postprandial discomfort, indigestion, and gastroesophageal reflux. In particular, the present invention relates to therapeutic agents which by various mechanisms are able to elevate cAMP in populations of neurons in the myenteric plexus, leading to release of excitatory transmitters, e.g., acetylcholine, and subsequent stimulation with resulting contraction of the smooth muscle of the antrum. The therapeutic compounds useful as active ingredients in the pharmaceutical compositions and methods of treatment of the present invention are closely related, in terms of their chemical structure and biological activity, to inhibitors of the phosphodiesterase-IV (PDE4) isoenzyme. However, to date the art has incorrectly taught that PDE4 inhibitors antagonize gastrointestinal contractile responses, suggesting their use as antikinetic agents for treating hypermotility disorders; rather than as prokinetic agents for treating gastric hypomotility, as surprisingly discovered in accordance with the present invention. The gastrointestinal system must preserve a proper balance between absorption and secretion of water and electrolytes in order to keep nutrients, wastes, electrolytes and water in a life-sustaining flux. Equally important to successful performance of this ongoing process is the maintenance along the gastrointestinal tract of the appropriate anterograde motility. Gastrointestinal motility is also known to be a key component of vomiting. This aspect of its role is important in light of the fact that some antiemetic agents have enhanced gastric emptying as a significant aspect of their actions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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System and method for sensing and evaluating physiological parameters and modeling an adaptable predictive analysis for symptoms management Inventor(s): Geatz, Michael W.; (Maple Groove, MN), Roiger, Richard J.; (Mankato, MN) Correspondence: Stuart R. Hemphill; Dorsey & Whitney Llp; Intellectual Property Department; 50 South Sixth Street, Suite 1500; Minneapolis; MN; 55402-1498; US Patent Application Number: 20030144829 Date filed: January 24, 2003 Abstract: A system senses various physiological parameters of a patient such as heart rate or temperature to evaluate the patient and predict when an episode of a chronic symptom may occur. The system further includes a modeling component which generates an individualized predictive model for a given patient wherein the patient's previous episodes of the symptom are utilized to shape the model. The system tests the model to assure accuracy and can revise the model as necessary. Once the model is established, the system monitors patient parameters and can alert the patient to the expected onset of the symptom and/or automatically administer an appropriate drug or other therapy to control the expected symptom. The system is applicable to allergic reactions, anxiety attacks, attention deficit hyperactivity disorders, backaches, depression, dizziness, drowsiness, epileptic seizures, fatigue, heart malfunction, hunger pangs, joint or other pain, loss of motor control, migraines, motion sickness, muscle spasm, nausea, nicotine fits, numbness, shaking, shortness of breath, sleep or sleep disorders, tremors, unconsciousness, vision impairment or other chronic symptoms. Excerpt(s): This patent application claims priority from provisional patent application No. 60/351,575, filed Jan. 25, 2002. This invention relates generally to medical devices, and more specifically to a method and apparatus for sensing and reacting to patient physiological data. Many people suffer from chronic or recurring symptoms or various other unpleasant or disturbing indications caused by a wide variety of medical ailments. Some possibilities include: allergic reactions, anxiety attacks, attention deficit hyperactivity disorders, backaches, depression, dizziness, drowsiness, epileptic seizures, fatigue, heart malfunction, hunger pangs, joint or other pain, loss of motor control, migraines, motion sickness, muscle spasm, nausea, nicotine "fit", numbness, shaking, shortness of breath, sleep or sleep disorders, tremors, unconsciousness, and vision impairment. In fact, approximately 1 in 5 people suffer from some sort of chronic acute symptoms during their lifetime. Understandably, these people desire and seek relief from the medical community. A typical patient suffering from such chronic symptoms might spend anywhere from $500 to $35,000 annually to treat or minimize their symptoms. Treatments for symptoms involve various drug and/or physical therapies, chiropractic care, acupuncture, meditation and yoga. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Treatment method Inventor(s): Dedrick, Russell L.; (Kensington, CA), Garovoy, Marvin R.; (San Anselmo, CA), Kramer, Susan M.; (San Francisco, CA), Starko, Karen M.; (Hillsborough, CA) Correspondence: Genentech, INC.; 1 Dna Way; South San Francisco; CA; 94080; US Patent Application Number: 20030223988 Date filed: June 20, 2003

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Abstract: A method is provided for reducing the occurrence of fever, headache, nausea and/or vomiting associated with administration of a therapeutic compound to a mammal in need thereof, comprising administering to the mammal a first conditioning dose of a non-target cell depleting compound which binds to a cell surface receptor on a target mammalian cell; and administering a second therapeutic dose of the compound, wherein the second dose is higher than the first dose. Excerpt(s): This application is a continuation of Ser. No. 09/819,921, filed on Mar. 28, 2001, which is a divisional of Ser. No. 09/527,957, filed on Mar. 17, 2000 (now abandoned) which claims the benefit under USC.sctn.119(e)(1) to provisional patent applications Serial No. 60/125,228 and Serial No. 60/125,351, both filed on Mar. 19, 1999, the disclosures of which are incorporated by reference herein in their entirety. The invention relates to methods of treating mammals, for example humans, to reduce the occurrence of undesired administration reactions, to treat an LFA-1 mediated disease, to condition a mammal to tolerate high doses of a therapeutic compound and to down modulate a cell surface receptor. Administration of many therapeutic agents rapidly induces adverse side effects, or events, including but not limited to fever, headache, nausea, vomiting, breathing difficulties and changes in blood pressure. These adverse events limit the amount of a drug or therapeutic compound that can be given, which in turn limits the therapeutic effectiveness that could be achieved with higher doses of the drug. There is a continuing need to develop techniques which limit the toxicity of higher drug doses so that therapeutic efficacy can be improved. This need exists for both polypeptide and non-polypeptide compounds. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Two-component anti-emetic composition Inventor(s): Jannetta, Anthony; (Haverford, PA) Correspondence: Patent Adminstrator; Katten Muchin Zavis; Suite 1600; 525 West Monroe Street; Chicago; IL; 60661; US Patent Application Number: 20020055495 Date filed: September 5, 2001 Abstract: The invention relates to an anti-emetic composition containing dexamethasone (DEX) and metoclopramide (MTC). In a particular embodiment, a composition containing DEX:MTC in a relative weight ratio of about 1 to less than 1.25 is found to be effective in providing relief from the discomfort caused by symptoms of both vomiting and nausea in all patients receiving the composition. Alternatively, an effective suppository composition may contain DEX:MTC in a relative weight ratio of about 1:112.5. Other effective compositions and methods of their use are also disclosed. Excerpt(s): This application claims the benefit of an earlier-filed provisional application No. 60/229,547 filed Sep. 5, 2000, the entire disclosure of which is incorporated herein by reference. The present invention relates to both a therapeutic composition comprising a synergistic combination of antiemetic drugs and to a method for treating emesis, including nausea. Nausea and vomiting can follow the administration of many drugs, particularly anticancer or chemotherapeutic agents. The symptoms also often accompany infectious and non-infectious gastrointestinal disorders. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Keeping Current In order to stay informed about patents and patent applications dealing with nausea, 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 “nausea” (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 nausea. You can also use this procedure to view pending patent applications concerning nausea. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 7. BOOKS ON NAUSEA Overview This chapter provides bibliographic book references relating to nausea. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on nausea 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 “nausea” (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 nausea: •

Uninvited Guests: The Inside Story on Intestinal Parasites and How to Protect Yourself from Them Source: New Canaan, CT: Keats Publishing, Inc. 1996. 48 p. Contact: Available from Keats Publishing, Inc. 27 Pine Street, Box 876, New Canaan, CT 06840-0876. (800) 540-9440. Fax (800) 998-3103. PRICE: $3.95 plus shipping and handling. ISBN: 0879837365. Summary: Human bodies are perfect homes for parasites, providing food and housing for any number of these uninvited guests. Relatively few patients and doctors realize that parasites cause some of the most common intestinal infections in the U.S. This booklet describes common parasites, from the water poisoning Cryptosporidium to the 15 foot fish tapeworm. The protozoan family of parasites, single celled organisms like Giardia intestinalis (formerly known as Giardia lamblia) and Cryptosporidium parvum are the ones most frequently found in Americans. Diarrhea, nausea, fevers, and

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abdominal pain may be some of the initial symptoms of infections. Bowel disorders, muscle and joint pain, fibromyalgia, fatigue, malnutrition, and allergic reactions may develop when parasites take up long term, undetected residence in a human body. The author discusses sources of contamination, definitions and symptoms, parasitic infections, the parasites themselves, treatment options, and prevention strategies. Sources of contamination include water, food, pets, day care centers, sexual practices, and widespread global travel. Parasites are discussed in four basic categories: Protozoa (microscopic, single celled organisms), Trematodes (flukes), Cestoda (tapeworms), and Nematoda (round, pin, and hook worms). The author reviews the incidence, symptoms, and transmission of each of these parasitic infections. A questionnaire that can be useful in diagnosis is included in the booklet. Treatment options discussed include chemotherapeutic agents, herbal alternatives, and diet and other supportive measures. The author stresses that the best prevention strategy is to build a strong, healthy immune system. 1 figure. 33 references. •

Heartburn and What to Do About It Source: Garden City Park, NY: Avery Publishing Group. 1998. 182 p. Contact: Available from Avery Publishing Group. 120 Old Broadway, Garden City Park, NY 11040. (800) 548-5757 or (516) 741-2155. Fax (516) 742-1892. E-mail: [email protected]. PRICE: $10.95 plus shipping and handling. ISBN 0895297922. Summary: In this book, the authors tell readers how to banish heartburn and other digestive symptoms once and for all, using natural therapies that are gentle on one's system. The authors emphasize that a lack of balance in the digestive tract, caused by improper diet and the stresses of modern life, is at the root of most people's intestinal upsets, and they explain both the problem and the solution in clear, nontechnical language. In Part One, after surveying the scope of the nation's digestive difficulties, the authors review the most common digestion related disorders. They discuss ulcers and the infection (Helicobacter pylori) that causes ulcers. The authors then look at disorders that can cause both common digestive symptoms, such as diarrhea, constipation, nausea, and gas, and symptoms that most readers may not associate with the digestive system, such as fatigue and skin rashes. In Part Two, the authors explain how to relieve and prevent digestive troubles through the use of proper diet, yogurt, and intestinal cleansers. Finally, the authors offer a detailed discussion of probiotics, the friendly bacteria that not only help protect the digestive tract from bad bacteria and assist in digestion itself, but also improve overall health. The authors conclude that restoring intestinal health first requires a change in diet, with a reduction in or elimination of highly processed, sugary, and fatty foods, and a corresponding increase in whole grains, fresh fruits and vegetables, limited amounts of organically raised meat, and cultured foods such as yogurt. These changes in diet must be supported by adequate exercise, rest, and stress reduction. The book concludes with a resource list, a suggested reading list, a list noting sources of products and services, endnotes, and a subject index. 250 references.

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PDR for Herbal Medicines. 1st ed Source: Montvale, NJ: Medical Economics Company. 1998. 1244 p. Contact: Available from Medical Economics Publishing Inc. P.O. Box 10689, Des Moines, IA 50336. (800) 922-0937. Fax (515) 284-6714. Website: www.medecbookstore.com. PRICE: $59.99. ISBN: 1563632926.

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Summary: Most of today's herbal remedies exhibit varying degrees of therapeutic value. Some, such as ginkgo, valerian, and saw palmetto, seem genuinely useful, while others, such as ephedra, tansy, and nightshade, can actually be dangerous. As the use of unfamiliar botanicals spreads, the need to steer patients toward the few truly useful preparations and warn them away from ineffective, dangerous alternatives is becoming an increasingly significant priority. This volume, from the publishers of Physicians Desk Reference, brings together the findings of the German Regulatory Authority's herbal watchdog agency (commonly caused Commission E). This agency conducted an intensive assessment of the peer-reviewed literature on some 300 common botanicals, weighing the quality of the clinical evidence and identifying the uses for which the herb can reasonably be considered effective. This reference book contains profiles of over 600 medicinal herbs. Each entry contains up to 9 standard sections: name(s), description, actions and pharmacology, indications and usage, contraindications, precautions and adverse reactions, overdosage, dosage, and literature. The entries have also been indexed by scientific and common name, indications, therapeutic category, and side effects. To assist in identification, the reference book includes a section of full-color plates of the plants included. The book concludes with a glossary of the specialized botanical nomenclature and other unfamiliar terminology, a list of poison control centers, and a list of drug information centers. Some of the herbs are listed for use for abdominal cramps or distress, acid indigestion, appetite stimulation, rectal bleeding, various bowel disorders, stomach cancer, cholelithiasis (gallstones), colic, colitis, constipation, dehydration, diarrhea, digestive disorders, dysentery, enteritis, anal fissure, flatulence (intestinal gas), gastritis, gastroenteritis, gastrointestinal disorders, gout, helminthiasis, hemorrhage, hemorrhoids, hepatitis, hypercholesterolemia, jaundice, liver and gall bladder complaints, liver disorders, malaria, nausea, abdominal pain, and vomiting. •

Orofacial Pain with a Neurological or Vascular Background Source: in Scully, C. Handbook of Oral Disease: Diagnosis and Management. New York, NY: Thieme New York. 2001. p.39-52. Contact: Available from Thieme New York. 333 Seventh Avenue, New York, NY 10001. (212) 760-0888, ext 110. PRICE: $35.00 plus shipping and handling. ISBN: 1841840874. Summary: Pain is the most common oral complaint. Usually it has a local cause, but neurological (nervous system), vascular (blood vessel), psychogenic (of psychological cause), and other causes should be excluded. This chapter on orofacial pain with a neurological or vascular background is from a handbook of oral disease that is intended to be used by all members of the dental team who need a ready office reference. The handbook covers the more common and important soft tissue orofacial disorders and gives clinically relevant aspects of the etiology, diagnosis, treatment, and prevention. This chapter covers causalgia (a persistent burning pain that follows surgery or trauma), cranial arteritis (also called temporal arteritis or giant-cell arteritis); Frey's syndrome, a burning pain, usually in the temporal area in front of the ear, associated with flushing and sweating on eating; glossopharyngeal neuralgia; herpetic and postherpetic neuralgia, which is pain that persists after herpes zoster (shingles); migraine, a severe headache associated with nausea and sometimes photophobia (light sensitivity); migrainous neuralgia or cluster headache; referred pain; and trigeminal neuralgia. For each condition, the authors note etiology (cause), diagnosis, symptoms, epidemiology, risk factors, treatment, and prevention (where possible). Much of the information is provided in table format for ease of reference. Full color photographs illustrate some conditions. 4 figures. 2 tables. 25 references.

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Dyspepsia Source: Philadelphia, PA: American College of Physicians. 191 p. Contact: Available from American College of Physicians (ACP). 190 N. Independence Mall West, Philadelphia, PA 19106-1572. (800) 523-1546 or (215) 351-2600. Website: www.acponline.org. PRICE: $35.00 plus shipping and handling. ISBN: 0943126975. Summary: The term dyspepsia represents a variety of symptoms pertaining to the upper gastrointestinal tract, including upper abdominal pain, discomfort, heartburn, nausea, bloating, and regurgitation. This book offers a guide to the clinical challenge of daily management of patients with dyspepsia. To accommodate the realities of managed health care and fiscal concerns, the authors emphasize cost effective strategies that achieve optimal clinical outcomes. The symptom pattern and response to empirical therapy are helpful in establishing the classification. The authors provide a bridge from the medical literature to informed decision making, covering epidemiology, etiology, natural history, motility problems, quality of life issues, and alternative therapies. The complexities of gastroesophageal reflux disease (GERD) and Helicobacter pylori infection are explored. Clinical vignettes demonstrate how experts approach frequently encountered dilemmas by using hypothetical case histories and posing treatment questions. The authors note that the diagnosis of dyspepsia in itself has significant cost implications; however, the ultimate goal of the physician is to balance the appropriate diagnostic strategy with the optimal use of health care resources. Similarly, the appropriate use of medical therapy should always focus on the medication that achieves the best symptomatic response. In addition, it is becoming increasingly well recognized that no or poor treatment of upper gastrointestinal visceral diseases has a significant effect on quality of life. Each chapter concludes with a list of key points and a reference list; a subject index concludes the book.

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Diabetes Problem Solver Source: Alexandria, VA: American Diabetes Association. 1999. 511 p. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $19.95 for members; plus shipping and handling. ISBN: 1570400091. Summary: This book is a reference guide that helps people who have diabetes identify and prevent the most common diabetes-related problems they encounter on a daily basis. The book is divided into two major sections. The first section consists of a series of flowcharts to help readers decide what they need to do about a particular condition or symptom. Flowcharts focus on arm and hand pain, back pain, blurry vision, chest pain, confusion, convulsions or seizures, difficulty breathing, dizziness, dry skin, eating disorders, emotional problems, emotional changes in women, feeling tired, fever, foot problems, headache, hyperglycemia, hypoglycemia, injection site problems, and intestinal problems. Other flowcharts deal with leg and foot pain, loss of consciousness, muscular weakness, nausea, numbness and tingling, pain or discomfort in women, palpitations, problems with the mouth, problems with blood glucose in women, sexual problems in men and women, skin discoloration, skin lesions, skin rashes and itchy skin, sleeping problems, stomach pain, sweating, swelling, thickening of the skin, urinary problems, vision problems, and vomiting. The second section provides more detailed information about many of the problems people who have diabetes face. Solutions are provided for monitoring and testing problems; hypoglycemia and hyperglycemia problems; insulin delivery and oral medication problems; circulation, neuropathy,

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kidney, vision, gastrointestinal, infection, foot, and skin problems; men's, women's, and children's problems; eating, exercise, and weight problems; lifestyle problems; coping problems; discrimination and insurance problems; and other medical problems. Each section provides the reader with information on the symptoms of the condition, who is at risk and what risk the particular condition poses for the reader, what the reader's immediate course of action should be, treatment in a medical setting, and how to prevent the condition from developing. The reader may use the book in two ways. If the reader knows he or she has a particular condition or wants more information, he or she can go straight to the second section and look up the condition. The reader may use the book as a guide to possible conditions that may be causing symptoms by referring to the flowcharts in the first section. The book also includes a glossary, resources, and an index. 6 figures. 5 tables. •

Managing the Side Effects of Chemotherapy and Radiation Therapy: A Guide for Patients and Their Families. 3rd ed Source: San Francisco, CA: UCSF Nursing Press. 1996. 198 p. Contact: Available from UCSF Nursing Press. 521 Parnassus Avenue, Room N-535C, San Francisco, CA 94143-0608. (415) 476-4992 or (415) 476-2626. Fax (415) 476-6042. PRICE: $20.00 plus $6.00 shipping and handling. ISBN: 0943671120. Summary: This book is designed to help patients and their families learn to cope with the many side effects of cancer chemotherapy and radiation therapy. The chemotherapy section lists every frequently used cancer drug and common side effects of each. This information is first presented in chart format, then discussed in some detail. Suggestions for managing each side effect are included. The section on side effects includes a description of the problem, its likely duration, recommended self-care measures, and when to consult with a health care provider. The remainder of the book discusses the common side effects of radiation therapy, with the same type of information and in the same format. Side effects particularly relevant to the digestive system include abdominal pain, constipation, diarrhea, liver damage, sore mouth or difficulty swallowing, nausea and vomiting, and stomach irritation and ulcers. A subject index concludes the book.

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Indigestion: Living Better with Upper Intestinal Problems from Heartburn to Ulcers and Gallstones Source: New York, NY: Oxford University Press. 1992. 227 p. Contact: Available from Oxford University Press. Order Department, 2001 Evans Road, Cary, NC 27513. (800) 451-7556. Fax (919) 677-1303. PRICE: $11.95 plus shipping and handling. ISBN: 019508554X. Summary: This book offers advice on how to take care of and avoid a whole complex of disturbances categorized as indigestion. The author begins with an overview of the anatomy and physiology of digestion, including a chapter on terminology and definitions. After an additional chapter on diagnostic testing, the author turns to specific problems, including acid related problems (heartburn, esophagitis, and hiatal hernia), peptic ulcers, nonulcer dyspepsia, chest pain, gallbladder problems and gallstones, pancreatic diseases, jaundice, malabsorption and maldigestion, food intolerance and food allergies, the impact of aging on the upper digestive tract (including the role of medications and drug interactions), and the brain gut connection. The appendices of the book offer coverage of related problems, including belching, nausea and vomiting, dry mouth and bitter taste, difficulty in tasting, lump in the throat, butterflies, difficulties in

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swallowing, delayed stomach emptying, the effects of diabetes on the upper digestive system, and the controversy over yeast. The author hopes to foster a cooperative dialogue between patients and their physicians as they work together to diagnose and manage upper digestive tract problems. A subject index concludes the book. 8 figures. 6 tables. •

Irritable Bowel Syndrome and the Mind-Body Brain-Gut Connection Source: Columbus, OH: Parkview Publishing. 1997. 302 p. Contact: Available from Parkview Publishing. P.O. Box 1103, Columbus, OH 43216. (888) 599-6464 or (614) 258-4848. Fax (614) 258-7272. PRICE: $19.95. ISBN: 0965703894. Summary: This book offers readers a guide to understanding and treating their functional gastrointestinal (GI) disorders, focusing on irritable bowel syndrome (IBS). The author emphasizes the role that individuals can play in managing their own symptoms and future. The book is framed around eight steps to positive change; eight chapters cover the GI tract and the mind-body connection; the common functional GI disorders; healing with diagnosis and education; understanding one's own symptoms and GI tract; identifying gut 'triggers'; emphasizing self-care and wellness; taking action if symptoms persist; and managing the functional GI disorder. Specific topics include the interplay between stress, psychology and symptoms; colitis and inflammatory bowel disease (IBD); the International Foundation for Functional Gastrointestinal Disorders (IFFGD); self-tests for personal and psychological problems; the role of a history of abuse; cognitive behavioral factors; food and symptom diaries; food allergy versus food intolerance and sensitivity; inflammation and infection; the menstrual cycle; seasonal changes; nutrition; weight; exercise; the impact of alcohol, nicotine, and tobacco; the use of an elimination diet; stress, emotional, and psychological issues; chronic pain management; and managing the symptoms of chest pain, heartburn, dysphagia, dyspepsia, nausea, vomiting, aerophagia (burping and belching), abdominal bloating, rectal gas and flatulence, abdominal pain, diarrhea, constipation, bowel incontinence, and anal and rectal pain. The book includes black and white photographs, charts, and figures; a subject index concludes the volume.

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Eating Hints for Cancer Patients: Before, During and After Treatment Source: Bethesda, MD: National Cancer Institute (NCI), National Institutes of Health (NIH). 1999. 60 p. Contact: Available from National Cancer Institute (NCI). Publications Ordering Service, P.O. Box 24128, Baltimore, MD 21227. Voice (800) 422-6237. TTY (800) 332-8615. Fax (301) 330-7968. PRICE: Single copy free; bulk rates available. NIH Publication Number 99-2079. Summary: This booklet contains a variety of ideas about food needs and eating problems that patients undergoing cancer therapy may encounter. The authors emphasize the need for eating well during cancer treatment and outline the nutrition problems that may arise with different cancer treatments. Strategies for coping with side effects are provided for loss of appetite, sore mouth or throat, changed sense of taste or smell, dry mouth, nausea, vomiting, diarrhea, constipation, weight gain, tooth decay, and lactose intolerance. The next section provides suggestions for increasing protein and calorie intake, including the use of healthy snacks. Another section discusses diets for patients with special needs, including the clear liquid diet, full liquid diet, soft diet, fiber restricted diet, low lactose diet, and commercial products to improve nutrition. The booklet includes a glossary of related terms and the contact information for two resource

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organizations: the Cancer Information Service (800-422-6237) and the American Cancer Society (800-227-2345). The booklet then provides 40 pages of recipes designed to help patients achieve better nutrition during cancer treatment. A recipe index is provided. Colorful drawings illustrate the booklet. 8 tables. •

Keep Yourself Healthy at Home: A Guide for Adults with Diabetes Source: South Deerfield, MA: Channing L. Bete Co., Inc. 2000. 60 p. Contact: Available from Channing L. Bete, Co., Inc. 200 State Road, South Deerfield, MA 01373-0200. (800) 628-7733. Fax (800) 499-6464. PRICE: $3.50 each; plus shipping and handling; quantity discounts available. Order number 97915. Summary: This illustrated handbook provides adults who have diabetes with information on health care. Section one provides general information about health care, the prevention of health problems, and the use of diabetes and general medications. Section two discusses specific problems and their treatment, focusing on allergies, appendicitis, asthma; back pain; bites and stings; bronchitis; bruises, cuts, and scrapes; burns and sunburns; chest pain; colds, flu, and cough; constipation; diarrhea; dizziness and fainting; fever; foot and leg problems; headaches; heartburn; mouth problems; nausea and vomiting; sexual concerns; sexually transmitted diseases; skin problems; sprains and strains; urinary tract infections; and vaginitis. Section three focuses on conditions of special concern for people who have diabetes, including heart disease and stroke and eye, kidney, and nerve diseases. Section four explains how to deal with hypoglycemia and hyperglycemia and provides space for writing down emergency numbers and other emergency information.

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Clinical Practice of Gastroenterology. Volume One Source: Philadelphia, PA: Current Medicine. 1999. 783 p. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. Website: www.wbsaunders.com. PRICE: $235.00 plus shipping and handling. ISBN: 0443065209 (two volume set); 0443065217 (volume 1); 0443065225 (volume 2). Summary: This lengthy textbook brings practitioners up to date on the complexities of gastroenterology practice, focusing on the essentials of patient care. This first volume includes 86 chapters in four sections: esophagus, stomach and duodenum, small bowel, and colon. Specific topics include normal esophageal physiology, gastroesophageal reflux disease (GERD), motor disorders of the esophagus, esophageal foreign bodies, esophagitis, esophageal trauma, esophageal surgery, gastric and duodenal histology and histopathology, gastroduodenal motility and motility disorders, abdominal pain, nausea and vomiting, dyspepsia (heartburn), Helicobacter pylori, gastric and duodenal ulcer, gastric cancer, gastric infection, gastric surgery, small intestine anatomy and physiology, symptoms and signs of small bowel disease, maldigestion and malabsorption, intestinal obstruction and pseudoobstruction, immunologic disorders, small intestinal malignancies (cancer), short bowel syndrome, Whipple's disease, infectious diarrhea, parasitic diseases of the small intestine, foodborne diseases of the small intestine, gastroenteritis, Crohn's disease, anatomy and physiology of the colon, irritable bowel syndrome (IBS), secretory diarrhea, constipation and fecal impaction, fecal incontinence, gas and flatulence, gastrointestinal bleeding, colitis (including ulcerative colitis), diverticulitis and diverticular hemorrhage, appendicitis, benign tumors of the colon and polyposis syndrome, malignant tumors of the colon, and anorectal disorders. The chapters include figures, algorithms, charts, graphs,

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radiographs, endoscopic pictures, intraoperative photographs, photomicrographs, tables, and extensive references. The volume concludes with a detailed subject index and a section of color plates. •

AIDS: Nutritional Care of the Patient With AIDS Contact: Bristol Meyers Squibb Company, Mead Johnson Nutritional Group, 2400 W Lloyd Expy, Evansville, IN, 47721, (812) 429-5000, http://www.meadjohnson.com. Summary: This manual provides information on Acquired immunodeficiency syndrome (AIDS) and nutrition, and guidelines on caring for patients with nutritional problems. The first section examines the pathophysiology of nutritional complications, including anorexia, diarrhea, nausea, and metabolic disorders. The second section explains the effects that nutrition may have on the functioning of the immune system. The manual then outlines components of nutritional care, including goals and assessment. Recommendations are given on nutrients, symptom-management, food safety, and nutritional support. The manual concludes with a look at future trends in care and treatment.

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Nutrition: Your Ammunition for AIDS Contact: University of California San Diego, Medical Center, Department of Clinical Nutrition, 225 Dickinson St H-802, San Diego, CA, 92103-1990, (619) 543-3783. Summary: This monograph addresses nutritional needs, especially for persons with HIV/AIDS. It states that the best nutritional status is maintained with a well-balanced diet and an ample amount of calories to prevent weight loss. It explains that symptoms of AIDS, such as fevers, nausea, vomiting, diarrhea, candidiasis (thrush), infection, and herpetic and Kaposi's sarcoma lesions have a direct effect on specific nutritional needs and lists ways to reduce such symptoms. Eating a variety of food from the basic food groups in frequent but small amounts is also recommended. It encourages taking vitamins, minerals, protein, and calorie supplements. Difficulties with chewing, swallowing, nausea, vomiting, diarrhea, are also addressed. It offers suggestions for eliminating loss of appetite, feeling full too soon, and being too tired to cook food. It also includes intake guidelines for males, females, and vegetarians with HIV/AIDS, highcalorie recipes, and foods that can be stored for days when a person with HIV/AIDS may be too tired to cook.

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Marijuana & AIDS: Pot, Politics, & PWAs in America Contact: Galen Press, PO Box 53318, Washington, DC, 20009, (202) 483-8595. Summary: This monograph examines the controversy surrounding the use of marijuana in medical treatment for Acquired immunodeficiency syndrome (AIDS). Proponents of the controlled substance say that it alleviates nausea and increases appetite, serious symptoms that often affect persons with Human immunodeficiency virus (HIV) infection. It presents four case studies of Persons with AIDS (PWA's) who obtained legal access to marijuana for treatment, then looks at the laws and legal issues surrounding the question.

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Pass the Calories, Please! Contact: American Dietetic Association, 216 W Jackson Blvd Ste 800, Chicago, IL, 606066995, (800) 877-1600, http://www.eatright.org.

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Summary: This monograph is designed as a practical guide for people who need suggestions on ways to increase calories in their diets. Practical tips are given on how to handle conditions that prevent one from eating well, such as nausea, vomiting, diarrhea, sore or dry mouth, or a general loss of appetite. The recipes included are rich in the nutrients that may be needed at such times, including vitamins, protein, and fiber. The book also discusses eating out, commercial supplements, and food safety. •

20 Common Problems in Gastroenterology Source: New York, NY: McGraw-Hill, Inc. 2002. 317 p. Contact: Available from McGraw-Hill, Inc. 1221 Avenue of the Americas, New York, NY 10020. (612) 832-7869. Website: www.bookstore.mcgraw-hill.com. PRICE: $45.00;plus shipping and handling. ISBN: 0070220557. Summary: This text is one from a series that provides concise, practical information for health care professionals. This book focuses on the most common gastroenterological problems encountered in a primary practice setting and represents a selection of 20 clinical issues that every practitioner of primary care and general gastroenterology will encounter on a regular basis. The chapters are organized to support rapid access to the information necessary to evaluate and treat most patients with these problems. The text features three sections: general gastroenterology, gastrointestinal (GI) bleeding, and hepatic (liver) and biliary problems. Twenty chapters cover heartburn, nausea and vomiting, dysphagia (swallowing difficulties), weight loss, dyspepsia, chronic abdominal pain (functional GI disorders), acute abdominal pain, acute upper GI bleeding, acute lower GI bleeding, occult (hidden) bleeding and iron deficiency anemia, flatulence (gasiness), acute diarrhea in adults, constipation, colorectal cancer screening, anal pain, viral hepatitis, right upper quadrant pain (gallbladder disease and its complications), liver masses, abnormal liver function tests, and biliary obstruction. Each chapter includes a chapter outline for quick reference, the text itself, a diagnostic and treatment algorithm, and selected references. The text concludes with a subject index. Color photographs are provided in a special section; black and white photographs, figures, and charts illustrate the volume.

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Functional Disorders of the Gut Source: London, England: Churchill Livingstone. 1998. 370 p. Contact: Available from Harcourt Brace and Company. Foots Cray High Street, Sidcup, Kent, DA14 5 HP, United Kingdom. 02083085700. Fax 02083085702. E-mail: [email protected]. Website: www.harcourt-international.com. PRICE: $65.00 plus shipping and handling. ISBN: 0443054207. Summary: This textbook provides practical, clinical advice on the management of patients with symptoms of abnormal gastrointestinal (GI) function. Experts in the field offer information about the conflicting management options in order to support patient care. The first section of the book deals with topics, including neurobiology, that are relevant to several or perhaps all functional disorders of the gut. Topics in this section include functional anatomy and physiology, enteric neuropathobiology, clinical pharmacology (drug therapy), epidemiology (incidence and prevalence), psychopathology of functional disorders of the gut, chronic abdominal pain, and hypersensitivity and food intolerance. The remainder of the book offers two parallel tracks through the successive regions of the digestive tract. The first summarizes the present views on physiology and pathophysiology, while the second addresses the problems of clinical management. Topics in this section include the esophagus,

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including disorders of swallowing and chest pain; nausea, vomiting and other food related symptoms of stomach problems; the clinical physiology of the small bowel; the colon and anorectum, including constipation, urgency, and pain syndromes; the clinical management of irritable bowel syndrome (IBS); and the symptoms and management of biliary tract problems. The text concludes with a postscript chapter summarizing both the changes and the consistencies in the field of functional bowel disorders. Each chapter concludes with numerous references, and a subject index concludes the volume. Drawings, charts, and reproductions are in black and white.

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

Cancer Treatment & Marijuana Therapy: Marijuana's Use in the Reduction of Nausea and Vomiting and for Appetite Stimulation in Cancer Patients. Testimony from Historic Federal Hearings on m (Marijuana, Medicine & the Law Series) by R. C. Randall (Editor); ISBN: 0936485051; http://www.amazon.com/exec/obidos/ASIN/0936485051/icongroupinterna

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Demons, Nausea, and Resistance in the Autobiography of Isabel De Jesus: 1611-1682 by Sherry M. Velasco, Sherry M. Valasco; ISBN: 0826316646; http://www.amazon.com/exec/obidos/ASIN/0826316646/icongroupinterna

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Hamlet and Man's Being: The Phenomenology of Nausea by Robert W. Luyster; ISBN: 0819137812; http://www.amazon.com/exec/obidos/ASIN/0819137812/icongroupinterna

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Jean-Paul Sartre's Existentialism in 'Nausea' by Jean Paul; ISBN: 0865781079; http://www.amazon.com/exec/obidos/ASIN/0865781079/icongroupinterna

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Key Aspects of Comfort: Management of Pain, Fatigue, and Nausea (Disseminating Nursing Research) by Sandra G. Funk (Editor), et al; ISBN: 0826167608; http://www.amazon.com/exec/obidos/ASIN/0826167608/icongroupinterna

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Love & Nausea by David Wilson; ISBN: 0349107807; http://www.amazon.com/exec/obidos/ASIN/0349107807/icongroupinterna

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Mechanisms & Management of Nausea & Emesis Associated With Cancer Therapy (Oncology) by M. Dicato (Editor); ISBN: 3805563353; http://www.amazon.com/exec/obidos/ASIN/3805563353/icongroupinterna

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Nausea by Jean-Paul Sartre, et al; ISBN: 0811201880; http://www.amazon.com/exec/obidos/ASIN/0811201880/icongroupinterna

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Nausea and Vomiting; ISBN: 3540154361; http://www.amazon.com/exec/obidos/ASIN/3540154361/icongroupinterna

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Nausea and Vomiting in Pregnancy -- An Integrated Approach to Management by Denise Tiran, Julian Woolfson; ISBN: 0443073929; http://www.amazon.com/exec/obidos/ASIN/0443073929/icongroupinterna

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Nausea and Vomiting of Pregnancy: State of the Art 2000 (Vol. 1) by MD, FACCT, FRCPC Gideon Koren (Editor), MD, MSc, DCH Raafat Bishai (Editor); ISBN: 0968659802; http://www.amazon.com/exec/obidos/ASIN/0968659802/icongroupinterna

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Nausea and Vomiting: Mechanisms and Treatment (Advances in Applied Neurological Sciences, Vol 3) by C.J. Davis, et al; ISBN: 0387154361; http://www.amazon.com/exec/obidos/ASIN/0387154361/icongroupinterna

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Nausea and Vomiting: Overview, Challenges, Practical Treatments and New Perspectives by W. Leroy Heinrichs, et al; ISBN: 1861560796; http://www.amazon.com/exec/obidos/ASIN/1861560796/icongroupinterna

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Nausea and Vomiting: Recent Research and Clinical Advances by John Kucharczyk, et al; ISBN: 0849367816; http://www.amazon.com/exec/obidos/ASIN/0849367816/icongroupinterna

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Nausea: The Wall and Other Stories by Jean-Paul Sartre, Lloyd Alexander (Translator); ISBN: 1567313345; http://www.amazon.com/exec/obidos/ASIN/1567313345/icongroupinterna

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The Handbook of Nausea and Vomiting by Marvin H. Sleisenger (Editor); ISBN: 1850705283; http://www.amazon.com/exec/obidos/ASIN/1850705283/icongroupinterna

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Treatment of cancer chemotherapy-induced nausea and vomiting; ISBN: 0893521531; http://www.amazon.com/exec/obidos/ASIN/0893521531/icongroupinterna

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Understanding and Management of Nausea and Vomiting by Jan Hawthorn; ISBN: 0632038195; http://www.amazon.com/exec/obidos/ASIN/0632038195/icongroupinterna

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Vertigo, Nausea, Tinnitus and Hearing Loss in Central and Peripheral Vestibular Diseases by Neurootological and Equilibriometric Society Scientific Meeting 1995, et al; ISBN: 0444821937; http://www.amazon.com/exec/obidos/ASIN/0444821937/icongroupinterna

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Vertigo, Nausea, Tinnitus, and Hypoacusia Due to Head and Neck Trauma: Proceedings of the Xviith Scientific Meeting of the Neurootological and Equil by Claus-Frenz Claussen, Milind V. Kirtane (Editor); ISBN: 0444811508; http://www.amazon.com/exec/obidos/ASIN/0444811508/icongroupinterna

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Vertigo, Nausea, Tinnitus, and Hypoacusia in Metabolic Disorders: Proceedings (International Congress Series, No 791) by Claus-Frenz Claussen, et al; ISBN: 0444810242; http://www.amazon.com/exec/obidos/ASIN/0444810242/icongroupinterna

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

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

Approach to the Patient with Nausea and Vomiting Source: in Textbook of Gastroenterology. 4th ed. [2-volume set]. Hagerstown, MD: Lippincott Williams and Wilkins. 2003. p. 760-780. Contact: Available from Lippincott Williams and Wilkins. P.O. Box 1600, Hagerstown, MD 21741. (800) 638-6423. Fax: (301) 223-2400. Website: www.lww.com. PRICE: $289.00. ISBN: 781728614. Summary: Nausea and vomiting are nonspecific symptomatic responses to a variety of conditions. This chapter on the approach to patients with nausea and vomiting is from a lengthy, two-volume textbook that integrates the various demands of science, technology, expanding information, good judgment, and common sense into the diagnosis and management of gastrointestinal patients. Topics include the socioeconomic impact, pathophysiology, differential diagnosis, history and physical examination, laboratory studies and diagnostic testing, and principles of management. The author notes that the care of the patient with nausea and vomiting involves assessment of the etiology and the severity of the condition, with prompt initiation of therapy to prevent complications. 3 figures. 4 tables. 282 references.

•

Gastroparesis, Nausea, and Vomiting Source: in Lewis, J.H., ed. Pharmacologic Approach to Gastrointestinal Disorders. Baltimore, MD: Williams and Wilkins. 1994. p. 131-162. Contact: Available from Williams and Wilkins. 351 West Camden Street, Baltimore, MD 21201-2436. (800) 638-0672 or (410) 528-4000. Fax (410) 528-4414. PRICE: $85 (as of 1995). ISBN: 0683049704. Summary: This chapter, from a book on the pharmacologic approach to gastrointestinal disorders, explains gastroparesis, nausea, and vomiting. The author reviews the normal regulation of gastric motility and the mechanism of emesis production and covers diseases that may benefit from treatment including peptic ulcer disease, diabetes, collagen diseases, anorexia nervosa, postoperative ileus, tachygastria, short bowel syndrome, and pernicious anemia. The author also describes medications available for the treatment of vomiting and gastric stasis, including anticholinergic and cholinomimetic agents, histamine receptor antagonists, neuroleptic drugs, adrenergic blocking drugs, substituted benzamides acting at multiple receptor sites, dopamine antagonists, 5-HT3-receptor antagonists, specific 5-HT4-receptor agonists, opioid agonists and antagonists, and motilin analogs. 2 figures. 3 tables. 244 references. (AAM).

Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to nausea have been published that consolidate information across

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various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:11 •

Directory of Plain Language Health Information Source: Ottawa, Ontario: Canadian Public Health Association. 1999. 104 p. Contact: Available from Canadian Public Health Association. 400-1565 Carling Avenue, Ottawa, Ontario, K1Z 8R1. (613) 725-3769. Fax (613) 725-9826. E-mail: [email protected]. PRICE: $19.95 plus shipping and handling. Also available at www.pls.cpha.ca for free. ISBN: 189432403X. Summary: Patient education materials are often written at a level that is higher than the reading level of the people who need the materials. This directory lists 'plain language' patient education materials. An extensive introductory chapter in the directory describes how patient education materials are evaluated and offers specific information about the best strategies to create plain language materials. Each piece of health information in the directory is rated according to its design assessment, in order to help readers make informed decisions about choosing materials. Part I is a list of health subjects presented in alphabetical order, in the style of a typical index. The page number after a listing notes where to find that piece of health information in Part II. Part II is a list of organizations and their contact information. Below the contact information is a list of the plain language health titles produced by the organization. Each title is grouped under a grade level heading, is numbered, and has a design rating. Part III is an alphabetical list of all the organizations in Part II. Materials related to digestive system diseases include allergies, constipation and soiling in children, cholesterol, hepatitis, constipation, diabetes and diet therapy, exercise for weight control, food choices, nutrition, heart health, immunization, low fat cooking, nausea, vomiting, diarrhea, smoking, and weight loss. Appendices to the directory include a guide to the S.M.O.G. readability formula, clear design tips, and plain language tips. The Directory is also available at www.pls.cpha.ca on the Internet.

11

You will need to limit your search to “Directory” and “nausea” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “nausea” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months.

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CHAPTER 8. MULTIMEDIA ON NAUSEA Overview In this chapter, we show you how to keep current on multimedia sources of information on nausea. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on nausea is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “nausea” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “nausea” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on nausea: •

Goodbye Gallstones Source: Madison, WI: University of Wisconsin Hospitals and Clinics, Department of Outreach Education. 1995. (videocassette). Contact: Available from University of Wisconsin Hospital and Clinics. Picture of Health, 702 North Blackhawk Avenue, Suite 215, Madison, WI 53705-3357. (800) 757-4354 or (608) 263-6510. Fax (608) 262-7172. PRICE: $19.95 plus shipping and handling; bulk copies available. Order number 020195A. Summary: More than one million people will discover they have gallstones this year, and most will be women. Not all gallstones cause problems, but when they do, a variety of treatments are available. This videotape is one in a series of health promotion programs called 'Picture of Health,' produced by the University of Wisconsin. In this program, moderated by Mary Lee and featuring Dr. Eberhard Mack, the common symptoms, diagnosis, and management of gallstones are covered. Dr. Mack introduces the function of the gallbladder as a storage bag for bile, which is a 'detergent' produced

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by the liver that is used for digestion. Dr. Mack shows an illustration of the anatomy of the gastrointestinal tract, including the gallbladder, and describes where gallstones tend to form. Dr. Mack then shows actual gallstones, one a cholesterol stone, one a black pigment stone, and describes how gallstones form and the speed of growth of different types of stones. Risk factors for gallstones include being gender, being over 40, having a fair complexion (genetics), having a familial tendency, losing weight rapidly, and giving birth to many children. Symptoms include sudden onset of pain in the upper right quadrant of the abdomen, sometimes accompanied by nausea or vomiting. The pain is usually one to two hours in duration, as the gallstone passes. Some people have gallstones that are asymptomatic. Diagnostic considerations include patient history, abdominal film (xray), ultrasound, and cardiovascular testing (to rule out cardiovascular disease). Dr. Mack reviews the complications of gallstones, including gallstone pancreatitis, acute cholecystitis (infection of the gallbladder), hydrops, and jaundice. The program concludes by describing the use of open cholecystectomy, using a mini incision technique, and the use of laparoscopic cholecystectomy; Dr. Mack demonstrates the instruments used for the latter technique. The program concludes by referring viewers to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). •

Someone You Know Source: Jenkintown, PA: Hepatitis B Foundation. 1997. (videocassette). Contact: Available from Hepatitis B Foundation. 101 Greenwood Avenue, Suite 570, Jenkintown, PA 19046. (215) 884-8786. Fax (215) 887-1931. E-mail: [email protected]. Website: http://www.hepb.org. PRICE: $6.00 for shipping. Summary: This general health education videotape program educates viewers about the hepatitis B virus (HBV) and its present status as an 'epidemic' in the U.S. The program begins with a brief overview of liver functions (energy generation, detoxification of drugs and poisons, and making blood proteins and clotting factors) and the pathology caused by HBV infections. The program stresses that there is no cure for hepatitis B, although a preventive vaccine is available. Dr. Thomas London reviews the symptoms of acute illness, including nausea, vomiting, fever, jaundice, and extreme fatigue; and explains how the virus is transmitted through blood contact (including that from sharing toothbrushes or razors), through sexual contact, and from infected mother to her child during childbirth. Other topics covered include child care issues, the use of universal precautions, classroom supplies to prevent transmission, the percentages of infected persons who go on to chronic carrier status, the role of the World Health Organization, the long term complications of carrying HBV, and the costs of health care associated with HBV. The program includes an interview with Dr. Baruch Blumberg, the scientist who won the Nobel prize for developing the HBV vaccine. Another physician interviewed, Dr. Timothy Block, emphasizes the importance of universal immunization, the problems with assuming safety if one is not a member of a supposed 'high risk' group, and the need for chronic carriers to take very good care of their health and be screened twice per year to prevent morbidity and mortality. The program features numerous interviews with patients who are chronic carriers of HBV; they focus on the psychosocial aspects, including the stigma of having the disease, the long-term effects of constant fatigue, and worries about infecting their children and loved ones. The program concludes with a brief summary of the Hepatitis B Foundation.

•

Preparing for an Upper GI Endoscopy: A Patient's Perspective Source: Research Triangle Park, NC: Glaxo. 1994.

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Contact: Available from Glaxo. Educational Resource Center, Five Moore Drive, Research Triangle Park, NC 27709. (800) 334-0032 or (919) 248-2100. PRICE: Single copy free. Available to health professionals only. Summary: This patient education videotape provides information for the person about to undergo a upper gastrointestinal (GI) endoscopic procedure. After brief definitions of endoscopy and the role of the gastroenterologist, the video addresses the anatomy and physiology of the upper GI tract, including the esophagus and duodenum; earlier diagnostic tests, including barium enema and x-rays; a description of the endoscope; indications for upper GI endoscopy, including pain, nausea, vomiting, swallowing difficulties, and diagnosing and treating active bleeding; preoperative considerations, including the patient consent form, a review of the procedure, and the IV prep, including sedative; the procedure itself, including throat anesthetic, the use of a mouthpiece, and biopsy; postoperative considerations, including the recovery room and instructions for home; and complications of the procedure. The videotape includes footage of the procedure itself, depictions of the doctor and patient, anatomical drawings, and photographs. •

Good Nutrition for People With HIV/AIDS Contact: Bristol Myers Squibb Company, Secure the Future, 345 Park Ave, New York, NY, 10154, (212) 546-4343, http://www.securethefuture.com/. Summary: This video explains the role that good nutrition plays in the management of HIV/AIDS. HIV/AIDS patients need adequate germ-free foods and fluids to help their bodies counteract infection-related energy loss and weakened immune systems. The video demonstrates utensil and surface care, as well as cleaning and preparation. Foods to avoid (such as shellfish and raw fish products) are listed, and the correct amounts of protein, carbohydrates, calories, and fluids are discussed. Extra calories can be obtained through the intake of canned food supplements, and important electrolytes can be refurbished with sports drinks and electrolyte-replenishing beverages. In some cases, HIV/AIDS patients will use an appetite stimulant before meals to increase and enhance their appetite. A variety of other issues are covered, including dehydration, nausea/vomiting, diarrhea, exercise, and vitamin supplements.

•

Nutrition and HIV Contact: Pyramid Media, PO Box 1048, Santa Monica, CA, 90406-1048, (310) 828-7577, http://www.pyramidmedia.com. Summary: This videorecording, divided into four sections, talks about the importance of nutrition to persons with HIV infection. Hosted by Dr. Larry Waites and Laurie Miello, a registered dietitian, it emphasizes the point that studies have shown a connection between nutrition and the progression of the illness. The first section looks at nutrition, weight loss, and the function of the immune system. The videorecording says that persons with AIDS (PWAs) have increased metabolic function and increased nutritional needs. The second section examines ways to change eating habits to overcome such symptoms as diarrhea, nausea, and appetite loss. It suggests foods to eat and foods to avoid. Next, the third section explains methods of defensive eating. It looks at ways to prepare foods safely. Finally, the videorecording mentions the concept of Total Parenteral Nutrition (TPN), which is receiving all the carbohydrates, fats, proteins, vitamins, and minerals necessary through intravenous feeding.

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•

AIDS: A Matter of Life Contact: Philadelphia Department of Public Health, AIDS Activities Coordinating Office, 1101 Market 9th Fl, Philadelphia, PA, 19107, (215) 685-5600, http://www.phila.gov/departments/health/AIDS/AIDS.html. Summary: Through interviews with Persons with AIDS (PWA's) from diverse backgrounds, this videorecording presents a macroview of Human immunodeficiency virus (HIV) transmission. It examines the physical, emotional, and psychological implications of the disease for patients and family. The videorecording addresses modes of contagion involving needle sharing, bisexual and multiple sex partners, and blood transfusions. It also stresses methods of prevention including safer sexual conduct and use of condoms. It mentions symptoms and illnesses that arise from the Acquired immunodeficiency syndrome (AIDS), such as nausea and fatigue, often followed by brain damage, pneumonia, and thrush. The role of the church as a support system is also examined.

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CHAPTER 9. PERIODICALS AND NEWS ON NAUSEA Overview In this chapter, we suggest a number of news sources and present various periodicals that cover nausea.

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

MGI Pharma sees nausea drug sales above forecast Source: Reuters Industry Breifing Date: March 17, 2004

•

New drug sharply cuts nausea after chemotherapy Source: Reuters Medical News Date: October 15, 2003

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•

Drug sharply cuts nausea after chemotherapy Source: Reuters Industry Breifing Date: October 15, 2003

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Next-generation mobile signals shown to cause nausea, headache Source: Reuters Medical News Date: September 30, 2003

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FDA approves MGI Pharma, Helsinn anti-nausea drug Source: Reuters Industry Breifing Date: July 25, 2003

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Electrical stimulation of median nerve relieves nausea, vomiting of pregnancy Source: Reuters Industry Breifing Date: June 30, 2003

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Glaxo injectable nausea drug faces generic Source: Reuters Industry Breifing Date: May 07, 2003

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Merck wins U.S. nod for nausea therapy Source: Reuters Industry Breifing Date: March 26, 2003

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FDA publishes notice on unapproved versions of nausea therapy Source: Reuters Industry Breifing Date: December 26, 2002 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 “nausea” (or synonyms) into the search box, and click on “Search News.” As this service is technology

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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 “nausea” (or synonyms). If you know the name of a company that is relevant to nausea, 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 “nausea” (or synonyms).

Newsletters on Nausea Find newsletters on nausea using the Combined Health Information Database (CHID). You will need to use the “Detailed Search” option. To access CHID, go to the following hyperlink: http://chid.nih.gov/detail/detail.html. Limit your search to “Newsletter” and “nausea.” Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter.” Type “nausea” (or synonyms) into the “For these words:” box. The following list was generated using the options described above: •

Kidney Disease Source: Sarcoidosis Networking. 8(3): 2. May-June 2000. Contact: Available from Sarcoid Network Association. Sarcoidosis Networking, 13925 80th Street East, Puyallup, WA 98372-3614. Email: [email protected]. Summary: Sarcoidosis is a chronic, progressive systemic granulomatous (causing lesions) disease of unknown cause (etiology), involving almost any organ or tissue, including the skin, lungs, lymph nodes, liver, spleen, eyes, and small bones of the hands or feet. This brief article, from a newsletter for patients with sarcoidosis, reviews kidney disease, its types, diagnosis, and management. The article begins with a summary of the anatomy and function of the kidneys, which filter the blood (removing waste and excess body fluids), and maintain the balance of some essential nutrients helping to regulate blood pressure, red blood cells, and elements such as potassium and calcium. Without functioning kidneys, one cannot live without dialysis, the mechanical filtration of the blood. Kidneys fail for a variety of reasons, including trauma to the kidney, toxins, heart failure, obstruction (kidney stones), overuse of some medications, and diseases that invade the kidney, such as sarcoidosis. Diabetes and high blood pressure are the most common causes for loss of kidney function. Warning signs of kidney disease are high blood pressure (hypertension), blood or protein in the urine, creatinine level greater

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than 1.2 in women or 1.4 in men, more frequent urination (especially at night), difficult or painful urination, and puffy eyes or swelling of the hands or feet (especially in children). Loss of kidney function can produce symptoms including fatigue, weakness, nausea, vomiting, diarrhea or constipation, headaches, loss of appetite, increased edema (fluid retention), and fever or chills. Kidney failure is characterized as acute kidney failure, chronic kidney insufficiency, and chronic kidney failure. The need to put a person on dialysis depends upon the levels of creatinine and urea nitrogen in the blood and the evaluation of body parameters such as fluid status, and symptoms of toxicity. The author encourages readers to practice preventive measures which include drinking 8 to 10 glasses of water per day, preventing or treating diabetes and high blood pressure, avoiding tobacco, eating a well balanced diet, practicing good hygiene, treating wounds and infections, limiting exposure to heavy metals and toxic chemicals, and avoiding unnecessary over the counter drug use. •

Special Edition: 1992 NAPPS/Creighton Symposium Source: Medford, MA: North American Pediatric Pseudo-obstruction Society. 1992. 12 p. Contact: Available from APHS. 158 Pleasant Street, North Andover, MA 01845-2797. (508) 685-4477. Fax (508) 685-4488. E-mail: [email protected]. Summary: This special edition of the American Pseudo-obstruction and Hirschsprung's Disease Society's (formerly the North American Pediatric Pseudo-obstruction Society) newsletter reports on the symposium 'Gastrointestinal Motility Disorders in Children and the Role of Intestinal Transplantation,' held in April 1992 in Omaha, NE. During the 2-day conference, there were 23 guest lecturers and 4 panel discussions. Topics in these sessions include parent-child interaction, psychosocial issues of hospitalization and home care, the parents' role as members of their child's health care team, misdiagnosis of motility disorders, small bowel transplants, ethical and legal issues, upper gastrointestinal motility disorders, the regulation of gastric emptying and lower esophageal sphincter function, current concepts in dual pH monitoring, cyclic nausea and vomiting and Munchausen Syndrome by Proxy, small intestinal motility in neonates and preterm infants, classification and histopathology of pseudo-obstruction syndromes, pharmacotherapy, the history of transplantation, clinical management issues, and intestinal motility following transplantation. The newsletter includes photographs of the speakers and comments from the evaluation forms completed by attendees.

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “nausea” (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 nausea: •

Study Suggests Anti-Nausea Drug May Treat Bulimia Source: WIN Notes. p. 6. Fall 2000.

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Contact: Weight-control Information Network. 1-877-WIN-4627. Summary: Odansetron, used for the prevention of nausea and vomiting caused by cancer chemotherapy, may be helpful in the treatment of bulimia nervosa. A study by Dr. Patricia L. Faris and coworkers from the University of Minneapolis Medical School published in the March 4, 2000, issue of The Lancet reports the study in which 26 patients with bulimia nervosa were given either odansetron or a placebo. Results indicated a significant improvement in the odansetron group. The binge/vomit episodes averaged 13.2 per week in the placebo group versus 6.5 per week in the drug group. The odansetron group demonstrated improvement in the number of normal meals and snacks eaten and a decrease in the time spent in bulimic behaviors. However, questions remain about odansetron as a treatment option for bulimia. Long-term safety has not been established, and it does not improve other bulimic symptoms such as poor body image or depression. The article notes the need for further research before odansetron is recommended for the treatment of bulimia.

Academic Periodicals covering Nausea Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to nausea. In addition to these sources, you can search for articles covering nausea that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for nausea. 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 nausea. 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 nausea: Allopurinol •

Systemic - U.S. Brands: Aloprim; Zyloprim http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202021.html

Altretamine •

Systemic - U.S. Brands: Hexalen http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202634.html

Aminoglutethimide •

Systemic - U.S. Brands: Cytadren http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202026.html

Anastrozole •

Systemic - U.S. Brands: Arimidex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203659.html

Androgens and Estrogens •

Systemic - U.S. Brands: Andrest 90-4; Andro-Estro 90-4; Androgyn L.A.; DeComberol; Deladumone; Delatestadiol; depAndrogyn; Depo-Testadiol; Depotestogen; Duo-Cyp; Duo-Gen L.A.; Dura-Dumone 90/4; Duratestin; Estratest; Estratest H.S.; Halodrin; Menoject-L.A.; OB http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202037.html

Anticholinergics/Antispasmodics •

Systemic - U.S. Brands: Anaspaz; A-Spas S/L; Banthine; Bentyl; Cantil; Cystospaz; Cystospaz-M; Donnamar; ED-SPAZ; Gastrosed; Homapin; Levbid; Levsin; Levsin/SL; Levsinex Timecaps; Pro-Banthine; Quarzan; Robinul; Robinul Forte; Symax SL; Transderm-Scop http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202049.html

Antidiabetic Agents, Sulfonylurea •

Systemic - U.S. Brands: Amaryl; DiaBeta; Diabinese; Dymelor; Glucotrol; Glucotrol XL; Glynase PresTab; Micronase; Orinase; Tolinase http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202742.html

Antihistamines •

Systemic - U.S. Brands: Aller-Chlor; AllerMax Caplets; Aller-med; Atarax; Banophen; Banophen Caplets; Benadryl; Benadryl Allergy; Bromphen; Calm X; Chlo-Amine; Chlorate; Chlor-Trimeton; Chlor-Trimeton Allergy; Chlor-Trimeton Repetabs; Claritin; Claritin Reditabs; Compoz; Conta http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202060.html

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Antihistamines, Phenothiazine-Derivative •

Systemic - U.S. Brands: Anergan 25; Anergan 50; Antinaus 50; Pentazine; Phenazine 25; Phenazine 50; Phencen-50; Phenergan; Phenergan Fortis; Phenergan Plain; Phenerzine; Phenoject-50; Pro-50; Promacot; Pro-Med 50; Promet; Prorex-25; Prorex-50; Prothazine; Prothazine Plain http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202063.html

Anti-Inflammatory Drugs, Nonsteroidal •

Systemic - U.S. Brands: Actron; Advil; Advil Caplets; Advil, Children's; Aleve; Anaprox; Anaprox DS; Ansaid; Bayer Select Ibuprofen Pain Relief Formula Caplets; Cataflam; Clinoril; Cotylbutazone; Cramp End; Daypro; Dolgesic; Dolobid; EC-Naprosyn; Excedrin IB http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202743.html

Asparaginase •

Systemic - U.S. Brands: Elspar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202072.html

Azathioprine •

Systemic - U.S. Brands: Imuran http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202077.html

Benzodiazepines •

Systemic - U.S. Brands: Alprazolam Intensol; Ativan; Dalmane; Diastat; Diazepam Intensol; Dizac; Doral; Halcion; Klonopin; Librium; Lorazepam Intensol; Paxipam; ProSom; Restoril; Serax; Tranxene T-Tab; Tranxene-SD; Tranxene-SD Half Strength; Valium; Xanax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202084.html

Bethanechol •

Systemic - U.S. Brands: Duvoid; Urabeth; Urecholine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202090.html

Bismuth Subsalicylate •

Oral - U.S. Brands: Bismatrol; Pepto-Bismol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202092.html

Bleomycin •

Systemic - U.S. Brands: Blenoxane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202093.html

Bromocriptine •

Systemic - U.S. Brands: Parlodel http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202094.html

Busulfan •

Systemic - U.S. Brands: Busulfex; Myleran http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202101.html

200 Nausea

Carbamazepine •

Systemic - U.S. Brands: Atretol; Carbatrol; Epitol; Tegretol; Tegretol-XR http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202111.html

Carbonic Anhydrase Inhibitors •

Systemic - U.S. Brands: Ak-Zol; Daranide; Dazamide; Diamox; Diamox Sequels; MZM; Neptazane; Storzolamide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202114.html

Carboplatin •

Systemic - U.S. Brands: Paraplatin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202115.html

Carmustine •

Systemic - U.S. Brands: BiCNU http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202117.html

Chlorambucil •

Systemic - U.S. Brands: Leukeran http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202124.html

Cisplatin •

Systemic - U.S. Brands: Platinol; Platinol-AQ http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202143.html

Cladribine •

Systemic - U.S. Brands: Leustatin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202699.html

Clomiphene •

Systemic - U.S. Brands: Clomid; Milophene; Serophene http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202151.html

Conjugated Estrogens and Medroxyprogesterone for Ovarian Hormone Therapy (OHT) •

Systemic - U.S. Brands: Premphase; Prempro http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/209441.html

Cromolyn •

Oral - U.S. Brands: Gastrocrom http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202169.html

Cyclophosphamide •

Systemic - U.S. Brands: Cytoxan; Neosar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202174.html

Cytarabine •

Systemic - U.S. Brands: Cytosar-U http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202177.html

Researching Medications

Cytarabine, Liposomal •

Intrathecal - U.S. Brands: DepoCyt http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500008.html

Dacarbazine •

Systemic - U.S. Brands: DTIC-Dome http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202178.html

Dactinomycin •

Systemic - U.S. Brands: Cosmegen http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202179.html

Daunorubicin •

Systemic - U.S. Brands: Cerubidine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202183.html

Daunorubicin, Liposomal •

Systemic - U.S. Brands: DaunoXome http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203539.html

Didanosine •

Systemic - U.S. Brands: Videx http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202616.html

Diuretics, Loop •

Systemic - U.S. Brands: Bumex; Edecrin; Lasix; Myrosemide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202205.html

Diuretics, Potassium-Sparing •

Systemic - U.S. Brands: Aldactone; Dyrenium; Midamor http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202206.html

Diuretics, Potassium-Sparing, and Hydrochlorothiazide •

Systemic - U.S. Brands: Aldactazide; Dyazide; Maxzide; Moduretic; Spirozide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202207.html

Docetaxel •

Systemic - U.S. Brands: Taxotere http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202920.html

Dolasetron •

Systemic - U.S. Brands: Anzemet http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203375.html

Doxorubicin •

Systemic - U.S. Brands: Rubex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202209.html

201

202 Nausea

Doxorubicin, Liposomal •

Systemic - U.S. Brands: Doxil http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203540.html

Dronabinol •

Systemic - U.S. Brands: Marinol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202210.html

Droperidol •

Systemic - U.S. Brands: Inapsine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203411.html

Epirubicin •

Systemic - U.S. Brands: Ellence http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500038.html

Ergotamine, Belladonna Alkaloids, and Phenobarbital •

Systemic - U.S. Brands: Bellergal-S http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202217.html

Estrogens •

Systemic - U.S. Brands: Alora; Aquest; Climara; Clinagen LA 40; Delestrogen; depGynogen; Depo-Estradiol; Depogen; Dioval 40; Dioval XX; Dura-Estrin; Duragen-20; E-Cypionate; Estinyl; Estrace; Estraderm; Estragyn 5; Estragyn LA 5; Estra-L 40; Estratab; Estro-A; Estro-Cyp http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202226.html

Estrogens and Progestins (Ovarian Hormone Therapy) •

Systemic - U.S. Brands: Activella; femhrt; Ortho-Prefest http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500070.html

Estrogens and Progestins Oral Contraceptives •

Systemic - U.S. Brands: Alesse; Brevicon; Demulen 1/35; Demulen 1/50; Desogen; Estrostep; Estrostep Fe; Genora 0.5/35; Genora 1/35; Genora 1/50; Intercon 0.5/35; Intercon 1/35; Intercon 1/50; Jenest; Levlen; Levlite; Levora 0.15/30; Lo/Ovral; Loestrin 1.5/30; Loestrin 1/20 http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202228.html

Etoposide •

Systemic - U.S. Brands: Etopophos; Toposar; VePesid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202234.html

Floxuridine •

Systemic - U.S. Brands: FUDR http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202241.html

Flucytosine •

Systemic - U.S. Brands: Ancobon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202243.html

Researching Medications

203

Fludarabine •

Systemic - U.S. Brands: Fludara http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202630.html

Fluorouracil •

Systemic - U.S. Brands: Adrucil http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202245.html

Fructose, Dextrose, and Phosphoric Acid •

Oral - U.S. Brands: Emetrol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202251.html

Gemcitabine •

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

Granisetron •

Systemic - U.S. Brands: Kytril http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202724.html

Haloperidol •

Systemic - U.S. Brands: Haldol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202278.html

Headache Medicines, Ergot Derivative-Containing •

Systemic - U.S. Brands: Cafergot; Cafertine; Cafetrate; D.H.E. 45; Ercaf; ErgoCaff; Ergomar; Ergostat; Gotamine; Migergot; Wigraine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202216.html

Hydroxyurea •

Systemic - U.S. Brands: Droxia; Hydrea http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202291.html

Idarubicin •

Systemic - U.S. Brands: Idamycin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202611.html

Ifosfamide •

Systemic - U.S. Brands: IFEX http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202293.html

Insulin •

Systemic - U.S. Brands: Humulin 50/50; Humulin 70/30; Humulin 70/30 Pen; Humulin L; Humulin N; Humulin N Pen; Humulin R; Humulin R, Regular U500 (Concentrated); Humulin U; Lente; Lente Iletin II; Novolin 70/30; Novolin 70/30 PenFill; Novolin 70/30 Prefilled; Novolin L http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203298.html

204 Nausea

Irinotecan •

Systemic - U.S. Brands: Camptosar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203051.html

Laxatives •

Oral - U.S. Brands: Afko-Lube; Afko-Lube Lax 40; Agoral Marshmallow; Agoral Raspberry; Alaxin; Alophen; Alphamul; Alramucil Orange; Alramucil Regular; Bilagog; Bilax; Bisac-Evac; Black-Draught; Black-Draught Lax-Senna; Carter's Little Pills; Cholac; Chronulac; Cillium http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202319.html

Lomustine •

Systemic - U.S. Brands: CeeNU http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202331.html

Mechlorethamine •

Systemic - U.S. Brands: Mustargen http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202341.html

Meclizine/Buclizine/Cyclizine •

Systemic - U.S. Brands: Antivert; Antivert/25; Antivert/50; Bonine; Dramamine II; Marezine; Meclicot; Medivert http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202343.html

Melphalan •

Systemic - U.S. Brands: Alkeran http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202345.html

Metformin •

Systemic - U.S. Brands: Glucophage http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202756.html

Methenamine •

Systemic - U.S. Brands: Hiprex; Mandelamine; Urex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202354.html

Methotrexate for Noncancerous Conditions •

Systemic - U.S. Brands: Folex; Rheumatrex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202356.html

Methysergide •

Systemic - U.S. Brands: Sansert http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202363.html

Metoclopramide •

Systemic - U.S. Brands: Octamide; Reglan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202364.html

Researching Medications

Metronidazole •

Systemic - U.S. Brands: Flagyl; Protostat http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202365.html

Mitomycin •

Systemic - U.S. Brands: Mutamycin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202376.html

Mitoxantrone •

Systemic - U.S. Brands: Novantrone http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202378.html

Naratriptan •

Systemic - U.S. Brands: Amerge http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203513.html

Niacin (Vitamin B 3 ) •

Systemic - U.S. Brands: Endur-Acin; Nia-Bid; Niac; Niacels; Niacor; Nico-400; Nicobid Tempules; Nicolar; Nicotinex Elixir; Slo-Niacin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202405.html

Niacin for High Cholesterol •

Systemic - U.S. Brands: Endur-Acin; Nia-Bid; Niac; Niacels; Niacor; Nico-400; Nicolar; Slo-Niacin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202404.html

Ondansetron •

Systemic - U.S. Brands: Zofran http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202424.html

Paclitaxel •

Systemic - U.S. Brands: Taxol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202682.html

Pegaspargase •

Systemic - U.S. Brands: Oncaspar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203543.html

Penicillins and Beta-Lactamase Inhibitors •

Systemic - U.S. Brands: Augmentin; Timentin; Unasyn; Zosyn http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202705.html

Pentostatin •

Systemic - U.S. Brands: Nipent http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202650.html

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206 Nausea

Phenothiazines •

Systemic - U.S. Brands: Chlorpromazine Hydrochloride Intensol; Compazine; Compazine Spansule; Mellaril; Mellaril Concentrate; Mellaril-S; Permitil; Permitil Concentrate; Prolixin; Prolixin Concentrate; Prolixin Decanoate; Prolixin Enanthate; Serentil; Serentil Concentrate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202457.html

Plicamycin •

Systemic - U.S. Brands: Mithracin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202467.html

Potassium Iodide •

Systemic - U.S. Brands: Pima http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202472.html

Potassium Supplements •

Systemic - U.S. Brands: Cena-K; Effer-K; Gen-K; Glu-K; K+ 10; K+ Care; K+ Care ET; K-8; Kaochlor 10%; Kaochlor S-F 10%; Kaon; Kaon-Cl; Kaon-Cl 20% Liquid; Kaon-Cl-10; Kato; Kay Ciel; Kaylixir; K-Dur; K-Electrolyte; K-G Elixir; K-Ide; KLease; K-Lor; Klor-Con 10; Klor-Con 8 http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202473.html

Probenecid •

Systemic - U.S. Brands: Benemid; Probalan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202480.html

Probenecid and Colchicine •

Systemic - U.S. Brands: ColBenemid; Col-Probenecid; Proben-C http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202481.html

Procarbazine •

Systemic - U.S. Brands: Matulane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202484.html

Rauwolfia Alkaloids •

Systemic - U.S. Brands: Harmonyl; Raudixin; Rauval; Rauverid; Serpalan; Wolfina http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202503.html

Rauwolfia Alkaloids and Thiazide Diuretics •

Systemic - U.S. Brands: Demi-Regroton; Diupres; Diurigen with Reserpine; Diutensen-R; Enduronyl; Enduronyl Forte; Oreticyl; Oreticyl Forte; Rauzide; Regroton http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202504.html

Reserpine, Hydralazine, and Hydrochlorothiazide •

Systemic - U.S. Brands: Cam-Ap-Es; Cherapas; Ser-A-Gen; Seralazide; Ser-ApEs; Serpazide; Tri-Hydroserpine; Unipres http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202506.html

Researching Medications

Ribavirin •

Systemic - U.S. Brands: Virazole http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202509.html

Ropinirole •

Systemic - U.S. Brands: Requip http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203364.html

Streptozocin •

Systemic - U.S. Brands: Zanosar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202532.html

Sulfinpyrazone •

Systemic - U.S. Brands: Anturane http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202538.html

Sumatriptan •

Systemic - U.S. Brands: Imitrex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202665.html

Tamoxifen •

Systemic - U.S. Brands: Nolvadex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202545.html

Temozolomide •

Systemic - U.S. Brands: Temodar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500076.html

Teniposide •

Systemic - U.S. Brands: Vumon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203661.html

Testolactone •

Systemic - U.S. Brands: Teslac http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202549.html

Thiabendazole •

Systemic - U.S. Brands: Mintezol http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202558.html

Thiethylperazine •

Systemic - U.S. Brands: Torecan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202561.html

Topotecan •

Systemic - U.S. Brands: Hycamtin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203049.html

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208 Nausea

Trimethobenzamide •

Systemic - U.S. Brands: Benzacot; Stemetic; Tebamide; Tigan; Tribenzagan; Trimazide http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202578.html

Vinblastine •

Systemic - U.S. Brands: Velban http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202593.html

Vincristine •

Systemic - U.S. Brands: Oncovin; Vincrex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202594.html

Vinorelbine •

Systemic - U.S. Brands: Navelbine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203542.html

Zalcitabine •

Systemic - U.S. Brands: HIVID http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202652.html

Zolmitriptan •

Systemic - U.S. Brands: Zomig http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203426.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.

Researching Medications

209

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.

211

APPENDICES

213

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute12: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

12

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

214

Nausea

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:14 •

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

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

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

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

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

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

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

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

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

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

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

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Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 14 See http://www.nlm.nih.gov/databases/databases.html.

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

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

The NLM Gateway15 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “nausea” (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 26833 468 1024 564 3780 32669

HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.19 Simply search by “nausea” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

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

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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). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19

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 Biologists20 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.21 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

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

The Genome Project and Nausea In the following section, we will discuss databases and references which relate to the Genome Project and nausea. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).23 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 20 Adapted 21

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. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 23 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “nausea” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for nausea: •

Hyperthermia, Cutaneous, with Headaches and Nausea Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=145590 Genes and Disease (NCBI - Map)

The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

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Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

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Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

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Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

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Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

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Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

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Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez

Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

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Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

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Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

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NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

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Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

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OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

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PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

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ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

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Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

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PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

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Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

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Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “nausea” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database24 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database25 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “nausea” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

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Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 25 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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

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Guides on nausea Nausea and Vomiting http://www.nlm.nih.gov/medlineplus/nauseaandvomiting.html

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Other guides Cancer Chemotherapy http://www.nlm.nih.gov/medlineplus/cancerchemotherapy.html Food Contamination and Poisoning http://www.nlm.nih.gov/medlineplus/foodcontaminationandpoisoning.html Gastroenteritis http://www.nlm.nih.gov/medlineplus/gastroenteritis.html

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

General/Overviews About Nausea and Vomiting Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/health/healthinfo/docs/1800/1810.asp?index=8106

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Diagnosis/Symptoms Nausea and Vomiting Source: American Academy of Family Physicians http://familydoctor.org/529.xml

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Nutrition Nutrition Tips for Managing Nausea and Vomiting Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01133

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Specific Conditions/Aspects Morning Sickness Source: American College of Obstetricians and Gynecologists http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZ146VY77C&s ub_cat=57 PDQ-Treatment-Patients: Cancer Information Summaries - Nausea and Vomiting Source: National Cancer Institute http://www.cancer.gov/cancerinfo/pdq/supportivecare/nausea/patient/

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Children Guide to Your Child's Symptoms: Vomiting Source: American Academy of Pediatrics http://www.aap.org/pubserv/vomiting.htm

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Nausea and Vomiting in Infants and Children Source: American Academy of Family Physicians http://familydoctor.org/530.xml Vomiting Source: Nemours Foundation http://kidshealth.org/parent/firstaid_safe/emergencies/vomit.html Vomiting and Diarrhea: Helping Your Child through Sickness Source: American Academy of Family Physicians http://familydoctor.org/196.xml What is Puke? Source: Nemours Foundation http://kidshealth.org/kid/ill_injure/sick/puke.html •

From the National Institutes of Health Cyclic Vomiting Syndrome Source: National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov/ddiseases/pubs/cvs/index.htm

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Organizations Cyclic Vomiting Syndrome Association http://www.cvsaonline.org National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/

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Teenagers Gastrointestinal Infections and Diarrhea Source: Nemours Foundation http://kidshealth.org/teen/infections/intestinal/diarrhea.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on nausea. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive:

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What You Can Do to Eat Well When You Are Nauseated Contact: AIDS Services of Austin, PO Box 4874, Austin, TX, 78765-9836, (512) 458-2437, http://www.asaustin.org. Summary: This fact sheet provides nutritional tips for persons experiencing gastrointestinal diseases and disorders, particularly nausea, associated with Acquired immunodeficiency syndrome (AIDS), caused by Human immunodeficiency virus (HIV). The fact sheet discusses medication, recommended foods, liquid intake, and eating suggestions.

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Controlling Nausea and Vomiting Source: San Bruno, CA: Krames Communications. 1998. 2 p. Contact: Available from Krames Communications. 1100 Grundy Lane, San Bruno, CA 94066-3030. (800) 333-3032. Fax (415) 244-4512. PRICE: $12.50 for pad of 50 sheets. Summary: This fact sheet provides suggestions on controlling nausea and vomiting in patients who are undergoing chemotherapy and radiation therapy. These side effects occur because the treatment affects normal cells as well as cancer cells. The cells lining the stomach and the part of the brain that controls vomiting may be affected. The fact sheet notes that nausea may be prevented or controlled with medications and lists such suggestions as taking medications as prescribed; eating small meals slowly throughout the day, preferably with a companion; eating foods at room temperature or colder to avoid strong smells; eating dry foods such as toast, crackers, or pretzels; and avoiding food for 1 to 2 hours before treatment. Other strategies are listed to help ease nausea and vomiting and to distract oneself from these side effects. Indications for when to contact the health care provider are also given. The fact sheet is illustrated with full-color line drawings and includes blank space for notes or special instructions. The fact sheet is one of a series of patient education materials on the complications of cancer treatment.

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Nausea and Vomiting Contact: National AIDS Treatment Information Project, Beth Israel Deaconess Medical Center, Beth Israel Hospital, 330 Brookline Ave Libby Bldg 317, Boston, MA, 02215, (617) 667-5520, http://www.natip.org. Summary: This fact sheet, for people with the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), discusses HIV-related nausea and vomiting. Nausea and vomiting are nonspecific symptoms resulting from side effects of medications, pregnancy, substance abuse, chemical imbalances, pain of the internal abdominal organs, motility problems of the digestive tract, conditions affecting balance, and psychological issues. Nausea and vomiting can lead to serious medical complications. Individuals with HIV who are vomiting or are nauseous should see a physician if they do not feel better within 12 to 24 hours, blood or partly digested blood appears, a fever persists, abdominal pain is experienced, sever headaches occur, the abdomen is swollen and bloated, or necessary medications are interfered with. The medical evaluation includes a review of how long and how often patients have been vomiting, what they have eaten in the past day, and a description of any associated symptoms. The best way to manage and treat nausea and vomiting is to identify and treat the condition that is causing them.

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Dietary Suggestions for Controlling Nausea and Vomiting Source: Rochester, MN: Mayo Clinic, Patient and Health Education Center. 1990. 2 p.

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Contact: Available From Mayo Clinic, Patient and Health Education Center. 200 First Street, SW, Rochester, MN 55905. (507) 284-2511. PRICE: $0.80 plus shipping and handling (for health care professionals). Order Number MC 657/R890. Summary: This patient education brochure offers dietary suggestions for managing nausea and vomiting. Topics include the importance of eating well-balanced, regularly scheduled meals; trying a variety of foods; the timing of fluid intake; and minimizing activities or surroundings that may make the nausea worse. The brochure includes blank spaces for the listing of health care providers and phone numbers. 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 “nausea” (or synonyms). The following was recently posted: •

(1) Best practice evidence-based guideline for the appropriate prescribing of hormone replacement therapy. (2) Guideline update: hormone replacement therapy Source: Effective Practice Institute, University of Auckland - Academic Institution; 2001 May (revised information released on 2002 September 30); 185 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3107&nbr=2333&a mp;string=nausea

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(1) Prevention and control of influenza. (2) Update: influenza activity-United States, 2003--04 season Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 1984 April (revised 2003 Apr; addendum released 2003 Dec); Original guideline: 36 pages; addendum: 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4428&nbr=3342&a mp;string=nausea

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2002 update of recommendations for the use of chemotherapy and radiotherapy protectants: clinical practice guidelines of the American Society of Clinical Oncology Source: American Society of Clinical Oncology - Medical Specialty Society; 1999 October (revised 2002 Jun); 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3348&nbr=2574&a mp;string=nausea

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AACE medical guidelines for clinical practice for the diagnosis and treatment of hyperandrogenic disorders Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 2001 Mar-April; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2847&nbr=2073&a mp;string=nausea

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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=nausea

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ACC/AHA 2002 guideline update for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for the Managemen Source: American College of Cardiology Foundation - Medical Specialty Society; 1999 June (revised 2002); 127 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3588&nbr=2814&a mp;string=nausea

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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 (Committee on 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=nausea

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ACR Appropriateness Criteriatm for bone metastases Source: American College of Radiology - Medical Specialty Society; 1996 September (revised 2000); 27 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2569&nbr=1795&a mp;string=nausea

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Adjuvant systemic therapy for node-negative breast cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1998 November 12 (new information released online 2002 Feb); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3280&nbr=2506&a mp;string=nausea

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Adjuvant therapy for breast cancer Source: National Cancer Institute - Federal Government Agency [U.S.]; 2000 November 3; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2715&nbr=1941&a mp;string=nausea

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American Gastroenterological Association medical position statement: nausea and vomiting Source: American Gastroenterological Association - Medical Specialty Society; 2000 May 21 (reviewed 2001); 2 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3060&nbr=2286&a mp;string=nausea

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APIC guideline for infection prevention and control in flexible endoscopy Source: Association for Professionals in Infection Control and Epidemiology, Inc. Professional Association; 2000; 18 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2227&nbr=1453&a mp;string=nausea

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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=nausea

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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=nausea

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Assessment and management of pain Source: Registered Nurses Association of Ontario - Professional Association; 2002 November; 142 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3720&nbr=2946&a mp;string=nausea

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Breast disease. Guide to prevention, diagnosis, and treatment Source: Brigham and Women's Hospital (Boston) - Hospital/Medical Center; 2001; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3431&nbr=2657&a mp;string=nausea

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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=nausea

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Chemotherapeutic management of stage IV non-small cell lung cancer Source: American College of Chest Physicians - Medical Specialty Society; 2003 January; 18 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3649&nbr=2875&a mp;string=nausea

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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=nausea

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Chronic kidney disease (non-dialysis) medical nutrition therapy protocol Source: American Dietetic Association - Professional Association; 2002 May; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3293&nbr=2519&a mp;string=nausea

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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=nausea

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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=nausea

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Congestive heart failure in adults Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1997 October (revised 2002 Jan); 71 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3165&nbr=2391&a mp;string=nausea

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Constipation in infants and children: evaluation and treatment Source: North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition - Professional Association; 1999 November; 15 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3595&nbr=2821&a mp;string=nausea

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Control of pain in patients with cancer. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2000 June; 61 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2910&nbr=2136&a mp;string=nausea

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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=nausea

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Diagnosis and treatment of autoimmune hepatitis Source: American Association for the Study of Liver Diseases - Private Nonprofit Research Organization; 2002 August; 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3447&nbr=2673&a mp;string=nausea

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Differential diagnosis of chest pain Source: Finnish Medical Society Duodecim - Professional Association; 2001 May 4; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2852&nbr=2078&a mp;string=nausea

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Diseases characterized by vaginal discharge. Sexually transmitted diseases treatment guidelines 2002 Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 1993 (revised 2002 May 10); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3237&nbr=2463&a mp;string=nausea

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Doxorubicin-based chemotherapy for the palliative treatment of adult patients with locally advanced or metastatic soft tissue sarcoma Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1999 November 30 (updated online 2002 Oct); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3600&nbr=2826&a mp;string=nausea

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Drug treatment for hyperlipidaemias Source: Finnish Medical Society Duodecim - Professional Association; 2001 April 4 (revised 2003 October 5); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=4357&nbr=3283&a mp;string=nausea

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Dyspepsia Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1998 October (revised 2003 Jan); 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3664&nbr=2890&a mp;string=nausea

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Early management of patients with a head injury. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2000 August; 43 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2912&nbr=2138&a mp;string=nausea

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Epirubicin, as a single agent or in combination, for metastatic breast cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1997 October 2 (updated online 2002 Feb); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3198&nbr=2424&a mp;string=nausea

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Evidence base for management of acute exacerbations of chronic obstructive pulmonary disease Source: American College of Chest Physicians - Medical Specialty Society; 2001 April 3; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2762&nbr=1988&a mp;string=nausea

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Evidence-based clinical practice guideline. Nursing care of the woman receiving regional analgesia/anesthesia in labor Source: Association of Women's Health, Obstetric, and Neonatal Nurses - Professional Association; 2001 January; 36 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2928&nbr=2154&a mp;string=nausea

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First-line chemotherapy for postoperative patients with stage II, III or IV epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2001 September 21 (revised online 2003 May); 35 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4007&nbr=3136&a mp;string=nausea

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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=nausea

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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=nausea

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Guidelines for Alzheimer's disease management. Source: Alzheimer's Association of Los Angeles, Riverside and San Bernardino Counties - Private Nonprofit Organization; 1999 January 8 (revised 2002 Jan 1); 52 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3157&nbr=2383&a mp;string=nausea

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Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children Source: North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition - Professional Association; 2001; 31 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3593&nbr=2819&a mp;string=nausea

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Guidelines for the management of heavy menstrual bleeding Source: New Zealand National Health Committee - National Government Agency [NonU.S.]; 1998 http://www.guideline.gov/summary/summary.aspx?doc_id=2184&nbr=1410&a mp;string=nausea

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HIV disease management Source: University of Texas Medical Branch Correctional Managed Care - Academic Institution; 1996 September (revised 2002 Jul); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3477&nbr=2703&a mp;string=nausea

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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=nausea

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Long-term management of asthma Source: Finnish Medical Society Duodecim - Professional Association; 2001 January 4 (revised 2001 December 30); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3375&nbr=2601&a mp;string=nausea

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Major depression in adults for mental health care providers Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1996 February (revised 2002 May); 43 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3354&nbr=2580&a mp;string=nausea

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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=nausea

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Management of early rheumatoid arthritis. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 2000 December; 44 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2914&nbr=2140&a mp;string=nausea

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Management of gastroesophageal reflux disease (GERD) Source: University of Michigan Health System - Academic Institution; 2002 March; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3372&nbr=2598&a mp;string=nausea

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Management of patients who have a history of penicillin allergy. Sexually transmitted diseases treatment guidelines 2002 Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 1993 (revised 2002 May 10); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3235&nbr=2461&a mp;string=nausea

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Management of sore throat and indications for tonsillectomy. A national clinical guideline Source: Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]; 1999 January; 23 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1841&nbr=1067&a mp;string=nausea

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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=nausea

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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=nausea

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Palliative treatment of cancer Source: Finnish Medical Society Duodecim - Professional Association; 2001 December 27 (revised 2003 May 30); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=4374&nbr=3296&a mp;string=nausea

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Pelvic inflammatory disease. Sexually transmitted diseases treatment guidelines 2002 Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 1993 (revised 2002 May 10); 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3238&nbr=2464&a mp;string=nausea

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Periodic health examination, 1999 update: 1. Detection, prevention and treatment of obesity Source: Canadian Task Force on Preventive Health Care - National Government Agency [Non-U.S.]; 1999; 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2054&nbr=1280&a mp;string=nausea

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Pharmacologic management of acute attacks of migraine and prevention of migraine headache Source: American Academy of Family Physicians - Medical Specialty Society; 2002 November; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3592&nbr=2818&a mp;string=nausea

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Pharmacologic treatment of acute major depression and dysthymia Source: American College of Physicians - Medical Specialty Society; 2000; 5 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2547&nbr=1773&a mp;string=nausea

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Pharyngitis Source: University of Michigan Health System - Academic Institution; 1996 November (updated 2000 Dec); 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2957&nbr=2183&a mp;string=nausea

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Practice advisory: the use of felbamate in the treatment of patients with intractable epilepsy. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society Source: American Academy of Neurology - Medical Specialty Society; 1999 May; 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2821&nbr=2047&a mp;string=nausea

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Practice guideline for the treatment of patients with bipolar disorder (revision) Source: American Psychiatric Association - Medical Specialty Society; 1994 December (revised 2002 Apr); 50 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3302&nbr=2528&a mp;string=nausea

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Practice guideline for the treatment of patients with borderline personality disorder Source: American Psychiatric Association - Medical Specialty Society; 2001 October; 52 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2972&nbr=2198&a mp;string=nausea

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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=nausea

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Practice guidelines for the management of cryptococcal disease Source: Infectious Diseases Society of America - Medical Specialty Society; 2000 April; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2666&nbr=1892&a mp;string=nausea

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Practice parameter: evidence-based guidelines for migraine headache (an evidencebased review). Report of the Quality Standards Subcommittee of the American Academy of Neurology Source: American Academy of Neurology - Medical Specialty Society; 2000 September; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2820&nbr=2046&a mp;string=nausea

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Practice parameters for the treatment of narcolepsy: an update for 2000. Source: American Academy of Sleep Medicine - Professional Association; 1994 (updated 2001 Jun); 16 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2933&nbr=2159&a mp;string=nausea

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Practice parameters for the use of light therapy in the treatment of sleep disorders Source: American Academy of Sleep Medicine - Professional Association; 1999; 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2273&nbr=1499&a mp;string=nausea

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Procedure guideline for brain perfusion single photon computed tomography (SPECT) using Tc-99m radiopharmaceuticals Source: Society of Nuclear Medicine, Inc - Medical Specialty Society; 1999 February; 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1334&nbr=602&am p;string=nausea

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Psoriasis Source: Finnish Medical Society Duodecim - Professional Association; 2002 May 7; Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3388&nbr=2614&a mp;string=nausea

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Radiotherapy fractionation for the palliation of uncomplicated painful bone metastases Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2003 March 14; 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3766&nbr=2992&a mp;string=nausea

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Recommendations for the evaluation and management of nausea and vomiting of early pregnancy ( Source: University of Texas at Austin School of Nursing, Family Nurse Practitioner Program - Academic Institution; 2002 May; 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3228&nbr=2454&a mp;string=nausea

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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=nausea

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Recommendations for the use of antiemetics: evidence-based, clinical practice guidelines Source: American Society of Clinical Oncology - Medical Specialty Society; 1999 September; 37 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2149&nbr=1375&a mp;string=nausea

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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=nausea

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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=nausea

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Screening for bacterial vaginosis in pregnancy: recommendations and rationale Source: United States Preventive Services Task Force - Independent Expert Panel; 1996 (revised 2001 Apr); 3 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2659&nbr=1885&a mp;string=nausea

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Smallpox vaccination and adverse reactions. Guidance for clinicians Source: Centers for Disease Control and Prevention - Federal Government Agency [U.S.]; 2003 January 24; 29 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3597&nbr=2823&a mp;string=nausea

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Smoking cessation Source: Singapore Ministry of Health - National Government Agency [Non-U.S.]; 2002 April; 33 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3437&nbr=2663&a mp;string=nausea

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Task force on the management of chest pain Source: European Society of Cardiology - Medical Specialty Society; 2002 August; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3426&nbr=2652&a mp;string=nausea

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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=nausea

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The role of aromatase inhibitors in the treatment of postmenopausal women with metastatic breast cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2002 September 3; 18 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3608&nbr=2834&a mp;string=nausea

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The role of octreotide in the management of patients with cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2003 May 7; 27 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4260&nbr=3260&a mp;string=nausea

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Tobacco use cessation 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=2576&nbr=1802&a mp;string=nausea

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Unstable chest pain Source: University of Texas Medical Branch Correctional Managed Care - Academic Institution; 2001 February (revised 2002 Nov); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3551&nbr=2777&a mp;string=nausea

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Urinary tract infection Source: University of Michigan Health System - Academic Institution; 1999 June; 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2284&nbr=1510&a mp;string=nausea

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Use of 5-HT Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2000 March 7 (updated online 2003 Jan); 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3746&nbr=2972&a mp;string=nausea

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Use of adjuvant chemotherapy following cystectomy in patients with deep muscleinvasive transitional cell carcinoma of the bladder Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2001 October 9 (revised online 2003 January 22); 18 pages http://www.guideline.gov/summary/summary.aspx?doc_id=4263&nbr=3263&a mp;string=nausea

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Use of amifostine to ameliorate the toxic effects of chemotherapy in the treatment of cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1998 December 18 (updated online 2003 Jan); 19 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3703&nbr=2929&a mp;string=nausea

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Use of bisphosphonates in women with breast cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1998 November 9 (revised December 2002); 23 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3705&nbr=2931&a mp;string=nausea

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Use of dexrazoxane as a cardioprotectant in patients receiving doxorubicin or epirubicin chemotherapy for the treatment of cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1998 November 16 (updated online 2002 Jun); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3358&nbr=2584&a mp;string=nausea

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Use of gemcitabine in the treatment of advanced pancreatic adenocarcinoma Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1998 May 22 (revised online 2002 Nov); 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3603&nbr=2829&a mp;string=nausea

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Use of irinotecan (CamptosarÂ®, CPT-11) combined with 5-fluorouracil and leucovorin (5FU/LV) as first-line therapy for metastatic colorectal cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 2001 October 23 (updated online 2003 Feb); 20 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3763&nbr=2989&a mp;string=nausea

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Use of irinotecan in the treatment of metastatic colorectal carcinoma Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1999 April 30 (updated online 2000 Apr); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3007&nbr=2233&a mp;string=nausea

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Use of preoperative chemotherapy with or without postoperative radiotherapy in technically resectable stage IIIA non-small cell lung cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1997 September 15 (updated online 2002 Apr); 14 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3281&nbr=2507&a mp;string=nausea

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Use of vinorelbine in non-small cell lung cancer Source: Practice Guidelines Initiative - State/Local Government Agency [Non-U.S.]; 1996 August 15 (new information released online August 2001); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=3202&nbr=2428&a mp;string=nausea

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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=nausea

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VHA/DOD clinical practice guideline for the management of major depressive disorder in adults Source: Department of Defense - Federal Government Agency [U.S.]; 1997 (updated 2000); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2585&nbr=1811&a mp;string=nausea

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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=nausea

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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=nausea

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Viral upper respiratory infection (VURI) in adults and children Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1994 June (revised 2002 Dec); 31 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3658&nbr=2884&a mp;string=nausea

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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: •

Marijuana Use in Supportive Care for Cancer Patients Summary: A fact sheet about marijuana use to treat chemotherapy-induced nausea, vomiting, anorexia and cachexia in cancer patients Source: Cancer Information Service, National Cancer Institute http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7054 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 nausea. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

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

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

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

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

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

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

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

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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 nausea. 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 “nausea” (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 “nausea”. 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 “nausea” (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 “nausea” (or a synonym) into the search box, and click “Submit Query.”

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

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.26

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

26

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)27: •

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

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

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

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

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

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

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California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

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

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

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

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

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

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

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

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

•

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

27

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

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Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

•

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

•

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

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on nausea: •

Basic Guidelines for Nausea Nausea and acupressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002117.htm Nausea and bananas Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002118.htm Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm

•

Signs & Symptoms for Nausea Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Abdominal swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003122.htm

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Blurred vision Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003029.htm Dark yellow urine Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003138.htm Diarrhea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003126.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Fever Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm Headache Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Headaches Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003024.htm Heartburn Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003114.htm Hematemesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003118.htm Increased thirst Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003085.htm Lethargy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003088.htm Morning sickness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003119.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Poor skin turgor Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003281.htm Runny nose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003051.htm Stiff neck Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Stomach upset Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm

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Upset stomach Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Vomiting blood Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003118.htm Weight loss Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003107.htm •

Diagnostics and Tests for Nausea 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 Urinalysis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003579.htm X-rays of the abdomen Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003815.htm

•

Nutrition for Nausea Coffee Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002445.htm

•

Background Topics for Nausea Abdominal discomfort Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002228.htm Chemotherapy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002324.htm Intravenous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002383.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Relieved by Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002288.htm

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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

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

255

NAUSEA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 5-hydroxyindoleacetic acid: 5HIAA. A break-down product of serotonin that is excreted in the urine. Serotonin is a hormone found in high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors. [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 Cramps: Abdominal pain due to spasmodic contractions of the bowel. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Ablate: In surgery, is to remove. [NIH] Acatalasia: A rare autosomal recessive disorder resulting from the absence of catalase activity. Though usually asymptomatic, a syndrome of oral ulcerations and gangrene may be present. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acclimatization: Adaptation to a new environment or to a change in the old. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] 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] Acetylcholinesterase: An enzyme that catalyzes the hydrolysis of acetylcholine to choline and acetate. In the CNS, this enzyme plays a role in the function of peripheral neuromuscular junctions. EC 3.1.1.7. [NIH] Achlorhydria: A lack of hydrochloric acid in gastric juice despite stimulation of gastric secretion. [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] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] 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

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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] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acupuncture Points: Designated locations along nerves or organ meridians for inserting acupuncture needles. [NIH] Acupuncture Therapy: Treatment of disease by inserting needles along specific pathways or meridians. The placement varies with the disease being treated. Heat or moxibustion and acupressure may be used in conjunction. [NIH] Acustimulation: Mild electrical stimulation of acupuncture points to control symptoms such as nausea and vomiting. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Monophosphate: Adenylic acid. Adenine nucleotide containing one phosphate group esterified to the sugar moiety in the 2'-, 3'-, or 5'-position. [NIH] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenaline: A hormone. Also called epinephrine. [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] Adrenergic Antagonists: Drugs that bind to but do not activate adrenergic receptors. Adrenergic antagonists block the actions of the endogenous adrenergic transmitters epinephrine and norepinephrine. [NIH] Adrenoreceptor: Receptors specifically sensitive to and operated by adrenaline and/or noradrenaline and related sympathomimetic drugs. Adrenoreceptor is an alternative name. [NIH]

Adverse Effect: An unwanted side effect of treatment. [NIH] Aerophagia: A condition that occurs when a person swallows too much air. Causes gas and

Dictionary 257

frequent belching. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age 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] Aggravation: An increasing in seriousness or severity; an act or circumstance that intensifies, or makes worse. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Agranulocytosis: A decrease in the number of granulocytes (basophils, eosinophils, and neutrophils). [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Alexia: The inability to recognize or comprehend written or printed words. [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]

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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] Allergens: Antigen-type substances (hypersensitivity, immediate). [NIH]

that

produce

immediate

hypersensitivity

Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Ameliorated: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amifostine: A phosphorothioate proposed as a radiation-protective agent. It causes splenic vasodilation and may block autonomic ganglia. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH]

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Amputation: Surgery to remove part or all of a limb or appendage. [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] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent that is used to abolish the sensation of pain. [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] Analeptic: A drug which acts as a restorative, such as caffeine, amphetamine, pentylenetetrazol, etc. [EU] 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] Analogous: Resembling or similar in some respects, as in function or appearance, but not in origin or development;. [EU] Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] 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] Anionic: Pertaining to or containing an anion. [EU] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or

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positive pole during electrolysis. [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] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anterograde: Moving or extending forward; called also antegrade. [EU] Anthracycline: A member of a family of anticancer drugs that are also antibiotics. [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [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]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [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] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Anticonvulsive: An agent that prevents or relieves convulsions. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several monoamine oxidase inhibitors are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents also appear to act through brain catecholamine systems. A third group (antidepressive agents, secondgeneration) is a diverse group of drugs including some that act specifically on serotonergic systems. [NIH]

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Antidote: A remedy for counteracting a poison. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

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] 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] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipsychotic Agents: Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in schizophrenia, senile dementia, transient psychosis following surgery or myocardial infarction, etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus. [NIH] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antispasmodic: An agent that relieves spasm. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Anuria: Inability to form or excrete urine. [NIH]

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Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Apathy: Lack of feeling or emotion; indifference. [EU] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Appendicitis: Acute inflammation of the vermiform appendix. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] 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] Aromatase: An enzyme which converts androgens to estrogens by desaturating ring A of the steroid. This enzyme complex is located in the endoplasmic reticulum of estrogenproducing cells including ovaries, placenta, testicular Sertoli and Leydig cells, adipose, and brain tissues. The enzyme complex has two components, one of which is the CYP19 gene product, the aromatase cytochrome P-450. The other component is NADPH-cytochrome P450 reductase which transfers reducing equivalents to P-450(arom). EC 1.14.13.-. [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteritis: Inflammation of an artery. [NIH] Arthroscopy: Endoscopic examination, therapy and surgery of the joint. [NIH] Articular: Of or pertaining to a joint. [EU] Ascorbic Acid: A six carbon compound related to glucose. It is found naturally in citrus fruits and many vegetables. Ascorbic acid is an essential nutrient in human diets, and necessary to maintain connective tissue and bone. Its biologically active form, vitamin C,

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functions as a reducing agent and coenzyme in several metabolic pathways. Vitamin C is considered an antioxidant. [NIH] Aspirate: Fluid withdrawn from a lump, often a cyst, or a nipple. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asthenia: Clinical sign or symptom manifested as debility, or lack or loss of strength and energy. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Aura: A subjective sensation or motor phenomenon that precedes and marks the of a paroxysmal attack, such as an epileptic attack on set. [EU] Auricular: Pertaining to an auricle or to the ear, and, formerly, to an atrium of the heart. [EU] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmune Hepatitis: A liver disease caused when the body's immune system destroys

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liver cells for no known reason. [NIH] 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] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Back Pain: Acute or chronic pain located in the posterior regions of the trunk, including the thoracic, lumbar, sacral, or adjacent regions. [NIH] Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Barbiturates: A class of chemicals derived from barbituric acid or thiobarbituric acid. Many of these are medically important as sedatives and hypnotics (sedatives, barbiturate), as anesthetics, or as anticonvulsants. [NIH] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Barium enema: A procedure in which a liquid with barium in it is put into the rectum and colon by way of the anus. Barium is a silver-white metallic compound that helps to show the image of the lower gastrointestinal tract on an x-ray. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance 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] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Belching: Noisy release of gas from the stomach through the mouth. Also called burping. [NIH]

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Belladonna: A species of very poisonous Solanaceous plants yielding atropine (hyoscyamine), scopolamine, and other belladonna alkaloids, used to block the muscarinic autonomic nervous system. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Benzamides: Benzoic acid amides. [NIH] Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Beta-Endorphin: A peptide consisting of amino acid sequence 61-91 of the endogenous pituitary hormone beta-lipotropin. The first four amino acids show a common tetrapeptide sequence with methionine- and leucine enkephalin. The compound shows opiate-like activity. Injection of beta-endorphin induces a profound analgesia of the whole body for several hours. This action is reversed after administration of naloxone. [NIH] Beta-pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Bile Pigments: Pigments that give a characteristic color to bile including: bilirubin, biliverdine, and bilicyanin. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Binding agent: A substance that makes a loose mixture stick together. For example, binding agents can be used to make solid pills from loose powders. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU]

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Bioequivalent: Having the same strength and similar bioavailability in the same dosage form as another specimen of a given drug substance. [EU] Biogenic Monoamines: Biogenic amines having only one amine moiety. Included in this group are all natural monoamines formed by the enzymatic decarboxylation of natural amino acids. [NIH] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Bioluminescence: The emission of light by living organisms such as the firefly, certain mollusks, beetles, fish, bacteria, fungi and protozoa. [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] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Coagulation Factors: Endogenous substances, usually proteins, that are involved in the blood coagulation process. [NIH] Blood Glucose: Glucose in blood. [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 Proteins: Proteins that are present in blood serum, including serum albumin, blood coagulation factors, and many other types of proteins. [NIH] Blood transfusion: The administration of blood or blood products into a blood vessel. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH]

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Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bone metastases: Cancer that has spread from the original (primary) tumor to the bone. [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] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [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] Brain Hypoxia: Lack of oxygen leading to unconsciousness. [NIH] Brain Infarction: The formation of an area of necrosis in the brain, including the cerebral hemispheres (cerebral infarction), thalami, basal ganglia, brain stem (brain stem infarctions), or cerebellum secondary to an insufficiency of arterial or venous blood flow. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

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Breakdown: A physical, metal, or nervous collapse. [NIH] Breast reconstruction: Surgery to rebuild a breast's shape after a mastectomy. [NIH] Bromine: A halogen with the atomic symbol Br, atomic number 36, and atomic weight 79.904. It is a volatile reddish-brown liquid that gives off suffocating vapors, is corrosive to the skin, and may cause severe gastroenteritis if ingested. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] 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] Bullous: Pertaining to or characterized by bullae. [EU] Buprenorphine: A derivative of the opioid alkaloid thebaine that is a more potent and longer lasting analgesic than morphine. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Butterflies: Slender-bodies diurnal insects having large, broad wings often strikingly colored and patterned. [NIH] Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic disease. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH] Camptothecin: An alkaloid isolated from the stem wood of the Chinese tree, Camptotheca acuminata. This compound selectively inhibits the nuclear enzyme DNA topoisomerase. Several semisynthetic analogs of camptothecin have demonstrated antitumor activity. [NIH] Candidiasis: Infection with a fungus of the genus Candida. It is usually a superficial

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infection of the moist cutaneous areas of the body, and is generally caused by C. albicans; it most commonly involves the skin (dermatocandidiasis), oral mucous membranes (thrush, def. 1), respiratory tract (bronchocandidiasis), and vagina (vaginitis). Rarely there is a systemic infection or endocarditis. Called also moniliasis, candidosis, oidiomycosis, and formerly blastodendriosis. [EU] Candidosis: An infection caused by an opportunistic yeasts that tends to proliferate and become pathologic when the environment is favorable and the host resistance is weakened. [NIH]

Cannabidiol: Compound isolated from Cannabis sativa extract. [NIH] Cannabinoids: Compounds extracted from Cannabis sativa L. and metabolites having the cannabinoid structure. The most active constituents are tetrahydrocannabinol, cannabinol, and cannabidiol. [NIH] Cannabinol: A physiologically inactive constituent of Cannabis sativa L. [NIH] Cannabis: The hemp plant Cannabis sativa. Products prepared from the dried flowering tops of the plant include marijuana, hashish, bhang, and ganja. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carboxy: Cannabinoid. [NIH] Carboxylic Acids: Organic compounds containing the carboxy group (-COOH). This group of compounds includes amino acids and fatty acids. Carboxylic acids can be saturated, unsaturated, or aromatic. [NIH] Carboxymethylcellulose: It is used as an emulsifier, thickener, suspending agent, etc., in cosmetics and pharmaceuticals; in research as a culture medium; in chromatography as a stabilizer for reagents; and therapeutically as a bulk laxative with antacid properties. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [NIH]

Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiotoxicity: Toxicity that affects the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high

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blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [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] Carotid Body: A small cluster of chemoreceptive and supporting cells located near the bifurcation of the internal carotid artery. The carotid body, which is richly supplied with fenestrated capillaries, senses the pH, carbon dioxide, and oxygen concentrations in the blood and plays a crucial role in their homeostatic control. [NIH] Carpal Tunnel Syndrome: A median nerve injury inside the carpal tunnel that results in symptoms of pain, numbness, tingling, clumsiness, and a lack of sweating, which can be caused by work with certain hand and wrist postures. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catalase: An oxidoreductase that catalyzes the conversion of hydrogen peroxide to water and oxygen. It is present in many animal cells. A deficiency of this enzyme results in acatalasia. EC 1.11.1.6. [NIH] Catalyse: To speed up a chemical reaction. [EU] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheter Ablation: Removal of tissue with electrical current delivered via electrodes positioned at the distal end of a catheter. Energy sources are commonly direct current (DCshock) or alternating current at radiofrequencies (usually 750 kHz). The technique is used most often to ablate the AV junction and/or accessory pathways in order to interrupt AV conduction and produce AV block in the treatment of various tachyarrhythmias. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell Lineage: The developmental history of cells as traced from the first division of the original cell or cells in the embryo. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids,

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proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] 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] Cerebral Arteries: The arteries supplying the cerebral cortex. [NIH] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [NIH] Chemoprotective: A quality of some drugs used in cancer treatment. Chemoprotective agents protect healthy tissue from the toxic effects of anticancer drugs. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory

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and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Child Care: Care of children in the home or institution. [NIH] Chiropractic: A system of treating bodily disorders by manipulation of the spine and other parts, based on the belief that the cause is the abnormal functioning of a nerve. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Cholelithiasis: Presence or formation of gallstones. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Choreatic Disorders: Acquired and hereditary conditions which feature chorea as a primary manifestation of the disease process. [NIH] Choroid: The thin, highly vascular membrane covering most of the posterior of the eye between the retina and sclera. [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] 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 Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Ciliary: Inflammation or infection of the glands of the margins of the eyelids. [NIH] Ciliary Body: A ring of tissue extending from the scleral spur to the ora serrata of the retina.

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It consists of the uveal portion and the epithelial portion. The ciliary muscle is in the uveal portion and the ciliary processes are in the epithelial portion. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] 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] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Citric Acid: A key intermediate in metabolism. It is an acid compound found in citrus fruits. The salts of citric acid (citrates) can be used as anticoagulants due to their calcium chelating ability. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [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] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlea: The part of the internal ear that is concerned with hearing. It forms the anterior part of the labyrinth, is conical, and is placed almost horizontally anterior to the vestibule. [NIH]

Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH]

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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] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Cancer: Cancer that occurs in the colon (large intestine) or the rectum (the end of the large intestine). A number of digestive diseases may increase a person's risk of colorectal cancer, including polyposis and Zollinger-Ellison Syndrome. [NIH] Colostomy: An opening into the colon from the outside of the body. A colostomy provides a new path for waste material to leave the body after part of the colon has been removed. [NIH] Combination chemotherapy: Treatment using more than one anticancer drug. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Combinatorial: A cut-and-paste process that churns out thousands of potentially valuable compounds at once. [NIH] Communicable disease: A disease that can be transmitted by contact between persons. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector

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not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU]

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Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Conflict of Interest: A situation in which an individual might benefit personally from official or professional actions. It includes a conflict between a person's private interests and official responsibilities in a position of trust. The term is not restricted to government officials. The concept refers both to actual conflict of interest and the appearance or perception of conflict. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] 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] Conscious Sedation: An alternative to general anesthesia in patients for whom general anesthesia is refused or considered inadvisable. It involves the administering of an antianxiety drug (minor tranquilizer) and an analgesic or local anesthetic. This renders the patient free of anxiety and pain while allowing the patient to remain in verbal contact with the physician or dentist. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Consolidation: The healing process of a bone fracture. [NIH] Consolidation therapy: Chemotherapy treatments given after induction chemotherapy to further reduce the number of cancer cells. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraceptive Agents: Chemical substances that prevent or reduce the probability of conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH]

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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]

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] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Arteriosclerosis: Thickening and loss of elasticity of the coronary arteries. [NIH] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees,

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and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] 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] Craniotomy: An operation in which an opening is made in the skull. [NIH] Creatinine: A compound that is excreted from the body in urine. Creatinine levels are measured to monitor kidney function. [NIH] Credentialing: The recognition of professional or technical competence through registration, certification, licensure, admission to association membership, the award of a diploma or degree, etc. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] 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] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cystectomy: Used for excision of the urinary bladder. [NIH] Cystitis: Inflammation of the urinary bladder. [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, . 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,

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including T and B cells. [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] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [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] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]

Day Care: Institutional health care of patients during the day. The patients return home at night. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [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] Dehydration: The condition that results from excessive loss of body water. [NIH] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [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

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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] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatitis Herpetiformis: Rare, chronic, papulo-vesicular disease characterized by an intensely pruritic eruption consisting of various combinations of symmetrical, erythematous, papular, vesicular, or bullous lesions. The disease is strongly associated with the presence of HLA-B8 and HLA-DR3 antigens. A variety of different autoantibodies has been detected in small numbers in patients with dermatitis herpetiformis. [NIH] Dermatologic Agents: Drugs used to treat or prevent skin disorders or for the routine care of skin. [NIH] Dermatosis: Any skin disease, especially one not characterized by inflammation. [EU] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dexamethasone: (11 beta,16 alpha)-9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4diene-3,20-dione. An anti-inflammatory glucocorticoid used either in the free alcohol or esterified form in treatment of conditions that respond generally to cortisone. [NIH] Dexrazoxane: A drug used to protect the heart from the toxic effects of anthracycline drugs such as doxorubicin. It belongs to the family of drugs called chemoprotective agents. [NIH]

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Dextrorotatory: Turning towards the right hand. [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] Diaphoresis: Perspiration, especially profuse perspiration. Called also sudoresis. [EU] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastolic: Of or pertaining to the diastole. [EU] Diastolic blood pressure: The minimum pressure that remains within the artery when the heart is at rest. [NIH] Dietary Fats: Fats present in food, especially in animal products such as meat, meat products, butter, ghee. They are present in lower amounts in nuts, seeds, and avocados. [NIH]

Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]

Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Diflunisal: A salicylate derivative and anti-inflammatory analgesic with actions and side effects similar to those of aspirin. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dihydroxy: AMPA/Kainate antagonist. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilator: A device used to stretch or enlarge an opening. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [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] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH]

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Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Dislocation: The displacement of any part, more especially of a bone. Called also luxation. [EU]

Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Distention: The state of being distended or enlarged; the act of distending. [EU] Diuresis: Increased excretion of urine. [EU] Diurnal: Occurring during the day. [EU] Diverticula: Plural form of diverticulum. [NIH] Diverticulitis: Inflammation of a diverticulum or diverticula. [NIH] Diverticulum: A pathological condition manifested as a pouch or sac opening from a tubular or sacular organ. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Domperidone: A specific blocker of dopamine receptors. It speeds gastrointestinal peristalsis, causes prolactin release, and is used as antiemetic and tool in the study of dopaminergic mechanisms. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dopamine Antagonists: Drugs that bind to but do not activate dopamine receptors, thereby blocking the actions of dopamine or exogenous agonists. Many drugs used in the treatment of psychotic disorders (antipsychotic agents) are dopamine antagonists, although their therapeutic effects may be due to long-term adjustments of the brain rather than to the acute effects of blocking dopamine receptors. Dopamine antagonists have been used for several other clinical purposes including as antiemetics, in the treatment of Tourette syndrome, and for hiccup. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the

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back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Dronabinol: A synthetic pill form of delta-9-tetrahydrocannabinol (THC), an active ingredient in marijuana that is used to treat nausea and vomiting associated with cancer chemotherapy. [NIH] Drug Industry: That segment of commercial enterprise devoted to the design, development, and manufacture of chemical products for use in the diagnosis and treatment of disease, disability, or other dysfunction, or to improve function. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Monitoring: The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenum: The first part of the small intestine. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dysentery: Any of various disorders marked by inflammation of the intestines, especially of the colon, and attended by pain in the abdomen, tenesmus, and frequent stools containing blood and mucus. Causes include chemical irritants, bacteria, protozoa, or parasitic worms. [EU]

Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU]

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Dyslexia: Partial alexia in which letters but not words may be read, or in which words may be read but not understood. [NIH] Dysmenorrhea: Painful menstruation. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU] Dysphoria: Disquiet; restlessness; malaise. [EU] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Dystonia Musculorum Deformans: A neurological disorder characterized by alterations in muscle tone. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Eclampsia: Onset of convulsions or coma in a previously diagnosed pre-eclamptic patient. [NIH]

Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] 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] Electroconvulsive Therapy: Electrically induced convulsions primarily used in the treatment of severe affective disorders and schizophrenia. [NIH] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current.

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[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] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Embryo Transfer: Removal of a mammalian embryo from one environment and replacement in the same or a new environment. The embryo is usually in the pre-nidation phase, i.e., a blastocyst. The process includes embryo or blastocyst transplantation or transfer after in vitro fertilization and transfer of the inner cell mass of the blastocyst. It is not used for transfer of differentiated embryonic tissue, e.g., germ layer cells. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]

Emetic: An agent that causes vomiting. [EU] Emetine: The principal alkaloid of ipecac, from the ground roots of Uragoga (or Cephaelis) ipecacuanha or U. acuminata, of the Rubiaceae. It is used as an amebicide in many different preparations and may cause serious cardiac, hepatic, or renal damage and violent diarrhea and vomiting. Emetine inhibits protein syntheis in eucaryotic but not prokaryotic cells. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]

Endemic: Present or usually prevalent in a population or geographical area at all times; said of a disease or agent. Called also endemial. [EU] 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] 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] Endocytosis: Cellular uptake of extracellular materials within membrane-limited vacuoles or microvesicles. Endosomes play a central role in endocytosis. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH]

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Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [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, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enema: The injection of a liquid through the anus into the large bowel. [NIH] Enhancer: Transcriptional element in the virus genome. [NIH] Enkephalin: A natural opiate painkiller, in the hypothalamus. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [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] 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] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord.

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An epidural injection is given into this space. [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epirubicin: An anthracycline antibiotic which is the 4'-epi-isomer of doxorubicin. The compound exerts its antitumor effects by interference with the synthesis and function of DNA. Clinical studies indicate activity in breast cancer, non-Hodgkin's lymphomas, ovarian cancer, soft-tissue sarcomas, pancreatic cancer, gastric cancer, small-cell lung cancer and acute leukemia. It is equal in activity to doxorubicin but exhibits less acute toxicities and less cardiotoxicity. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial ovarian cancer: Cancer that occurs in the cells lining the ovaries. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epoprostenol: A prostaglandin that is biosynthesized enzymatically from prostaglandin endoperoxides in human vascular tissue. It is a potent inhibitor of platelet aggregation. The sodium salt has been also used to treat primary pulmonary hypertension. [NIH] Equilenin: 3-Hydroxyestra-1,3,5(10),6,8-pentaen-17-one. A naturally occurring steroid with estrogenic activity obtained from the urine of pregnant mares. [NIH] Equilin: 3-Hydroxyestra-1,3,5(10)7-tetraen-17-one. A naturally occurring steroid with estrogenic activity obtained from the urine of pregnant mares. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Ergot Alkaloids: Alkaloids isolated from the ergot fungus Claviceps purpurea (Hypocreaceae). The ergot alkaloids were the first alpha-adrenergic antagonists discovered, but side effects generally prevent their administration in doses that would produce more than a minimal blockade in humans. Their smooth muscle-stimulating activities may be attributed to alpha-agonistic properties, thus characterizing these alkaloids as a series of partial agonists. They have many clinical applications, notably in obstetrics and the treatment of migraine. (From Martindale, The Extra Pharmacopoeia, 28th ed, p662). [NIH] Erythrina: A genus of leguminous shrubs or trees, mainly tropical, yielding certain alkaloids, lectins, and other useful compounds. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH]

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Escalation: Progressive use of more harmful drugs. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Esotropia: A form of ocular misalignment characterized by an excessive convergence of the visual axes, resulting in a "cross-eye" appearance. An example of this condition occurs when paralysis of the lateral rectus muscle causes an abnormal inward deviation of one eye on attempted gaze. [NIH] Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrone: 3-Hydroxyestra-1,3,5(10)-trien-17-one. A metabolite of estradiol but possessing less biological activity. It is found in the urine of pregnant women and mares, in the human placenta, and in the urine of bulls and stallions. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), estrone may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Ethylene Glycol: A colorless, odorless, viscous dihydroxy alcohol. It has a sweet taste, but is poisonous if ingested. Ethylene glycol is the most important glycol commercially available and is manufactured on a large scale in the United States. It is used as an antifreeze and coolant, in hydraulic fluids, and in the manufacture of low-freezing dynamites and resins. [NIH]

Etodolac: A nonsteroidal anti-inflammatory agent with potent analgesic and antiarthritic properties. It has been shown to be effective in the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and in the alleviation of postoperative pain. [NIH] Euphoria: An exaggerated feeling of physical and emotional well-being not consonant with apparent stimuli or events; usually of psychologic origin, but also seen in organic brain disease and toxic states. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH]

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Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excrete: To get rid of waste from the body. [NIH] Exercise Therapy: Motion of the body or its parts to relieve symptoms or to improve function, leading to physical fitness, but not physical education and training. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exotropia: A form of ocular misalignment where the visual axes diverge inappropriately. For example, medial rectus muscle weakness may produce this condition as the affected eye will deviate laterally upon attempted forward gaze. An exotropia occurs due to the relatively unopposed force exerted on the eye by the lateral rectus muscle, which pulls the eye in an outward direction. [NIH] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]

Expiration: The act of breathing out, or expelling air from the lungs. [EU] 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] Extracorporeal: Situated or occurring outside the body. [EU] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Facial: Of or pertaining to the face. [EU] Facial Pain: Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as facial pain syndromes. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH]

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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] Fecal Incontinence: Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fentanyl: A narcotic opioid drug that is used in the treatment of pain. [NIH] Fertilization in Vitro: Fertilization of an egg outside the body when the egg is normally fertilized in the body. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrillation: A small, local, involuntary contraction of muscle, invisible under the skin, resulting from spontaneous activation of single muscle cells or muscle fibres. [EU] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] Fish Flour: A flour made of pulverized, dried fish or fish parts. [NIH] Fish Products: Food products manufactured from fish (e.g., fish flour, fish meal). [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Flatulence: Production or presence of gas in the gastrointestinal tract which may be expelled through the anus. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and

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megaloblastic anemia. [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] Fossa: A cavity, depression, or pit. [NIH] Fractionation: Dividing the total dose of radiation therapy into several smaller, equal doses delivered over a period of several days. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Fungemia: The presence of fungi circulating in the blood. Opportunistic fungal sepsis is seen most often in immunosuppressed patients with severe neutropenia or in postoperative patients with intravenous catheters and usually follows prolonged antibiotic therapy. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gait: Manner or style of walking. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallstones: The solid masses or stones made of cholesterol or bilirubin that form in the gallbladder or bile ducts. [NIH] 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] Ganglion: 1. A knot, or knotlike mass. 2. A general term for a group of nerve cell bodies located outside the central nervous system; occasionally applied to certain nuclear groups within the brain or spinal cord, e.g. basal ganglia. 3. A benign cystic tumour occurring on a aponeurosis or tendon, as in the wrist or dorsum of the foot; it consists of a thin fibrous capsule enclosing a clear mucinous fluid. [EU] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastric Fundus: The superior portion of the body of the stomach above the level of the cardiac notch. [NIH]

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Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastroenteritis: An acute inflammation of the lining of the stomach and intestines, characterized by anorexia, nausea, diarrhoea, abdominal pain, and weakness, which has various causes, including food poisoning due to infection with such organisms as Escherichia coli, Staphylococcus aureus, and Salmonella species; consumption of irritating food or drink; or psychological factors such as anger, stress, and fear. Called also enterogastritis. [EU] Gastroenterologist: A doctor who specializes in diagnosing and treating disorders of the digestive system. [NIH] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gastroparesis: Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gemcitabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]

Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Germ-free: Free of bacteria, disease-causing viruses, and other organisms that can cause infection. [NIH]

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Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Giant Cells: Multinucleated masses produced by the fusion of many cells; often associated with viral infections. In AIDS, they are induced when the envelope glycoprotein of the HIV virus binds to the CD4 antigen of uninfected neighboring T4 cells. The resulting syncytium leads to cell death and thus may account for the cytopathic effect of the virus. [NIH] Ginger: Deciduous plant rich in volatile oil (oils, volatile). It is used as a flavoring agent and has many other uses both internally and topically. [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] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [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] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glycols: A generic grouping for dihydric alcohols with the hydroxy groups (-OH) located on different carbon atoms. They are viscous liquids with high boiling points for their molecular weights. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Gout:

Hereditary

metabolic

disorder

characterized

by

recurrent

acute

arthritis,

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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] Granisetron: A serotonin receptor (5HT-3 selective) antagonist that has been used as an antiemetic for cancer chemotherapy patients. [NIH] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Granulocytopenia: A deficiency in the number of granulocytes, a type of white blood cell. [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] Gynaecological: Pertaining to gynaecology. [EU] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Habituation: Decline in response of an organism to environmental or other stimuli with repeated or maintained exposure. [NIH] Haematemesis: The vomiting of blood. [EU] Hair Cells: Mechanoreceptors located in the organ of Corti that are sensitive to auditory stimuli and in the vestibular apparatus that are sensitive to movement of the head. In each case the accessory sensory structures are arranged so that appropriate stimuli cause movement of the hair-like projections (stereocilia and kinocilia) which relay the information centrally in the nervous system. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Hallucinogens: Drugs capable of inducing illusions, hallucinations, delusions, paranoid ideations, and other alterations of mood and thinking. Despite the name, the feature that distinguishes these agents from other classes of drugs is their capacity to induce states of altered perception, thought, and feeling that are not experienced otherwise. [NIH]

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Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis. [NIH] Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Helminthiasis: Infestation with parasitic worms of the helminth class. [NIH] Hemicrania: An ache or a pain in one side of the head, as in migraine. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemolysis: The destruction of erythrocytes by many different causal agents such as antibodies, bacteria, chemicals, temperature, and changes in tonicity. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH]

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Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Herpes: Any inflammatory skin disease caused by a herpesvirus and characterized by the formation of clusters of small vesicles. When used alone, the term may refer to herpes simplex or to herpes zoster. [EU] Herpes Zoster: Acute vesicular inflammation. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Heterotropia: One in which the angle of squint remains relatively unaltered on conjugate movement of the eyes. [NIH] Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormonal therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called hormone therapy or endocrine therapy. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH]

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Host: Any animal that receives a transplanted graft. [NIH] Humeral: 1. Of, relating to, or situated in the region of the humerus: brachial. 2. Of or belonging to the shoulder. 3. Of, relating to, or being any of several body parts that are analogous in structure, function, or location to the humerus or shoulder. [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydration: Combining with water. [NIH] Hydrochloric Acid: A strong corrosive acid that is commonly used as a laboratory reagent. It is formed by dissolving hydrogen chloride in water. Gastric acid is the hydrochloric acid component of gastric juice. [NIH] Hydrogel: A network of cross-linked hydrophilic macromolecules used in biomedical applications. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydroxides: Inorganic compounds that contain the OH- group. [NIH] Hydroxyl Radical: The univalent radical OH that is present in hydroxides, alcohols, phenols, glycols. [NIH] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [EU] Hyperbilirubinemia: Pathologic process consisting of an abnormal increase in the amount of bilirubin in the circulating blood, which may result in jaundice. [NIH] Hypercholesterolemia: Abnormally high levels of cholesterol in the blood. [NIH] Hyperesthesia: Increased sensitivity to cutaneous stimulation due to a diminished threshold or an increased response to stimuli. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperkinesia: Abnormally increased motor function or activity; hyperactivity. [EU] Hypersecretion: Excessive secretion. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypersensitivity, Immediate: Hypersensitivity reactions which occur within minutes of exposure to challenging antigen due to the release of histamine which follows the antigenantibody reaction and causes smooth muscle contraction and increased vascular

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permeability. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertensive Encephalopathy: Brain dysfunction or damage resulting from malignant hypertension, usually associated with a diastolic blood pressure in excess of 125 mmHg. Clinical manifestations include headache, nausea, emesis, seizures, altered mental status (in some cases progressing to coma), papilledema, and retinal hemorrhage. Focal neurologic signs may develop. Pathologically, this condition may be associated with the formation of ischemic lesions in the brain (brain ischemia). [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] Hypesthesia: Absent or reduced sensitivity to cutaneous stimulation. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypoxemia: Deficient oxygenation of the blood; hypoxia. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hysterectomy: Excision of the uterus. [NIH] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [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] Ileal: Related to the ileum, the lowest end of the small intestine. [NIH] Ileostomy: Surgical creation of an external opening into the ileum for fecal diversion or drainage. Loop or tube procedures are most often employed. [NIH] Ileum: The lower end of the small intestine. [NIH] Ileus: Obstruction of the intestines. [EU] Illusion: A false interpretation of a genuine percept. [NIH] Iloprost: An eicosanoid, derived from the cyclooxygenase pathway of arachidonic acid metabolism. It is a stable and synthetic analog of epoprostenol, but with a longer half-life than the parent compound. Its actions are similar to prostacyclin. Iloprost produces vasodilation and inhibits platelet aggregation. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression,

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dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]

Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune Sera: Serum that contains antibodies. It is obtained from an animal that has been immunized either by antigen injection or infection with microorganisms containing the antigen. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunoglobulin: A protein that acts as an antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [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] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [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] Impotence: The inability to perform sexual intercourse. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU]

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Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infectious Diarrhea: Diarrhea caused by infection from bacteria, viruses, or parasites. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Influenza: An acute viral infection involving the respiratory tract. It is marked by inflammation of the nasal mucosa, the pharynx, and conjunctiva, and by headache and severe, often generalized, myalgia. [NIH] Information Centers: Facilities for collecting and organizing information. They may be specialized by subject field, type of source material, persons served, location, or type of services. [NIH] Informed Consent: Voluntary authorization, given to the physician by the patient, with full comprehension of the risks involved, for diagnostic or investigative procedures and medical and surgical treatment. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inner ear: The labyrinth, comprising the vestibule, cochlea, and semicircular canals. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inoperable: Not suitable to be operated upon. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the

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purpose of observation, care, diagnosis or treatment. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insufflation: The act of blowing a powder, vapor, or gas into any body cavity for experimental, diagnostic, or therapeutic purposes. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] 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] 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] Intestinal: Having to do with the intestines. [NIH] Intestinal Obstruction: Any impairment, arrest, or reversal of the normal flow of intestinal contents toward the anus. [NIH]

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Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Pressure: Pressure within the cranial cavity. It is influenced by brain mass, the circulatory system, CSF dynamics, and skull rigidity. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraocular: Within the eye. [EU] Intraocular pressure: Pressure of the fluid inside the eye; normal IOP varies among individuals. [NIH] Intraoperative Complications: Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] 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]

Invertebrates: Animals that have no spinal column. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ipecac: A syrup made from the dried rhizomes of two different species, Cephaelis ipecacuanha and C. acuminata, belonging to the Rubiaciae family. They contain emetine, cephaeline, psychotrine and other isoquinolines. Ipecac syrup is used widely as an emetic acting both locally on the gastric mucosa and centrally on the chemoreceptor trigger zone. [NIH]

Irinotecan: An anticancer drug that belongs to a family of anticancer drugs called topoisomerase inhibitors. It is a camptothecin analogue. Also called CPT 11. [NIH] Iris: The most anterior portion of the uveal layer, separating the anterior chamber from the posterior. It consists of two layers - the stroma and the pigmented epithelium. Color of the iris depends on the amount of melanin in the stroma on reflection from the pigmented epithelium. [NIH] Irradiation: The use of high-energy radiation from x-rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes

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produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Irradiation is also called radiation therapy, radiotherapy, and x-ray therapy. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Irritants: Drugs that act locally on cutaneous or mucosal surfaces to produce inflammation; those that cause redness due to hyperemia are rubefacients; those that raise blisters are vesicants and those that penetrate sebaceous glands and cause abscesses are pustulants; tear gases and mustard gases are also irritants. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Isoflurane: A stable, non-explosive inhalation anesthetic, relatively free from significant side effects. [NIH] Isonicotinic: A drug used in the treatment of tuberculosis. [NIH] Isopropyl: A gene mutation inducer. [NIH] Jaundice: A clinical manifestation of hyperbilirubinemia, consisting of deposition of bile pigments in the skin, resulting in a yellowish staining of the skin and mucous membranes. [NIH]

Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Jet lag: Symptoms produced in human beings by fast travel through large meridian difference. [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] Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Ketoprofen: An ibuprofen-type anti-inflammatory analgesic and antipyretic. It is used in the treatment of rheumatoid arthritis and osteoarthritis. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney

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failure, chronic) is irreversible and requires hemodialysis. [NIH] Kidney Failure, Acute: A clinical syndrome characterized by a sudden decrease in glomerular filtration rate, often to values of less than 1 to 2 ml per minute. It is usually associated with oliguria (urine volumes of less than 400 ml per day) and is always associated with biochemical consequences of the reduction in glomerular filtration rate such as a rise in blood urea nitrogen (BUN) and serum creatinine concentrations. [NIH] Kidney Failure, Chronic: An irreversible and usually progressive reduction in renal function in which both kidneys have been damaged by a variety of diseases to the extent that they are unable to adequately remove the metabolic products from the blood and regulate the body's electrolyte composition and acid-base balance. Chronic kidney failure requires hemodialysis or surgery, usually kidney transplantation. [NIH] Kidney stone: A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis, or in the ureters. [NIH] Kidney Transplantation: The transference of a kidney from one human or animal to another. [NIH] Killer Cells: Lymphocyte-like effector cells which mediate antibody-dependent cell cytotoxicity. They kill antibody-coated target cells which they bind with their Fc receptors. [NIH]

Labyrinth: The internal ear; the essential part of the organ of hearing. It consists of an osseous and a membranous portion. [NIH] Lactation: The period of the secretion of milk. [EU] Lactose Intolerance: The disease state resulting from the absence of lactase enzyme in the musocal cells of the gastrointestinal tract, and therefore an inability to break down the disaccharide lactose in milk for absorption from the gastrointestinal tract. It is manifested by indigestion of a mild nature to severe diarrhea. It may be due to inborn defect genetically conditioned or may be acquired. [NIH] Lag: The time elapsing between application of a stimulus and the resulting reaction. [NIH] Lamivudine: A reverse transcriptase inhibitor and zalcitabine analog in which a sulfur atom replaces the 3' carbon of the pentose ring. It is used to treat HIV disease. [NIH] Lanolin: A yellow fat obtained from sheep's wool. It is used as an emollient, cosmetic, and pharmaceutic aid. [NIH] Laparoscopy: Examination, therapy or surgery of the abdomen's interior by means of a laparoscope. [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] Lassitude: Weakness; exhaustion. [EU] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Length of Stay: The period of confinement of a patient to a hospital or other health facility.

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[NIH]

Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leucovorin: The active metabolite of folic acid. Leucovorin is used principally as its calcium salt as an antidote to folic acid antagonists which block the conversion of folic acid to folinic acid. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]

Lithium Carbonate: A lithium salt, classified as a mood-stabilizing agent. Lithium ion alters the metabolism of biogenic monoamines in the central nervous system, and affects multiple neurotransmission systems. [NIH] Lithotripsy: The destruction of a calculus of the kidney, ureter, bladder, or gallbladder by physical forces, including crushing with a lithotriptor through a catheter. Focused percutaneous ultrasound and focused hydraulic shock waves may be used without surgery. Lithotripsy does not include the dissolving of stones by acids or litholysis. Lithotripsy by laser is laser lithotripsy. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or

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site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Low 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] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Luminescence: The property of giving off light without emitting a corresponding degree of heat. It includes the luminescence of inorganic matter or the bioluminescence of human matter, invertebrates and other living organisms. For the luminescence of bacteria, bacterial luminescence is available. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] 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] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphokine: A soluble protein produced by some types of white blood cell that stimulates

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other white blood cells to kill foreign invaders. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnesium Hydroxide: Magnesium hydroxide (Mg(OH)2). An inorganic compound that occurs in nature as the mineral brucite. It acts as an antacid with cathartic effects. [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] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune responseassociated (Ia) antigens, the immune response (Ir) genes which control the ability of an animal to respond immunologically to antigenic stimuli, and genes which determine the structure and/or level of the first four components of complement. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malabsorption syndrome: A group of symptoms such as gas, bloating, abdominal pain, and diarrhea resulting from the body's inability to properly absorb nutrients. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malaria: A protozoan disease caused in humans by four species of the genus Plasmodium (P. falciparum (malaria, falciparum), P. vivax (malaria, vivax), P. ovale, and P. malariae) and transmitted by the bite of an infected female mosquito of the genus Anopheles. Malaria is endemic in parts of Asia, Africa, Central and South America, Oceania, and certain Caribbean islands. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Malaria in animals is caused by other species of plasmodia. [NIH] Malaria, Falciparum: Malaria caused by Plasmodium falciparum. This is the severest form of malaria and is associated with the highest levels of parasites in the blood. This disease is characterized by irregularly recurring febrile paroxysms that in extreme cases occur with acute cerebral, renal, or gastrointestinal manifestations. [NIH] Malaria, Vivax: Malaria caused by Plasmodium vivax. This form of malaria is less severe than malaria, falciparum, but there is a higher probability for relapses to occur. Febrile paroxysms often occur every other day. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Mandibular Nerve: A branch of the trigeminal (5th cranial) nerve. The mandibular nerve

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carries motor fibers to the muscles of mastication and sensory fibers to the teeth and gingivae, the face in the region of the mandible, and parts of the dura. [NIH] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Marijuana Abuse: The excessive use of marijuana with associated psychological symptoms and impairment in social or occupational functioning. [NIH] Mastectomy: Surgery to remove the breast (or as much of the breast tissue as possible). [NIH] Mastication: The act and process of chewing and grinding food in the mouth. [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]

Meat Products: Articles of food which are derived by a process of manufacture from any portion of carcasses of any animal used for food (e.g., head cheese, sausage, scrapple). [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical oncologist: A doctor who specializes in diagnosing and treating cancer using chemotherapy, hormonal therapy, and biological therapy. A medical oncologist often serves as the main caretaker of someone who has cancer and coordinates treatment provided by other specialists. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Mefenamic Acid: A non-steroidal anti-inflammatory agent with analgesic, antiinflammatory, and antipyretic properties. It is an inhibitor of cyclooxygenase. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH]

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Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Fluidity: The motion of phospholipid molecules within the lipid bilayer, dependent on the classes of phospholipids present, their fatty acid composition and degree of unsaturation of the acyl chains, the cholesterol concentration, and temperature. [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] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] 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 the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Metastatic cancer: Cancer that has spread from the place in which it started to other parts of the body. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH]

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Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [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] Mineralocorticoids: A group of corticosteroids primarily associated with the regulation of water and electrolyte balance. This is accomplished through the effect on ion transport in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by plasma volume, serum potassium, and angiotensin II. [NIH] Miscarriage: Spontaneous expulsion of the products of pregnancy before the middle of the second trimester. [NIH] Mistletoe lectin: A substance that comes from the mistletoe plant, and that is being studied as a treatment for cancer. A lectin is a complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [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] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is

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important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motilin: A 22-amino acid polypeptide (molecular weight 2700) isolated from the duodenum. At low pH it inhibits gastric motor activity, whereas at high pH it has a stimulating effect. [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] 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] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle 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]

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Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle Spasticity: Strongly marked hypertonicity of muscles. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Myalgia: Pain in a muscle or muscles. [EU] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myenteric: On stimulation of an intestinal segment, the segment above contracts and that below relaxes. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasal Mucosa: The mucous membrane lining the nasal cavity. [NIH] Natural killer cells: NK cells. A type of white blood cell that contains granules with enzymes that can kill tumor cells or microbial cells. Also called large granular lymphocytes (LGL). [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit.

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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] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle Sharing: Usage of a single needle among two or more people for injecting drugs. Needle sharing is a high-risk behavior for contracting infectious disease. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nervousness: Excessive excitability and irritability, with mental and physical unrest. [EU] 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]

Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neurasthenia: A mental disorder characterized by chronic fatigue and concomitant physiologic symptoms. [NIH] Neuritis: A general term indicating inflammation of a peripheral or cranial nerve. Clinical manifestation may include pain; paresthesias; paresis; or hypesthesia. [NIH] Neuroblastoma: Cancer that arises in immature nerve cells and affects mostly infants and children. [NIH] Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with

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atrophy of the affected central or peripheral nervous system structures. [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] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neurology: A medical specialty concerned with the study of the structures, functions, and diseases of the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU]

Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutropenia: An abnormal decrease in the number of neutrophils, a type of white blood cell. [NIH] Neutrophil: A type of white blood cell. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks

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synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [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] Nociceptors: Peripheral receptors for pain. Nociceptors include receptors which are sensitive to painful mechanical stimuli, extreme heat or cold, and chemical stimuli. All nociceptors are free nerve endings. [NIH] Node-negative: Cancer that has not spread to the lymph nodes. [NIH] Non-small cell lung cancer: A group of lung cancers that includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. [NIH] Nonulcer Dyspepsia: Constant pain or discomfort in the upper GI tract. Symptoms include burning, nausea, and bloating, but no ulcer. Possibly caused by muscle spasms. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [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] Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH]

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Obstetrics: A medical-surgical specialty concerned with management and care of women during pregnancy, parturition, and the puerperium. [NIH] Occult: Obscure; concealed from observation, difficult to understand. [EU] Octreotide: A potent, long-acting somatostatin octapeptide analog which has a wide range of physiological actions. It inhibits growth hormone secretion, is effective in the treatment of hormone-secreting tumors from various organs, and has beneficial effects in the management of many pathological states including diabetes mellitus, orthostatic hypertension, hyperinsulinism, hypergastrinemia, and small bowel fistula. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Oculomotor: Cranial nerve III. It originate from the lower ventral surface of the midbrain and is classified as a motor nerve. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oliguria: Clinical manifestation of the urinary system consisting of a decrease in the amount of urine secreted. [NIH] Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Oncologist: A doctor who specializes in treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. [NIH] Oncology: The study of cancer. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Opportunistic Infections: An infection caused by an organism which becomes pathogenic under certain conditions, e.g., during immunosuppression. [NIH] Optic Nerve: The 2nd cranial nerve. The optic nerve conveys visual information from the retina to the brain. The nerve carries the axons of the retinal ganglion cells which sort at the optic chiasm and continue via the optic tracts to the brain. The largest projection is to the lateral geniculate nuclei; other important targets include the superior colliculi and the suprachiasmatic nuclei. Though known as the second cranial nerve, it is considered part of the central nervous system. [NIH] Orbit: One of the two cavities in the skull which contains an eyeball. Each eye is located in a bony socket or orbit. [NIH] Orbital: Pertaining to the orbit (= the bony cavity that contains the eyeball). [EU] Orchiectomy: The surgical removal of one or both testicles. [NIH] Organelles: Specific particles of membrane-bound organized living substances present in eukaryotic cells, such as the mitochondria; the golgi apparatus; endoplasmic reticulum;

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lysomomes; plastids; and vacuoles. [NIH] Orgasm: The crisis of sexual excitement in either humans or animals. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Orthostatic: Pertaining to or caused by standing erect. [EU] Osmolality: The concentration of osmotically active particles in solution expressed in terms of osmoles of solute per kilogram of solvent. The osmolality is directly proportional to the colligative properties of solutions; osmotic pressure, boiling point elevation, freezing point depression, and vapour pressure lowering. [EU] Osmoles: The standard unit of osmotic pressure. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] 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] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdosage: 1. The administration of an excessive dose. 2. The condition resulting from an excessive dose. [EU] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Pacemaker: An object or substance that influences the rate at which a certain phenomenon occurs; often used alone to indicate the natural cardiac pacemaker or an artificial cardiac pacemaker. In biochemistry, a substance whose rate of reaction sets the pace for a series of interrelated reactions. [EU] Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU]

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Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Papaverine: An alkaloid found in opium but not closely related to the other opium alkaloids in its structure or pharmacological actions. It is a direct-acting smooth muscle relaxant used in the treatment of impotence and as a vasodilator, especially for cerebral vasodilation. The mechanism of its pharmacological actions is not clear, but it apparently can inhibit phosphodiesterases and it may have direct actions on calcium channels. [NIH] Papilledema: Swelling around the optic disk. [NIH] Paraffin: A mixture of solid hydrocarbons obtained from petroleum. It has a wide range of uses including as a stiffening agent in ointments, as a lubricant, and as a topical antiinflammatory. It is also commonly used as an embedding material in histology. [NIH] Paralysis: Loss of ability to move all or part of the body. [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] Parasitic Diseases: Infections or infestations with parasitic organisms. They are often contracted through contact with an intermediate vector, but may occur as the result of direct exposure. [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]

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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] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxetine: A serotonin uptake inhibitor that is effective in the treatment of depression. [NIH]

Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Parturition: The act or process of given birth to a child. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

PDQ: Physician Data Query. PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information is available on the CancerNet Web site, and more specific information about PDQ can be found at http://cancernet.nci.nih.gov/pdq.html. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the

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corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [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] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Perineum: The area between the anus and the sex organs. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [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] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] 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] Pernicious: Tending to a fatal issue. [EU] Pernicious anemia: A type of anemia (low red blood cell count) caused by the body's inability to absorb vitamin B12. [NIH]

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Perspiration: Sweating; the functional secretion of sweat. [EU] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] 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] Phenylmethylsulfonyl Fluoride: An enzyme inhibitor that inactivates IRC-50 arvin, subtilisin, and the fatty acid synthetase complex. [NIH] Phobia: A persistent, irrational, intense fear of a specific object, activity, or situation (the phobic stimulus), fear that is recognized as being excessive or unreasonable by the individual himself. When a phobia is a significant source of distress or interferes with social functioning, it is considered a mental disorder; phobic disorder (or neurosis). In DSM III phobic disorders are subclassified as agoraphobia, social phobias, and simple phobias. Used as a word termination denoting irrational fear of or aversion to the subject indicated by the stem to which it is affixed. [EU] Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. [NIH] Phosphates: Inorganic salts of phosphoric acid. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and

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function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphoric Acids: Inorganic derivatives of phosphoric acid (H3PO4). Inorganic salts are known as phosphates and organic esters are phosphoric acid esters. [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] Photophobia: Abnormal sensitivity to light. This may occur as a manifestation of eye diseases; migraine; subarachnoid hemorrhage; meningitis; and other disorders. Photophobia may also occur in association with depression and other mental disorders. [NIH] Photosensitization: The development of abnormally heightened reactivity of the skin to sunlight. [EU] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Fitness: A state of well-being in which performance is optimal, often as a result of physical conditioning which may be prescribed for disease therapy. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

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

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Piroxicam: 4-Hydroxy-2-methyl-N-2-pyridyl-2H-1,2-benzothiazine-3-carboxamide 1,1dioxide. A non-steroidal anti-inflammatory agent that is well established in the treatment of rheumatoid arthritis and osteoarthritis. Its usefulness has also been demonstrated in the treatment of musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily. The drug has also been shown to be effective if administered rectally. Gastrointestinal complaints are the most frequently reported side effects. [NIH] Pituitary Gland: A small, unpaired gland situated in the sella turcica tissue. It is connected to the hypothalamus by a short stalk. [NIH] Placebo Effect: An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plana: The radiographic term applied to a vertebral body crushed to a thin plate. [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

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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 protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] 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] Platelet Count: A count of the number of platelets per unit volume in a sample of venous blood. [NIH] Platelet Transfusion: The transfer of blood platelets from a donor to a recipient or reinfusion to the donor. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Poison Control Centers: Facilities which provide information concerning poisons and treatment of poisoning in emergencies. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Pollen: The male fertilizing element of flowering plants analogous to sperm in animals. It is released from the anthers as yellow dust, to be carried by insect or other vectors, including wind, to the ovary (stigma) of other flowers to produce the embryo enclosed by the seed. The pollens of many plants are allergenic. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU]

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Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [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] Postherpetic Neuralgia: Variety of neuralgia associated with migraine in which pain is felt in or behind the eye. [NIH] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitating Factors: Factors associated with the definitive onset of a disease, illness, accident, behavioral response, or course of action. Usually one factor is more important or more obviously recognizable than others, if several are involved, and one may often be regarded as "necessary". Examples include exposure to specific disease; amount or level of an infectious organism, drug, or noxious agent, etc. [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] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Pre-eclamptic: A syndrome characterized by hypertension, albuminuria, and generalized oedema, occurring only in pregnancy. [NIH]

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Pregnancy Outcome: Results of conception and ensuing pregnancy, including live birth, stillbirth, spontaneous abortion, induced abortion. The outcome may follow natural or artificial insemination or any of the various reproduction techniques, such as embryo transfer or fertilization in vitro. [NIH] Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Premenstrual: Occurring before menstruation. [EU] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [NIH] Progeny: The offspring produced in any generation. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prokaryotic Cells: Cells, such as those of bacteria and the blue green algae, which lack a nuclear membrane so that the nuclear material is either scattered in the cytoplasm or collected in a nucleoid region. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Propanolol: Beta blocker. [NIH] Prophylaxis: An attempt to prevent disease. [NIH]

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Propofol: A widely used anesthetic. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Propulsive: Tending or having power to propel; driving onward or forward; impelling to action or motion. [EU] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes. [NIH] 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] Prostaglandins D: Physiologically active prostaglandins found in many tissues and organs. They show pressor activity, are mediators of inflammation, and have potential antithrombotic effects. [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] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] 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]

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Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] 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]

Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychophysiology: The study of the physiological basis of human and animal behavior. [NIH]

Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Psychotropic Drugs: A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents). [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and

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editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pupil: The aperture in the iris through which light passes. [NIH] Purulent: Consisting of or containing pus; associated with the formation of or caused by pus. [EU] Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU] Pyloric Sphincter: The muscle between the stomach and the small intestine. [NIH] Pyoderma: Any purulent skin disease (Dorland, 27th ed). [NIH] Pyoderma Gangrenosum: An idiopathic, rapidly evolving, and severely debilitating disease occurring most commonly in association with chronic ulcerative colitis. It is characterized by the presence of boggy, purplish ulcers with undermined borders, appearing mostly on the legs. The majority of cases are in people between 40 and 60 years old. Its etiology is unknown. [NIH] Pyridoxal: 3-Hydroxy-5-(hydroxymethyl)-2-methyl-4- pyridinecarboxaldehyde. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can

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also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiopharmaceuticals: Drugs containing a radioactive substance that are used in the diagnosis and treatment of cancer and in pain management of bone metastases. Also called radioactive drugs. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [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]

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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] Reconstitution: 1. A type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. The restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Recovery Room: Hospital unit providing continuous monitoring of the patient following anesthesia. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red blood cells: RBCs. Cells that carry oxygen to all parts of the body. Also called erythrocytes. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] 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] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Registries: The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal pelvis: The area at the center of the kidney. Urine collects here and is funneled into the ureter, the tube that connects the kidney to the bladder. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus

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limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Reproduction Techniques: Methods pertaining to the generation of new individuals. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retching: Dry vomiting. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU] Retinal Hemorrhage: Bleeding from the vessels of the retina. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retrobulbar: Behind the pons. [EU] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [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] Ribose: A pentose active in biological systems usually in its D-form. [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

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developing a disease. [NIH] Ritonavir: An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rye: A hardy grain crop, Secale cereale, grown in northern climates. It is the most frequent host to ergot (claviceps), the toxic fungus. Its hybrid with wheat is triticale, another grain. [NIH]

Saccharin: Flavoring agent and non-nutritive sweetener. [NIH] Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Salicylic: A tuberculosis drug. [NIH] Saline: A solution of salt and water. [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] Salvage Therapy: A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoidosis: An idiopathic systemic inflammatory granulomatous disorder comprised of epithelioid and multinucleated giant cells with little necrosis. It usually invades the lungs with fibrosis and may also involve lymph nodes, skin, liver, spleen, eyes, phalangeal bones, and parotid glands. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Scopolamine: An alkaloid from Solanaceae, especially Datura metel L. and Scopola carniolica. Scopolamine and its quaternary derivatives act as antimuscarinics like atropine, but may have more central nervous system effects. Among the many uses are as an anesthetic premedication, in urinary incontinence, in motion sickness, as an antispasmodic, and as a mydriatic and cycloplegic. [NIH]

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Screening: Checking for disease when there are no symptoms. [NIH] Second Messenger Systems: Systems in which an intracellular signal is generated in response to an intercellular primary messenger such as a hormone or neurotransmitter. They are intermediate signals in cellular processes such as metabolism, secretion, contraction, phototransduction, and cell growth. Examples of second messenger systems are the adenyl cyclase-cyclic AMP system, the phosphatidylinositol diphosphate-inositol triphosphate system, and the cyclic GMP system. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sedatives, Barbiturate: Those derivatives of barbituric or thiobarbituric acid that are used as hypnotics or sedatives. The structural class of all such derivatives, regardless of use, is barbiturates. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semicircular canal: Three long canals of the bony labyrinth of the ear, forming loops and opening into the vestibule by five openings. [NIH] Senescence: The bodily and mental state associated with advancing age. [NIH] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] 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] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serrata: The serrated anterior border of the retina located approximately 8.5 mm from the limbus and adjacent to the pars plana of the ciliary body. [NIH] Serrated: Having notches or teeth on the edge as a saw has. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins

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have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [NIH] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Sexually Transmitted Diseases: Diseases due to or propagated by sexual contact. [NIH] Shivering: Involuntary contraction or twitching of the muscles. It is a physiologic method of heat production in man and other mammals. [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]

Shock, Septic: Shock due to circulatory insufficiency caused most commonly by gramnegative bacteremia. It is less often the result of the persistent presence of other microorganisms in the blood (fungemia, viremia); in rare instances, it is caused by gram-positive organisms, but with different symptomatology. [NIH] Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of small bowel. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Single-agent: The use of a single drug or other therapy. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Sleep apnea: A serious, potentially life-threatening breathing disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effort. [NIH] Small cell lung cancer: A type of lung cancer in which the cells appear small and round when viewed under the microscope. Also called oat cell lung cancer. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the

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large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Isolation: The separation of individuals or groups resulting in the lack of or minimizing of social contact and/or communication. This separation may be accomplished by physical separation, by social barriers and by psychological mechanisms. In the latter, there may be interaction but no real communication. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Soft tissue sarcoma: A sarcoma that begins in the muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Somnolence: Sleepiness; also unnatural drowsiness. [EU] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU]

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Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrophotometry: The art or process of comparing photometrically the relative intensities of the light in different parts of the spectrum. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal tap: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a lumbar puncture. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] Spontaneous Abortion: The non-induced birth of an embryo or of fetus prior to the stage of viability at about 20 weeks of gestation. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] 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] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the

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skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Stabilization: The creation of a stable state. [EU] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stem Cells: Relatively undifferentiated cells of the same lineage (family type) that retain the ability to divide and cycle throughout postnatal life to provide cells that can become specialized and take the place of those that die or are lost. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] 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] Stillbirth: The birth of a dead fetus or baby. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strabismus: Deviation of the eye which the patient cannot overcome. The visual axes assume a position relative to each other different from that required by the physiological conditions. The various forms of strabismus are spoken of as tropias, their direction being indicated by the appropriate prefix, as cyclo tropia, esotropia, exotropia, hypertropia, and hypotropia. Called also cast, heterotropia, manifest deviation, and squint. [EU] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [NIH] 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]

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Stroke Volume: The amount of blood pumped out of the heart per beat not to be confused with cardiac output (volume/time). [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] 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]

Subtilisin: A serine endopeptidase isolated from Bacillus subtilis. It hydrolyzes proteins with broad specificity for peptide bonds, and a preference for a large uncharged residue in P1. It also hydrolyzes peptide amides. (From Enzyme Nomenclature, 1992) EC 3.4.21.62. [NIH]

Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfonic Acids: Inorganic or organic oxy acids of sulfur which contain the RSO2(OH) radical. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Supportive care: Treatment given to prevent, control, or relieve complications and side effects and to improve the comfort and quality of life of people who have cancer. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supraspinal: Above the spinal column or any spine. [NIH] Supratentorial: Located in the upper part of the brain. [NIH] Sweat: The fluid excreted by the sweat glands. It consists of water containing sodium chloride, phosphate, urea, ammonia, and other waste products. [NIH] Sweat Glands: Sweat-producing structures that are embedded in the dermis. Each gland consists of a single tube, a coiled body, and a superficial duct. [NIH] Sympathectomy: The removal or interruption of some part of the sympathetic nervous system for therapeutic or research purposes. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral

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column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic therapy: Treatment that uses substances that travel through the bloodstream, reaching and affecting cells all over the body. [NIH] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] Tapeworm: A flatworm that is an endoparasite and belongs to the class Cestoda. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU]

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Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or mucous membranes. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Tenesmus: Straining, especially ineffectual and painful straining at stool or in urination. [EU] Tennis Elbow: A condition characterized by pain in or near the lateral humeral epicondyle or in the forearm extensor muscle mass as a result of unusual strain. It occurs in tennis players as well as housewives, artisans, and violinists. [NIH] Terminator: A DNA sequence sited at the end of a transcriptional unit that signals the end of transcription. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thermoregulation: Heat regulation. [EU] Thoracic: Having to do with the chest. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH]

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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] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Time Management: Planning and control of time to improve efficiency and effectiveness. [NIH]

Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Topical: On the surface of the body. [NIH] Topoisomerase inhibitors: A family of anticancer drugs. The topoisomerase enzymes are responsible for the arrangement and rearrangement of DNA in the cell and for cell growth and replication. Inhibiting these enzymes may kill cancer cells or stop their growth. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] 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] Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating. [NIH]

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Tranquilizing Agents: A traditional grouping of drugs said to have a soothing or calming effect on mood, thought, or behavior. Included here are the anti-anxiety agents (minor tranquilizers), antimanic agents, and the antipsychotic agents (major tranquilizers). These drugs act by different mechanisms and are used for different therapeutic purposes. [NIH] Transaminase: Aminotransferase (= a subclass of enzymes of the transferase class that catalyse the transfer of an amino group from a donor (generally an amino acid) to an acceptor (generally 2-keto acid). Most of these enzymes are pyridoxal-phosphate-proteins. [EU]

Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcutaneous: Transdermal. [EU] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transfer Factor: Factor derived from leukocyte lysates of immune donors which can transfer both local and systemic cellular immunity to nonimmune recipients. [NIH] Transfusion: The infusion of components of blood or whole blood into the bloodstream. The blood may be donated from another person, or it may have been taken from the person earlier and stored until needed. [NIH] Transitional cell carcinoma: A type of cancer that develops in the lining of the bladder, ureter, or renal pelvis. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [NIH] Translocation: The movement of material in solution inside the body of the plant. [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] Trees: Woody, usually tall, perennial higher plants (Angiosperms, Gymnosperms, and some Pterophyta) having usually a main stem and numerous branches. [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] Tricuspid Atresia: Absence of the orifice between the right atrium and ventricle, with the

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presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy because the right ventricle is absent or not functional. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] 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] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] 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] Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] 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] Univalent: Pertaining to an unpaired chromosome during the zygotene stage of prophase to first metaphase in meiosis. [NIH] Universal Precautions: Prudent standard preventive measures to be taken by professional and other health personnel in contact with persons afflicted with a communicable disease, to avoid contracting the disease by contagion or infection. Precautions are especially applicable in the diagnosis and care of AIDS patients. [NIH] Unresectable: Unable to be surgically removed. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including

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nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureter: One of a pair of thick-walled tubes that transports urine from the kidney pelvis to the bladder. [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 breaks down this protein, uric acid levels rise and can form stones. [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] 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] Vacuoles: Any spaces or cavities within a cell. They may function in digestion, storage, secretion, or excretion. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vaginal Discharge: A common gynecologic disorder characterized by an abnormal, nonbloody discharge from the genital tract. [NIH] Vaginitis: Inflammation of the vagina characterized by pain and a purulent discharge. [NIH] Vaginosis: A condition caused by the overgrowth of anaerobic bacteria (e. g., Gardnerella vaginalis), resulting in vaginal irritation and discharge. [NIH] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH]

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Valerian: Valeriana officinale, an ancient, sedative herb of the large family Valerianaceae. The roots were formerly used to treat hysterias and other neurotic states and are presently used to treat sleep disorders. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] 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] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU]

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Vestibular Nerve: The vestibular part of the 8th cranial nerve (vestibulocochlear nerve). The vestibular nerve fibers arise from neurons of Scarpa's ganglion and project peripherally to vestibular hair cells and centrally to the vestibular nuclei of the brain stem. These fibers mediate the sense of balance and head position. [NIH] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [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] Vinorelbine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Viral Hepatitis: Hepatitis caused by a virus. Five different viruses (A, B, C, D, and E) most commonly cause this form of hepatitis. Other rare viruses may also cause hepatitis. [NIH] Viral Load: The quantity of measurable virus in the blood. Change in viral load, measured in plasma, is used as a surrogate marker in HIV disease progression. [NIH] Viremia: The presence of viruses in the blood. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitamin U: A vitamin found in green vegetables. It is used in the treatment of peptic ulcers, colitis, and gastritis and has an effect on secretory, acid-forming, and enzymatic functions of the intestinal tract. [NIH] Vitreoretinal: A rare familial condition characterized by a clear vitreous, except for preretinal filaments and veils which have been loosened from the retina, a dense hyaloid membrane which is perforated and detached, and masses of peripheral retinal pigmentation inters. [NIH] Vitreous Body: The transparent, semigelatinous substance that fills the cavity behind the crystalline lens of the eye and in front of the retina. It is contained in a thin hyoid membrane and forms about four fifths of the optic globe. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH]

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Vivo: Outside of or removed from the body of a living organism. [NIH] Voltage-gated: It is opened by the altered charge distribution across the cell membrane. [NIH]

Weight Gain: Increase in body weight over existing weight. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] X-ray therapy: The use of high-energy radiation from x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials called radioisotopes. Radioisotopes produce radiation and can be placed in or near the tumor or in the area near cancer cells. This type of radiation treatment is called internal radiation therapy, implant radiation, interstitial radiation, or brachytherapy. Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. X-ray therapy is also called radiation therapy, radiotherapy, and irradiation. [NIH] Yawning: An involuntary deep inspiration with the mouth open, often accompanied by the act of stretching. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zalcitabine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by a hydrogen. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication at low concentrations, acting as a chainterminator of viral DNA by binding to reverse transcriptase. Its principal toxic side effect is axonal degeneration resulting in peripheral neuropathy. [NIH] Zidovudine: A dideoxynucleoside compound in which the 3'-hydroxy group on the sugar moiety has been replaced by an azido group. This modification prevents the formation of phosphodiester linkages which are needed for the completion of nucleic acid chains. The compound is a potent inhibitor of HIV replication, acting as a chain-terminator of viral DNA during reverse transcription. It improves immunologic function, partially reverses the HIVinduced neurological dysfunction, and improves certain other clinical abnormalities associated with AIDS. Its principal toxic effect is dose-dependent suppression of bone marrow, resulting in anemia and leukopenia. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

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349

INDEX 5 5-hydroxyindoleacetic acid, 45, 255 A Abdominal Cramps, 175, 255 Ablate, 255, 270 Acatalasia, 255, 270 Acceptor, 123, 255, 305, 317, 342 Acclimatization, 117, 255 Accommodation, 16, 255 Acetaminophen, 14, 121, 133, 144, 158, 255 Acetylcholine, 165, 167, 169, 255, 272, 315 Acetylcholinesterase, 150, 255 Achlorhydria, 169, 255 Acidosis, 19, 255 Acne, 154, 255 Acquired Immunodeficiency Syndrome, 149, 255 Actin, 8, 256 Activities of Daily Living, 34, 148, 256 Acupuncture Points, 14, 123, 256 Acupuncture Therapy, 124, 256 Acustimulation, 40, 55, 70, 71, 72, 73, 77, 78, 256 Acyl, 256, 309 Adaptability, 256, 270, 271 Adenine, 256 Adenocarcinoma, 32, 240, 256, 315 Adenosine, 18, 134, 256, 268, 322 Adenosine Monophosphate, 19, 256 Adenylate Cyclase, 129, 256 Adjunctive Therapy, 17, 256 Adjuvant, 133, 158, 226, 239, 256, 292 Adrenal Cortex, 256, 277, 278, 288, 325 Adrenal Medulla, 256, 270, 287, 315 Adrenaline, 256 Adrenergic, 28, 184, 256, 260, 261, 282, 287, 339, 343 Adrenergic Antagonists, 256, 287 Adrenoreceptor, 157, 256 Adverse Effect, 11, 23, 69, 117, 132, 142, 145, 146, 167, 256, 262, 334 Aerophagia, 178, 256 Aerosol, 114, 148, 149, 257 Afferent, 16, 18, 28, 122, 128, 257 Affinity, 22, 29, 119, 138, 141, 146, 257, 263, 305, 335 Age of Onset, 257, 343 Aggravation, 148, 257

Agonist, 21, 27, 118, 130, 140, 147, 153, 157, 159, 165, 168, 257, 262, 268, 282, 312, 314, 339 Agoraphobia, 257, 299, 318, 321 Agranulocytosis, 154, 257 Airway, 257, 334 Akathisia, 123, 257, 261 Albumin, 129, 257, 323 Alertness, 257, 268 Alexia, 257, 284 Algorithms, 179, 257, 266 Alimentary, 257, 318, 319 Alkaline, 255, 257, 258, 264, 268 Alkaloid, 145, 258, 263, 268, 273, 285, 311, 314, 318, 332 Allergens, 139, 258 Alopecia, 12, 258, 278 Alpha Particles, 258, 328 Alternative medicine, 192, 258 Alveoli, 258, 345 Ameliorated, 5, 117, 131, 143, 258 Ameliorating, 132, 143, 258 Amenorrhea, 80, 258, 260 Amifostine, 239, 258 Amine, 198, 258, 266, 296 Amino Acid Sequence, 258, 260, 265 Amino Acids, 91, 116, 258, 265, 266, 269, 287, 314, 320, 323, 326, 338, 342, 343, 344 Ammonia, 258, 338, 344 Amnestic, 258, 290 Amphetamine, 258, 259 Ampulla, 258, 285 Amputation, 144, 259 Amyloid, 11, 26, 259 Anaerobic, 259, 344 Anaesthetic, 153, 259 Anal, 175, 178, 181, 259, 290 Anal Fissure, 175, 259 Analeptic, 123, 259 Analgesic, 27, 46, 67, 117, 118, 126, 133, 137, 141, 143, 146, 149, 152, 153, 158, 168, 255, 259, 268, 273, 276, 281, 288, 298, 303, 308, 311, 316, 341 Analog, 12, 259, 290, 298, 304, 316 Analogous, 259, 297, 323, 342 Analysis of Variance, 33, 259 Anatomical, 116, 125, 151, 189, 259, 263, 267, 276, 281, 299, 332

Nausea

Androgens, 198, 256, 259, 262, 277 Anemia, 83, 86, 181, 219, 259, 291, 307, 320, 347 Anesthetics, 52, 95, 122, 259, 264, 287 Aneurysm, 259, 345 Angina, 18, 226, 259 Animal model, 6, 7, 12, 259 Anionic, 115, 259 Anions, 257, 259, 302, 334 Anorectal, 179, 260 Anorexia Nervosa, 169, 184, 260 Antagonism, 27, 131, 260, 268 Anterograde, 169, 260 Anthracycline, 260, 279, 280, 287 Antiallergic, 260, 278 Anti-Anxiety Agents, 121, 122, 260, 325, 327, 342 Antibacterial, 260, 336 Antibiotic, 5, 260, 279, 283, 287, 291, 319, 325, 336 Antibiotic Prophylaxis, 260, 325 Antibodies, 260, 263, 295, 299, 306, 328 Antibody, 257, 260, 261, 274, 295, 297, 299, 300, 303, 304, 308, 311, 328, 329, 336, 347 Anticholinergic, 184, 260 Anticoagulant, 260, 326 Anticonvulsant, 148, 260 Anticonvulsive, 143, 260 Antidepressant, 115, 125, 152, 157, 260, 298, 345 Antidepressive Agents, 260, 327 Antidote, 261, 305 Antiepileptic, 23, 261 Antigen, 257, 258, 260, 261, 275, 293, 297, 299, 300, 308 Anti-Inflammatory Agents, 133, 158, 261, 263, 278 Antimetabolite, 261, 290 Antineoplastic, 261, 278, 283, 290, 317, 346 Antioxidant, 261, 263 Antipsychotic, 143, 261, 282, 314, 342 Antipsychotic Agents, 261, 282, 342 Antipyretic, 255, 261, 303, 308 Antispasmodic, 261, 316, 332 Antitussive, 261, 316 Anuria, 261, 303 Anus, 259, 260, 262, 264, 267, 286, 290, 301, 320, 330 Anxiety Disorders, 262, 318 Anxiolytic, 115, 157, 262, 316 Apathy, 262, 314 Aperture, 116, 262, 328

350

Apnea, 133, 262 Apomorphine, 117, 143, 262 Apoptosis, 11, 165, 262 Appendicitis, 80, 179, 262 Applicability, 24, 262 Aqueous, 142, 262, 264, 279, 297 Arachidonic Acid, 262, 298, 326 Arginine, 120, 159, 160, 262, 315 Aromatase, 238, 262 Aromatic, 119, 262, 269 Arterial, 8, 38, 143, 262, 267, 277, 298, 326, 339 Arteries, 8, 262, 266, 271, 277, 309, 312, 328 Arterioles, 8, 262, 266, 312, 345 Arteritis, 175, 262 Arthroscopy, 51, 262 Articular, 262, 317 Ascorbic Acid, 120, 159, 160, 262, 297 Aspirate, 24, 263 Aspirin, 10, 121, 133, 141, 158, 263, 281 Assay, 19, 29, 165, 263 Asthenia, 146, 263 Astrocytes, 263, 310 Asymptomatic, 19, 188, 255, 263, 318 Ataxia, 23, 218, 219, 263, 271, 340 Atrial, 39, 263, 277, 343 Atrioventricular, 263, 277 Atrium, 263, 277, 342, 345 Atrophy, 218, 263, 314 Atropine, 58, 263, 265, 332 Auditory, 263, 294, 344 Aura, 129, 148, 263 Auricular, 69, 263 Autoantibodies, 263, 280 Autodigestion, 263, 318 Autoimmune disease, 140, 263, 311 Autoimmune Hepatitis, 229, 263 Autonomic, 10, 255, 258, 261, 264, 265, 293, 315, 320, 335, 338 Autonomic Nervous System, 264, 265, 320, 335, 338 Axonal, 22, 264, 347 B Back Pain, 35, 176, 179, 264 Bacteremia, 264, 334 Bactericidal, 264, 288 Bacteriostatic, 264, 287 Barbiturates, 133, 147, 165, 166, 167, 264, 333 Barium, 189, 264 Barium enema, 189, 264 Basal Ganglia, 261, 263, 264, 267, 272, 291

351

Basal Ganglia Diseases, 263, 264, 272 Base, 116, 124, 126, 144, 152, 160, 230, 231, 256, 264, 279, 280, 288, 303, 304, 340, 344 Basophils, 257, 264, 294, 305 Belching, 163, 177, 178, 257, 264 Belladonna, 202, 263, 265 Benign, 34, 179, 265, 269, 291, 295, 313, 329 Benign tumor, 179, 265 Benzamides, 122, 184, 265 Benzene, 265 Benzodiazepines, 29, 157, 165, 166, 167, 199, 265 Beta-Endorphin, 153, 265 Beta-pleated, 259, 265 Bewilderment, 265, 276 Bilateral, 55, 130, 265, 319 Bile, 187, 265, 291, 292, 299, 303, 305, 337 Bile Acids, 265, 292, 337 Bile Acids and Salts, 265 Bile Ducts, 265, 291 Bile Pigments, 265, 303 Biliary, 181, 182, 265, 268, 318 Biliary Tract, 182, 265, 268, 318 Bilirubin, 257, 265, 291, 297 Binding agent, 126, 152, 265 Bioavailability, 21, 154, 265, 266 Biochemical, 129, 131, 136, 161, 165, 261, 265, 266, 304, 310, 317, 333 Bioequivalent, 164, 266 Biogenic Monoamines, 266, 305 Biological response modifier, 266, 301 Biological therapy, 266, 294, 308 Biological Transport, 266, 281 Bioluminescence, 266, 306 Biopsy, 189, 266, 320 Biotechnology, 34, 35, 192, 215, 217, 218, 219, 266 Bipolar Disorder, 165, 166, 167, 235, 266 Bladder, 5, 80, 175, 239, 266, 278, 299, 305, 311, 314, 326, 330, 342, 344 Bloating, 4, 6, 16, 28, 176, 178, 266, 292, 300, 303, 307, 315 Blood Cell Count, 266, 320 Blood Coagulation, 266, 268, 340 Blood Coagulation Factors, 266 Blood Glucose, 6, 176, 266, 295, 301 Blood Platelets, 266, 323, 333 Blood Proteins, 188, 266 Blood transfusion, 190, 266 Blood-Brain Barrier, 131, 161, 267 Body Composition, 30, 267

Body Fluids, 129, 193, 267, 283, 290, 315, 335 Body Image, 195, 267, 280 Body Regions, 267, 274 Bone Marrow, 31, 45, 265, 267, 299, 306, 311, 335, 347 Bone Marrow Transplantation, 31, 45, 267 Bone metastases, 226, 236, 267, 329 Bowel Movement, 7, 267, 281, 337 Brachial, 267, 297, 308 Brachial Plexus, 267, 308 Brachytherapy, 267, 301, 303, 328, 347 Bradykinin, 267, 315, 323 Brain Hypoxia, 267, 340 Brain Infarction, 267 Brain Ischemia, 140, 267, 298 Brain Stem, 267, 346 Branch, 232, 239, 249, 267, 285, 306, 307, 319, 336, 339, 340 Breakdown, 268, 281, 291 Breast reconstruction, 53, 268 Bromine, 115, 268 Bronchi, 268, 287, 289, 341 Bronchial, 114, 148, 149, 268, 296 Bronchitis, 81, 179, 268, 272 Bulimia, 81, 165, 166, 167, 194, 195, 268 Bullous, 268, 280 Buprenorphine, 123, 268 Burns, 179, 268 Burns, Electric, 268 Butterflies, 177, 268 C Cachexia, 21, 22, 32, 242, 268 Caffeine, 55, 118, 121, 133, 158, 259, 268 Calcium, 129, 130, 193, 268, 273, 275, 305, 318, 334 Calculi, 268, 294 Camptothecin, 268, 302 Candidiasis, 180, 268 Candidosis, 269 Cannabidiol, 60, 72, 142, 143, 269 Cannabinoids, 27, 31, 34, 60, 118, 140, 159, 269 Cannabinol, 269 Cannabis, 60, 72, 269, 340 Capsules, 114, 126, 152, 269, 283, 292 Carbohydrate, 269, 277, 293, 324 Carbon Dioxide, 269, 270, 279, 291, 322, 331, 345 Carboxy, 169, 269 Carboxylic Acids, 122, 269 Carboxymethylcellulose, 126, 152, 269

Nausea

Carcinogen, 269, 288 Carcinogenic, 265, 269, 300, 325, 337 Carcinoid, 255, 269 Carcinoma, 32, 226, 240, 269, 315, 337 Cardiac Output, 18, 269, 338 Cardiotoxicity, 269, 287 Cardiovascular, 18, 117, 144, 188, 228, 258, 269, 270, 333, 335 Cardiovascular disease, 144, 188, 228, 269 Cardiovascular System, 18, 270 Carnitine, 63, 270 Carotid Body, 270, 272 Carpal Tunnel Syndrome, 68, 270 Case report, 39, 270, 273 Catalase, 11, 255, 270 Catalyse, 270, 342 Catecholamine, 260, 270, 282, 321 Catheter Ablation, 52, 270 Caudal, 46, 270, 298, 324 Causal, 54, 270, 295 Cause of Death, 8, 21, 270 Cell, 5, 8, 9, 12, 16, 25, 27, 30, 86, 129, 136, 171, 175, 218, 219, 255, 256, 257, 262, 263, 264, 266, 270, 271, 272, 273, 275, 278, 279, 280, 284, 285, 286, 287, 288, 289, 291, 293, 294, 299, 300, 301, 302, 304, 310, 311, 313, 315, 316, 317, 322, 323, 326, 329, 330, 331, 333, 334, 339, 340, 341, 342, 343, 344, 347 Cell Cycle, 270, 273, 326 Cell Death, 27, 262, 270, 293, 313 Cell Differentiation, 270, 334 Cell Division, 218, 264, 270, 271, 294, 310, 323 Cell Lineage, 12, 270 Cell membrane, 136, 266, 270, 280, 322, 347 Cell proliferation, 271, 334 Cell Respiration, 271, 331 Cell Survival, 271, 294 Cellobiose, 271 Cellulose, 125, 126, 152, 271, 291, 323 Central Nervous System Infections, 271, 295 Cerebellar, 141, 263, 271, 330, 342 Cerebellar Diseases, 263, 271, 342 Cerebral, 8, 11, 14, 129, 134, 263, 264, 267, 271, 277, 279, 287, 288, 307, 318, 327, 336 Cerebral Arteries, 8, 271 Cerebral Palsy, 271, 336 Cerebrospinal, 271, 306, 336 Cerebrospinal fluid, 271, 306, 336

352

Cerebrovascular, 8, 264, 269, 271, 340 Cerebrum, 271, 343 Cervical, 136, 137, 267, 271, 308, 313 Cervix, 271 Cesarean Section, 18, 271 Chemoprotective, 271, 280 Chemoreceptor, 117, 122, 164, 261, 271, 302 Chest Pain, 176, 177, 178, 179, 182, 229, 238, 239, 272 Child Care, 188, 272 Chiropractic, 170, 272 Chlorine, 115, 272 Cholecystectomy, 36, 40, 42, 43, 44, 53, 70, 73, 188, 272 Cholecystitis, 188, 272 Cholelithiasis, 175, 272 Cholesterol, 10, 83, 185, 188, 205, 265, 272, 277, 291, 297, 309, 337, 339 Choline, 64, 118, 255, 272 Cholinergic, 10, 165, 167, 261, 272, 314 Chorea, 117, 140, 165, 166, 167, 261, 272 Choreatic Disorders, 272 Choroid, 272, 331 Chromatin, 262, 272, 286 Chromosome, 272, 295, 305, 343 Chronic Disease, 150, 162, 268, 272, 274 Chronic Obstructive Pulmonary Disease, 231, 241, 272 Chronic renal, 272, 323, 343 Ciliary, 272, 333 Ciliary Body, 272, 333 Circadian, 157, 273 Circadian Rhythm, 157, 273 Circulatory system, 273, 285, 302 CIS, 137, 169, 273, 331 Cisplatin, 12, 16, 38, 56, 63, 135, 200, 273, 316 Citric Acid, 118, 273 Citrus, 262, 273 Clamp, 29, 273 Clinical study, 273, 277 Clinical trial, 5, 9, 11, 12, 14, 15, 21, 56, 107, 110, 215, 273, 276, 277, 283, 311, 319, 326, 329 Cloning, 266, 273 Coca, 273 Cocaine, 165, 166, 167, 273 Cochlea, 273, 300 Codeine, 141, 149, 273, 316 Coenzyme, 93, 263, 274 Cofactor, 129, 274, 326, 340

353

Cognition, 274, 314 Cognitive restructuring, 274, 337 Colic, 47, 175, 274 Colitis, 86, 175, 178, 179, 274, 303, 346 Collagen, 184, 274, 292, 323, 325 Collagen disease, 184, 274 Collapse, 268, 274, 334 Colloidal, 257, 274, 284, 334 Colorectal, 81, 181, 240, 274 Colorectal Cancer, 81, 181, 240, 274 Colostomy, 6, 274 Combination chemotherapy, 108, 274 Combination Therapy, 11, 274 Combinatorial, 140, 274 Communicable disease, 274, 343 Comorbidity, 29, 274 Complement, 274, 275, 307, 323 Complementary and alternative medicine, 13, 67, 69, 104, 275 Complementary medicine, 69, 275 Computational Biology, 215, 217, 275 Computed tomography, 236, 275 Computerized axial tomography, 275 Computerized tomography, 275 Conception, 275, 276, 290, 325, 337 Concomitant, 10, 132, 169, 275, 313 Condoms, 190, 276 Conduction, 151, 270, 276 Conflict of Interest, 41, 276 Confusion, 176, 276, 282, 314, 344 Congestion, 261, 276 Conjunctiva, 276, 300, 343 Connective Tissue, 262, 267, 274, 276, 290, 291, 292, 306, 320, 331, 332 Conscious Sedation, 153, 276 Consciousness, 176, 259, 260, 276, 279, 280, 282 Consolidation, 123, 276 Consolidation therapy, 123, 276 Constriction, 276, 303, 345 Constriction, Pathologic, 276, 345 Consultation, 4, 276 Consumption, 9, 55, 116, 166, 276, 292, 315, 317 Contamination, 174, 222, 276 Contraception, 127, 276 Contraceptive, 48, 127, 276 Contraceptive Agents, 127, 276 Contraindications, ii, 175, 276 Control group, 6, 14, 17, 25, 32, 67, 276, 329 Controlled clinical trial, 133, 158, 277, 329

Controlled study, 58, 277 Convulsions, 8, 176, 260, 277, 284 Coordination, 277, 311 Cor, 10, 277 Coronary, 269, 277, 309, 312 Coronary Arteriosclerosis, 277, 312 Coronary heart disease, 269, 277 Coronary Thrombosis, 277, 309, 312 Corpus, 277, 306, 320, 325 Corpus Luteum, 277, 306, 325 Cortex, 263, 271, 277, 288, 330 Cortical, 277, 289, 333, 340 Corticosteroid, 135, 277 Cortisol, 10, 31, 257, 278 Cortisone, 278, 280 Cranial, 148, 175, 278, 293, 295, 302, 307, 313, 316, 320, 343, 344, 346 Craniocerebral Trauma, 264, 278, 295, 340 Craniotomy, 53, 55, 278 Creatinine, 193, 278, 304, 343 Credentialing, 69, 278 Cues, 134, 135, 278 Curative, 24, 278, 340 Cutaneous, 22, 79, 218, 269, 278, 297, 298, 303, 306 Cyclic, 10, 19, 194, 223, 256, 268, 278, 294, 315, 321, 333 Cyclophosphamide, 33, 93, 200, 278 Cyst, 263, 278 Cystectomy, 239, 278 Cystitis, 5, 278 Cytochrome, 262, 278 Cytokine, 31, 32, 278 Cytoplasm, 262, 264, 270, 279, 286, 294, 311, 325 Cytotoxic, 162, 164, 279, 316, 328, 329, 334 Cytotoxic chemotherapy, 279, 316 Cytotoxicity, 273, 279, 304 D Data Collection, 17, 279 Databases, Bibliographic, 215, 279 Daunorubicin, 201, 279, 283 Day Care, 61, 174, 279 Deamination, 279, 310, 344 Decarboxylation, 266, 279, 296 Decision Making, 176, 279 Degenerative, 279, 296, 311, 317 Dehydration, 175, 189, 279 Deletion, 262, 279 Delirium, 123, 261, 279 Delusions, 279, 294, 327 Dementia, 132, 165, 166, 167, 256, 261, 279

Nausea

Dendrites, 280, 314 Density, 27, 280, 316, 335 Dental Caries, 280, 290 Depersonalization, 280, 318, 332 Depolarization, 280, 334 Depressive Disorder, 241, 280, 305 Deprivation, 130, 280 Derealization, 280, 318 Dermal, 142, 280 Dermatitis, 139, 154, 280 Dermatitis Herpetiformis, 154, 280 Dermatologic Agents, 280 Dermatosis, 154, 280 Detoxification, 145, 188, 280 Deuterium, 280, 297 Dexamethasone, 10, 40, 42, 45, 52, 73, 109, 110, 128, 135, 171, 280 Dexrazoxane, 240, 280 Dextrorotatory, 133, 281 Diabetes Mellitus, 16, 81, 281, 293, 295, 316 Diagnostic procedure, 113, 193, 281 Diaphoresis, 130, 281 Diaphragm, 281, 296 Diarrhoea, 281, 292 Diastolic, 281, 298 Diastolic blood pressure, 281, 298 Dietary Fats, 23, 281 Dietitian, 189, 281 Diffusion, 127, 141, 266, 281 Diflunisal, 141, 281 Digestive system, 111, 126, 152, 174, 177, 178, 185, 281, 292 Digestive tract, 116, 163, 174, 177, 181, 224, 281, 334, 337 Dihydrotestosterone, 281, 330 Dihydroxy, 281, 288 Dilatation, 8, 259, 281, 325, 345 Dilatation, Pathologic, 281, 345 Dilation, 267, 281, 345 Dilator, 144, 281 Dimethyl, 143, 281 Diploid, 281, 323 Direct, iii, 8, 10, 18, 33, 131, 148, 161, 180, 197, 270, 281, 282, 318, 330, 339 Discrimination, 177, 281 Disease Progression, 282, 346 Disinfectant, 282, 288 Dislocation, 282, 336 Disorientation, 134, 276, 279, 282 Dissociation, 257, 282 Distal, 6, 28, 264, 270, 282, 284, 292, 327

354

Distention, 6, 122, 282 Diuresis, 268, 282 Diurnal, 10, 116, 268, 282 Diverticula, 282 Diverticulitis, 179, 282 Diverticulum, 282 Dizziness, 23, 26, 118, 123, 130, 137, 142, 146, 154, 170, 176, 179, 282, 318, 345 Domperidone, 4, 141, 282 Dopamine, 29, 184, 258, 261, 262, 273, 282, 309, 310 Dopamine Antagonists, 184, 282 Dorsal, 32, 282, 324 Dorsum, 282, 283, 291 Dosage Forms, 126, 143, 149, 152, 167, 283 Dose-dependent, 11, 31, 283, 347 Double-blinded, 53, 283 Doxorubicin, 33, 201, 202, 230, 240, 280, 283, 287 Drive, ii, vi, 20, 59, 130, 179, 189, 283, 305 Dronabinol, 14, 21, 149, 202, 283, 340 Drug Industry, 126, 152, 283 Drug Interactions, 177, 208, 283 Drug Monitoring, 29, 283 Drug Tolerance, 283, 341 Duct, 258, 283, 289, 299, 332, 338 Duodenal Ulcer, 179, 283 Duodenum, 179, 189, 265, 283, 285, 291, 292, 303, 311, 318, 320, 337 Dyes, 259, 264, 283 Dysentery, 145, 175, 283 Dyskinesia, 117, 123, 165, 166, 167, 261, 283 Dyslexia, 165, 166, 167, 284 Dysmenorrhea, 81, 284, 322 Dyspepsia, 16, 20, 44, 74, 146, 163, 176, 178, 179, 181, 230, 284, 300 Dysphagia, 178, 181, 284 Dysphoria, 29, 123, 284 Dysphoric, 280, 284 Dysplasia, 219, 284 Dyspnea, 284, 318 Dystonia, 117, 165, 166, 167, 261, 284 Dystonia Musculorum Deformans, 117, 284 Dystrophy, 218, 228, 237, 284 E Eating Disorders, 139, 176, 284 Eclampsia, 8, 284 Edema, 8, 194, 284, 344 Effector, 32, 255, 274, 284, 304, 314, 321 Effector cell, 32, 284, 304, 314

355

Ejaculation, 29, 140, 284, 333 Elastin, 274, 284 Electroacupuncture, 74, 107, 284 Electroconvulsive Therapy, 79, 157, 284 Electrode, 124, 284 Electrolyte, 122, 129, 189, 206, 277, 279, 284, 290, 304, 310, 315, 324, 335, 344 Electrons, 261, 264, 284, 302, 307, 317, 328, 329 Electrophoresis, 19, 284 Electrophysiological, 22, 285 Elementary Particles, 284, 285, 307, 314, 326 Emaciation, 256, 285 Embryo, 270, 285, 300, 323, 325, 336 Embryo Transfer, 285, 325 Emesis, 33, 39, 41, 46, 47, 48, 57, 117, 122, 128, 130, 135, 157, 160, 164, 166, 171, 182, 184, 261, 285, 298 Emetic, 10, 21, 105, 119, 122, 130, 135, 141, 145, 165, 171, 262, 285, 302 Emetine, 145, 285, 302 Emollient, 285, 304, 316 Emphysema, 272, 285 Empirical, 31, 176, 285 Encapsulated, 114, 126, 152, 285 Endemic, 285, 307, 336 Endocarditis, 269, 285 Endocrine System, 285, 314 Endocytosis, 8, 285 Endometrium, 285, 309 Endoscope, 189, 285 Endoscopic, 180, 189, 262, 285, 286 Endoscopy, 188, 189, 227, 286 Endothelial cell, 8, 267, 286, 340 Endothelium, 8, 286, 315 Endothelium, Lymphatic, 286 Endothelium, Vascular, 286 Endothelium-derived, 286, 315 Endotoxin, 286, 343 End-stage renal, 272, 286, 323 Enema, 286 Enhancer, 21, 155, 286 Enkephalin, 265, 286 Enteritis, 175, 286 Enterocolitis, 286 Environmental Exposure, 286, 316 Environmental Health, 214, 216, 286 Enzymatic, 19, 266, 268, 275, 280, 286, 296, 331, 346 Eosinophils, 257, 286, 294, 305 Epidemic, 188, 286, 336

Epidermis, 286, 328 Epidural, 18, 286 Epigastric, 287, 318 Epinephrine, 256, 282, 287, 315, 343 Epirubicin, 202, 230, 240, 287 Epithelial, 155, 231, 256, 266, 273, 287, 296 Epithelial ovarian cancer, 231, 287 Epithelium, 286, 287, 302 Epoprostenol, 287, 298 Equilenin, 130, 287 Equilin, 130, 287 Erectile, 26, 117, 143, 287, 319 Erection, 143, 287 Ergot, 133, 203, 287, 332 Ergot Alkaloids, 133, 287 Erythrina, 97, 100, 287 Erythrocytes, 259, 266, 267, 287, 295, 330 Erythromycin, 4, 287 Escalation, 9, 288 Esophageal, 116, 179, 288, 292 Esophagitis, 177, 179, 288, 292 Esophagus, 163, 179, 181, 189, 281, 288, 292, 295, 306, 320, 321, 330, 337 Esotropia, 288, 337 Essential Tremor, 218, 288 Estradiol, 24, 202, 288 Estrogen, 20, 23, 105, 130, 262, 288, 325, 333, 339 Estrone, 130, 288 Ethanol, 9, 11, 126, 152, 288 Ether, 126, 140, 152, 288 Ethylene Glycol, 168, 288 Etodolac, 126, 152, 288 Euphoria, 137, 288 Evacuation, 276, 288, 291, 304 Evoke, 288, 337 Excipients, 22, 126, 152, 288 Excitability, 33, 129, 288, 312, 313 Excitation, 18, 271, 289 Excitatory, 146, 169, 289, 293 Excrete, 261, 289, 303 Exercise Therapy, 14, 289 Exhaustion, 82, 260, 289, 304, 307 Exocrine, 289, 318 Exogenous, 282, 289, 343 Exotropia, 289, 337 Expectorant, 145, 289 Expiration, 289, 331 Extensor, 289, 327, 340 External-beam radiation, 289, 302, 328, 347 Extracellular, 259, 263, 276, 285, 289, 335

Nausea

Extracorporeal, 43, 289 Extraction, 54, 271, 289 Extrapyramidal, 123, 257, 261, 282, 289 Extremity, 267, 289, 308, 319 Exudate, 289, 316 F Facial, 148, 289, 319, 335 Facial Pain, 148, 289 Family Planning, 215, 289 Family Relations, 39, 289 Fat, 23, 28, 185, 262, 265, 267, 277, 289, 304, 305, 311, 331, 335 Fatigue, 16, 25, 30, 53, 81, 123, 133, 150, 170, 174, 182, 188, 190, 194, 241, 290, 295, 313 Fatty acids, 119, 163, 257, 269, 290, 326 Febrile, 290, 307, 336 Fecal Incontinence, 179, 290, 299 Feces, 276, 290, 337 Fentanyl, 46, 153, 290 Fertilization in Vitro, 290, 325 Fetus, 271, 290, 322, 325, 336, 337, 344 Fibrillation, 39, 290 Fibrosis, 219, 290, 332 Filtration, 193, 290, 304 Fish Flour, 290 Fish Products, 189, 290 Fistula, 290, 292, 316 Flatulence, 175, 178, 179, 181, 290 Flatus, 7, 290, 291 Fluid Therapy, 290, 315 Fluorine, 115, 290 Fluorouracil, 33, 95, 203, 240, 290 Flushing, 130, 146, 175, 290 Fluvoxamine, 48, 95, 290 Fold, 23, 119, 150, 290 Folic Acid, 290, 305 Foodborne Illness, 229, 291 Forearm, 266, 291, 308, 340 Fossa, 76, 291 Fractionation, 236, 291 Functional Disorders, 181, 291 Fungemia, 291, 334 Fungus, 268, 287, 291, 332 G Gait, 3, 271, 291 Gallbladder, 82, 177, 181, 187, 255, 265, 272, 281, 291, 292, 305 Gallstones, 82, 175, 177, 187, 265, 272, 291 Gamma Rays, 291, 328, 329 Ganglia, 255, 258, 264, 291, 313, 320, 339 Ganglion, 291, 316, 346

356

Gas exchange, 291, 345 Gastric Acid, 115, 165, 166, 167, 291 Gastric Emptying, 5, 16, 20, 163, 169, 194, 291, 292 Gastric Fundus, 16, 291 Gastric Juices, 292, 320 Gastrin, 292, 296 Gastritis, 82, 175, 292, 346 Gastroduodenal, 179, 292 Gastroenteritis, 10, 175, 179, 222, 268, 292 Gastroenterologist, 189, 292 Gastroenterology, 3, 21, 48, 49, 179, 181, 184, 229, 232, 292 Gastroesophageal Reflux, 163, 169, 176, 179, 232, 233, 292 Gastroesophageal Reflux Disease, 176, 179, 233, 292 Gastrointestinal tract, 4, 17, 117, 169, 176, 188, 264, 288, 290, 292, 304, 333, 335 Gastroparesis, 4, 5, 16, 20, 184, 292 Gelatin, 114, 126, 152, 163, 292, 338 Gemcitabine, 32, 203, 240, 292 Gene, 11, 12, 48, 219, 220, 262, 266, 292, 303, 316 Gene Expression, 12, 219, 292 Genetics, 188, 292, 319 Genital, 292, 344 Genotype, 292, 321 Germ-free, 189, 292 Gestation, 293, 320, 322, 336 Giant Cells, 293, 332 Ginger, 16, 36, 43, 44, 53, 56, 60, 70, 73, 74, 76, 77, 78, 95, 96, 103, 108, 109, 293 Gland, 256, 278, 293, 306, 318, 319, 322, 326, 333, 337, 338, 341 Glossopharyngeal Nerve, 289, 293 Glucocorticoid, 280, 293 Glucose, 21, 218, 262, 266, 271, 281, 293, 295, 301, 332 Glucose Intolerance, 281, 293 Glucose tolerance, 21, 293 Glucose Tolerance Test, 293 Glutamate, 11, 33, 293 Glycols, 293, 297 Glycoprotein, 293, 340, 343 Gonadal, 293, 337 Gonadotropin, 21, 293 Gout, 82, 175, 293 Governing Board, 294, 324 Grade, 114, 185, 294 Graft, 294, 297 Gram-negative, 294, 334

357

Gram-positive, 294, 334 Granisetron, 35, 39, 40, 45, 73, 135, 138, 203, 294 Granulocytes, 257, 294, 334, 347 Granulocytopenia, 11, 294 Growth factors, 23, 294 Guanylate Cyclase, 294, 315 Gynaecological, 52, 294 H Habitual, 123, 294 Habituation, 34, 124, 294 Haematemesis, 285, 294 Hair Cells, 12, 294, 346 Half-Life, 294, 298, 322 Hallucinogens, 294, 327 Haploid, 295, 323 Haptens, 257, 295 Headache Disorders, 148, 295 Health Education, 188, 224, 225, 295 Health Promotion, 187, 295 Heart attack, 269, 295 Heart failure, 193, 229, 295 Heartburn, 4, 120, 159, 163, 169, 174, 176, 177, 178, 179, 181, 252, 295, 296, 300 Helminthiasis, 175, 271, 295 Hemicrania, 295 Hemodialysis, 295, 304 Hemodynamics, 18, 295 Hemoglobin, 259, 266, 287, 295, 305 Hemoglobinuria, 218, 295 Hemolysis, 154, 295 Hemorrhage, 175, 179, 278, 295, 322, 337 Hemorrhoids, 82, 175, 295 Hemostasis, 296, 333 Hepatic, 181, 257, 279, 285, 293, 296, 311 Hepatitis, 82, 175, 185, 188, 296, 346 Hepatocytes, 296 Hereditary, 272, 293, 296, 311, 313, 331 Heredity, 292, 296 Herpes, 144, 175, 296 Herpes Zoster, 144, 175, 296 Heterogeneity, 257, 296 Heterotropia, 296, 337 Hiatal Hernia, 177, 296 Hiccup, 282, 296 Histamine, 19, 184, 261, 296, 297 Histidine, 296 Histology, 179, 296, 318 Homeostasis, 10, 32, 296, 335 Homogeneous, 127, 296, 321 Hormonal, 130, 263, 278, 296, 308 Hormonal therapy, 296, 308

Hormone, 127, 130, 200, 202, 225, 255, 256, 265, 273, 277, 278, 287, 288, 292, 296, 301, 316, 325, 331, 333, 334, 335, 340, 341 Hormone Replacement Therapy, 127, 225, 296 Host, 9, 32, 269, 297, 299, 332, 344, 346 Humeral, 297, 340 Hybrid, 29, 297, 332 Hydration, 5, 126, 152, 297 Hydrochloric Acid, 255, 297 Hydrogel, 126, 152, 297 Hydrogen, 169, 255, 258, 264, 269, 270, 280, 297, 305, 310, 314, 317, 321, 326, 347 Hydrogen Peroxide, 270, 297, 305 Hydrolysis, 255, 271, 273, 297, 321, 323 Hydrophilic, 155, 297 Hydroxides, 297 Hydroxyl Radical, 19, 297 Hydroxylysine, 274, 297 Hydroxyproline, 274, 297 Hyperalgesia, 144, 146, 297 Hyperbilirubinemia, 297, 303 Hypercholesterolemia, 83, 175, 297 Hyperesthesia, 26, 297 Hyperglycemia, 176, 179, 297 Hyperkinesia, 165, 166, 167, 297 Hypersecretion, 165, 166, 167, 297 Hypersensitivity, 139, 181, 258, 297, 331 Hypersensitivity, Immediate, 258, 297 Hypertension, 8, 18, 83, 140, 144, 165, 166, 167, 193, 269, 295, 298, 316, 324, 344 Hypertensive Encephalopathy, 8, 298 Hypertrophy, 277, 298, 343 Hyperuricemia, 294, 298 Hypesthesia, 298, 313 Hypnotic, 24, 298 Hypoglycemia, 176, 179, 298 Hypotension, 11, 18, 38, 261, 277, 298 Hypothalamic, 10, 130, 298 Hypothalamus, 264, 286, 298, 322, 335 Hypoxemia, 18, 298 Hypoxia, 279, 298 Hysterectomy, 72, 298 Hysterotomy, 271, 298 I Ibuprofen, 10, 141, 199, 298, 303 Idiopathic, 16, 132, 161, 298, 328, 332 Ileal, 28, 298 Ileostomy, 6, 298 Ileum, 298, 303 Ileus, 6, 184, 298 Illusion, 298, 345

Nausea

Iloprost, 60, 298 Imidazole, 115, 296, 298 Imipramine, 23, 298 Immune function, 31, 299 Immune response, 9, 25, 256, 261, 263, 278, 295, 299, 307, 338, 344, 346 Immune Sera, 299 Immune system, 31, 118, 159, 164, 174, 180, 189, 263, 266, 284, 299, 306, 307, 311, 344, 347 Immunity, 255, 299, 342 Immunization, 185, 188, 231, 299 Immunodeficiency, 30, 180, 190, 218, 224, 255, 299 Immunodeficiency syndrome, 180, 190, 224, 299 Immunoglobulin, 31, 260, 299, 311 Immunohistochemistry, 28, 299 Immunologic, 179, 299, 329, 347 Immunology, 256, 257, 299 Immunosuppressant, 290, 299 Immunosuppressive, 278, 293, 299 Impaction, 179, 299 Impairment, 26, 29, 119, 132, 156, 159, 170, 263, 265, 279, 283, 299, 301, 308, 309, 327 Implant radiation, 299, 301, 303, 328, 347 Impotence, 143, 287, 299, 318 In vitro, 22, 33, 164, 285, 299 In vivo, 22, 23, 33, 118, 159, 164, 299 Incision, 188, 298, 299, 302 Incompetence, 292, 299 Incontinence, 26, 178, 299, 332 Indicative, 182, 299, 319, 345 Indigestion, 60, 169, 175, 177, 300, 304 Induction, 27, 38, 259, 261, 276, 300, 325 Infarction, 84, 267, 300, 330 Infectious Diarrhea, 179, 300 Inflammatory bowel disease, 165, 166, 167, 178, 300 Influenza, 83, 225, 237, 300 Information Centers, 175, 300 Informed Consent, 17, 300 Infusion, 5, 11, 16, 43, 300, 342 Ingestion, 16, 142, 156, 293, 300, 323 Inhalation, 21, 22, 114, 122, 257, 296, 300, 303, 323 Initiation, 25, 32, 184, 300 Inner ear, 12, 300 Innervation, 267, 300, 308 Inoperable, 12, 300 Inorganic, 122, 273, 297, 300, 306, 307, 311, 321, 322, 338

358

Inotropic, 282, 300 Inpatients, 67, 300 Insight, 12, 29, 301 Insomnia, 6, 30, 123, 154, 157, 301, 325 Insufflation, 122, 301 Insulator, 301, 311 Insulin, 4, 176, 203, 293, 301, 343 Insulin-dependent diabetes mellitus, 301 Interferon, 25, 301 Interferon-alpha, 301 Interleukin-1, 31, 301 Interleukin-2, 301 Intermittent, 4, 123, 232, 290, 301 Internal Medicine, 15, 32, 292, 301 Internal radiation, 301, 303, 328, 347 Interstitial, 17, 267, 301, 303, 347 Intervertebral, 301, 306 Intervertebral Disk Displacement, 301, 306 Intestinal Obstruction, 179, 301 Intestine, 28, 127, 179, 265, 267, 274, 286, 302, 304, 320 Intoxication, 14, 279, 302, 347 Intracellular, 268, 300, 302, 315, 324, 330, 333, 334 Intracranial Pressure, 122, 302 Intramuscular, 17, 163, 302, 318 Intraocular, 118, 158, 159, 302 Intraocular pressure, 118, 158, 159, 302 Intraoperative Complications, 24, 302 Intrathecal, 50, 61, 201, 302 Intravenous, 18, 36, 40, 46, 47, 57, 142, 153, 162, 189, 253, 291, 300, 302, 318 Intrinsic, 16, 28, 257, 302 Invasive, 20, 114, 116, 124, 151, 153, 239, 299, 302, 307 Invertebrates, 302, 306 Involuntary, 264, 272, 288, 290, 302, 312, 330, 334, 335, 347 Ion Channels, 263, 302, 314, 339 Ionizing, 258, 286, 302, 329 Ions, 129, 264, 282, 284, 297, 302, 310 Ipecac, 97, 285, 302 Irinotecan, 204, 240, 302 Iris, 92, 302, 328 Irradiation, 32, 302, 347 Irritants, 283, 303 Ischemia, 19, 263, 267, 303, 330 Isoenzyme, 169, 303 Isoflurane, 52, 303 Isonicotinic, 122, 303 Isopropyl, 38, 40, 72, 303

359

J Jaundice, 175, 177, 188, 297, 303 Jejunostomy, 6, 303 Jejunum, 303 Jet lag, 150, 165, 166, 167, 303 Joint, 170, 174, 262, 303, 317, 336, 339 K Kb, 214, 303 Keto, 303, 342 Ketoprofen, 36, 98, 141, 303 Kidney Disease, 111, 188, 193, 214, 219, 223, 228, 233, 303 Kidney Failure, 194, 286, 303, 304 Kidney Failure, Acute, 303, 304 Kidney Failure, Chronic, 194, 304 Kidney stone, 193, 304, 344 Kidney Transplantation, 304 Killer Cells, 304 L Labyrinth, 134, 273, 300, 304, 333, 346 Lactation, 304, 325 Lactose Intolerance, 178, 304 Lag, 304 Lamivudine, 9, 304 Lanolin, 139, 304 Laparoscopy, 47, 55, 56, 78, 304 Large Intestine, 274, 281, 302, 304, 330, 335 Lassitude, 123, 304 Latent, 304, 324 Laxative, 269, 304 Lectin, 164, 304, 310 Length of Stay, 17, 304 Leprosy, 154, 305 Lesion, 305, 339, 343 Lethargy, 19, 166, 252, 305 Leucine, 265, 305 Leucovorin, 240, 305 Leukemia, 218, 283, 287, 305 Leukocytes, 264, 266, 267, 286, 294, 301, 305, 311, 343 Leukopenia, 305, 347 Libido, 157, 259, 305 Library Services, 248, 305 Ligament, 305, 326, 336 Ligands, 140, 305 Linkage, 168, 271, 305 Lipid, 11, 136, 272, 301, 303, 305, 309, 311 Lipid Peroxidation, 11, 305 Lipophilic, 155, 305 Lithium, 157, 261, 305 Lithium Carbonate, 157, 305 Lithotripsy, 43, 305

Localization, 29, 299, 305 Localized, 26, 267, 280, 285, 300, 306, 310, 313, 322, 343 Locomotion, 306, 323 Locomotor, 27, 306 Loop, 19, 98, 201, 298, 306 Low Back Pain, 68, 306 Lower Esophageal Sphincter, 194, 292, 306 Lumbar, 133, 264, 301, 306, 336 Lumbar puncture, 133, 306, 336 Luminescence, 23, 306 Lupus, 84, 86, 274, 306 Lutein Cells, 306, 325 Lymph, 193, 271, 273, 286, 306, 315, 332 Lymph node, 193, 271, 306, 315, 332 Lymphatic, 84, 286, 300, 306, 323, 335, 336, 341 Lymphatic system, 306, 335, 336, 341 Lymphocyte, 255, 261, 304, 306, 307, 308 Lymphocyte Count, 255, 306 Lymphoid, 260, 306, 307 Lymphokine, 25, 306 Lymphoma, 40, 73, 218, 307 M Macrophage, 301, 307 Magnesium Hydroxide, 118, 307 Magnetic Resonance Imaging, 7, 307 Magnetic Resonance Spectroscopy, 27, 307 Major Histocompatibility Complex, 164, 307 Malabsorption, 177, 179, 218, 307, 334 Malabsorption syndrome, 307, 334 Malaise, 7, 284, 307 Malaria, 154, 175, 307 Malaria, Falciparum, 307 Malaria, Vivax, 307 Malignant, 140, 179, 218, 256, 261, 298, 307, 313, 329, 332 Malignant tumor, 179, 307 Malnutrition, 28, 162, 174, 257, 263, 268, 307, 312 Mammary, 23, 307, 339 Mandible, 307, 308 Mandibular Nerve, 55, 307 Mania, 121, 122, 123, 128, 150, 308 Manic, 261, 266, 305, 308, 327 Manic-depressive psychosis, 308, 327 Manifest, 264, 308, 337 Marijuana Abuse, 29, 308 Mastectomy, 25, 268, 308 Mastication, 308, 343

Nausea

Meat, 174, 281, 308 Meat Products, 281, 308 Medial, 7, 289, 308 Median Nerve, 192, 270, 308 Mediate, 282, 304, 308, 346 Mediator, 10, 19, 30, 301, 308, 333 Medical oncologist, 15, 308 Medical Records, 15, 308 Medical Staff, 156, 283, 308 MEDLINE, 215, 217, 219, 308 Mefenamic Acid, 141, 308 Melanocytes, 308, 309 Melanoma, 218, 309 Membrane Fluidity, 136, 309 Memory, 11, 26, 29, 132, 150, 154, 260, 279, 280, 309 Meninges, 271, 278, 309 Meningitis, 309, 322 Menopause, 84, 136, 309, 324, 325 Menstrual Cycle, 20, 178, 309, 325 Menstruation, 258, 284, 309, 325 Mental Disorders, 111, 309, 322, 327 Mental Health, iv, 4, 111, 214, 216, 232, 309 Mental Processes, 282, 309, 327 Mesolimbic, 261, 309 Meta-Analysis, 43, 309 Metabolic disorder, 180, 293, 309 Metabolite, 27, 137, 138, 281, 288, 305, 309, 325 Metastasis, 309 Metastatic, 13, 17, 32, 130, 230, 238, 240, 309 Metastatic cancer, 17, 309 Methionine, 265, 281, 309, 338 Metoclopramide, 4, 35, 40, 43, 48, 52, 54, 60, 73, 99, 122, 141, 171, 204, 309 MI, 254, 309 Microbe, 310, 341 Microorganism, 274, 310, 346 Micro-organism, 280, 310, 334 Microscopy, 8, 29, 310 Microtubules, 310, 317 Mineralocorticoids, 256, 277, 310 Miscarriage, 55, 310 Mistletoe lectin, 164, 310 Mitosis, 262, 310 Mobilization, 32, 310 Modeling, 170, 310 Modification, 310, 328, 347

360

Molecular, 12, 21, 23, 126, 127, 140, 152, 215, 217, 259, 266, 275, 293, 310, 311, 325, 330, 343 Molecular Structure, 310, 343 Monitor, 278, 310, 315 Monoamine, 48, 157, 159, 258, 260, 310, 343 Monoamine Oxidase, 157, 159, 258, 260, 310, 343 Monoclonal, 303, 311, 328, 347 Monocytes, 164, 301, 305, 311 Mononuclear, 32, 311, 343 Mood Disorders, 114, 148, 149, 311 Morphine, 37, 52, 131, 146, 153, 161, 168, 169, 262, 268, 273, 311, 312, 316 Morphological, 16, 285, 291, 308, 311 Morphology, 12, 311 Motilin, 184, 311 Motion Sickness, 42, 84, 117, 119, 134, 142, 151, 170, 311, 313, 332 Motor Activity, 277, 311 Motor nerve, 311, 316 Movement Disorders, 261, 311, 340 Mucosa, 155, 286, 302, 306, 311, 325 Mucus, 283, 289, 311, 343 Multicenter study, 55, 78, 311 Multiple sclerosis, 3, 60, 140, 144, 149, 311 Muscle Fibers, 311, 312 Muscle relaxant, 260, 311 Muscle Relaxation, 69, 78, 312 Muscle Spasticity, 114, 148, 149, 312 Muscular Atrophy, 218, 312 Muscular Dystrophies, 284, 312 Musculature, 312, 336 Myalgia, 300, 312 Mydriatic, 281, 312, 332 Myelin, 311, 312 Myenteric, 28, 169, 312 Myocardial infarction, 41, 73, 226, 261, 277, 309, 312 Myocardial Ischemia, 18, 312 Myocardium, 309, 312 Myotonic Dystrophy, 218, 312 N Naloxone, 168, 265, 312 Naltrexone, 9, 123, 146, 312 Narcolepsy, 236, 312 Narcosis, 162, 312 Narcotic, 124, 131, 141, 153, 161, 290, 311, 312, 341 Nasal Mucosa, 300, 312 Natural killer cells, 31, 312

361

NCI, 1, 107, 108, 109, 110, 178, 213, 273, 313, 319 Neck Pain, 4, 313 Necrosis, 262, 267, 300, 309, 312, 313, 331, 332 Needle Sharing, 190, 313 Neonatal, 133, 231, 313 Neoplasia, 218, 313 Neoplasm, 313, 332 Neoplastic, 289, 307, 313, 332 Nephropathy, 303, 313 Nerve Endings, 313, 315 Nervousness, 154, 313 Neural, 7, 16, 28, 257, 259, 311, 313 Neural Pathways, 8, 28, 313 Neuralgia, 175, 313, 324 Neurasthenia, 26, 313 Neuritis, 154, 313 Neuroblastoma, 119, 313 Neurodegenerative Diseases, 140, 264, 313 Neuroendocrine, 10, 314 Neurogenic, 12, 314 Neuroleptic, 23, 184, 257, 261, 314, 316 Neurologic, 8, 260, 298, 314 Neurology, 4, 8, 117, 134, 235, 236, 314 Neuromuscular, 19, 129, 255, 314, 344 Neuromuscular Junction, 255, 314 Neuronal, 27, 128, 129, 136, 146, 165, 167, 312, 314, 320 Neurons, 12, 22, 28, 29, 32, 146, 169, 273, 280, 289, 291, 311, 313, 314, 338, 339, 346 Neuropathy, 144, 169, 176, 314, 347 Neuropeptide, 138, 314 Neurosis, 314, 321 Neurotic, 26, 260, 314, 345 Neurotoxicity, 11, 314 Neurotransmitters, 9, 314, 335 Neutrons, 258, 302, 314, 328 Neutropenia, 5, 291, 314 Neutrophil, 5, 314 Nicotine, 132, 145, 150, 165, 166, 167, 170, 178, 314 Nitric Oxide, 8, 315 Nitrogen, 160, 194, 258, 259, 278, 304, 315, 343 Nociceptors, 18, 315 Node-negative, 226, 315 Non-small cell lung cancer, 11, 228, 240, 241, 315 Nonulcer Dyspepsia, 177, 315 Nonverbal Communication, 315, 327 Norepinephrine, 138, 256, 282, 315

Normotensive, 8, 315 Nuclear, 236, 264, 268, 284, 289, 291, 313, 315, 325 Nuclear Family, 289, 315 Nuclei, 258, 284, 307, 310, 314, 315, 316, 326, 346 Nucleic acid, 315, 347 Nucleus, 7, 262, 264, 272, 278, 279, 280, 285, 286, 291, 301, 311, 314, 315, 326, 335, 340, 346 Nutritional Status, 116, 180, 315 Nutritional Support, 6, 180, 315 O Obstetrics, 36, 42, 43, 48, 49, 50, 53, 70, 73, 75, 76, 77, 287, 316 Occult, 181, 316 Octreotide, 238, 316 Ocular, 51, 149, 288, 289, 316 Oculomotor, 34, 316 Odour, 262, 316, 344 Ointments, 283, 316, 318 Oliguria, 303, 304, 316 Oncogene, 218, 316 Oncologist, 39, 308, 316 Oncology, 13, 33, 38, 41, 42, 46, 48, 50, 51, 55, 56, 72, 78, 79, 182, 225, 228, 237, 316 Ondansetron, 9, 35, 36, 37, 39, 40, 42, 50, 51, 52, 60, 70, 72, 73, 109, 110, 132, 160, 205, 316 Opacity, 280, 316 Opium, 123, 168, 311, 316, 318 Opportunistic Infections, 256, 316 Optic Nerve, 316, 331 Orbit, 316 Orbital, 51, 316 Orchiectomy, 130, 316 Organelles, 279, 308, 311, 316 Orgasm, 284, 317 Orofacial, 175, 289, 317 Orthostatic, 261, 316, 317 Osmolality, 162, 317 Osmoles, 317 Osmotic, 257, 317, 334 Osteoarthritis, 14, 68, 85, 137, 237, 288, 303, 317, 322 Outpatient, 5, 9, 41, 56, 78, 317 Ovaries, 262, 287, 317 Ovary, 277, 288, 317, 323 Overdosage, 175, 317 Ovum, 277, 293, 317, 325 Oxidation, 116, 255, 261, 278, 305, 317 Oxygen Consumption, 317, 331

Nausea

Oxygenation, 18, 298, 317 P Pacemaker, 5, 317 Paclitaxel, 11, 99, 205, 317 Paediatric, 36, 46, 50, 55, 75, 76, 317 Palliative, 13, 50, 67, 230, 234, 317, 340 Palsy, 165, 166, 167, 318 Pancreas, 28, 255, 281, 292, 301, 318, 335 Pancreatic, 32, 177, 218, 240, 270, 287, 292, 318 Pancreatic cancer, 32, 218, 287, 318 Pancreatic Juice, 292, 318 Pancreatitis, 85, 188, 318 Panic, 115, 157, 165, 166, 167, 290, 299, 318 Panic Disorder, 157, 165, 166, 167, 290, 299, 318 Papaverine, 316, 318 Papilledema, 298, 318 Paraffin, 139, 318 Paralysis, 4, 288, 318, 319, 336 Parasite, 318 Parasitic, 174, 179, 283, 295, 318 Parasitic Diseases, 179, 318 Parenteral, 6, 153, 189, 318, 319 Parenteral Nutrition, 6, 189, 319 Paresis, 313, 319 Paresthesias, 313, 318, 319 Parkinsonism, 261, 262, 319 Parotid, 293, 319, 332 Paroxetine, 29, 64, 319 Paroxysmal, 34, 218, 263, 295, 319 Particle, 21, 22, 319, 335, 342 Parturition, 316, 319, 325 Patch, 29, 319, 342 Pathogenesis, 10, 19, 319 Pathologic, 11, 255, 262, 266, 269, 277, 297, 319, 327 Pathologic Processes, 262, 319 Pathophysiology, 180, 181, 184, 319 Patient Compliance, 167, 319 Patient Education, 185, 189, 223, 224, 225, 246, 248, 254, 319 PDQ, 222, 319 Pelvic, 234, 319, 326 Penicillin, 233, 260, 319 Penis, 143, 276, 284, 319 Pepsin, 320 Peptic, 85, 177, 184, 320, 346 Peptic Ulcer, 85, 177, 184, 320, 346 Peptide, 265, 320, 323, 326, 338 Perception, 34, 276, 280, 294, 320, 332 Percutaneous, 305, 320

362

Perforation, 262, 320 Perfusion, 236, 298, 320 Pericardium, 125, 151, 320 Perinatal, 27, 41, 55, 320 Perineum, 143, 320 Peripheral blood, 32, 301, 320 Peripheral Nerves, 305, 320 Peripheral Nervous System, 314, 318, 320, 335, 338 Peristalsis, 282, 320 Peritoneal, 231, 320 Peritoneum, 320 Pernicious, 184, 320 Pernicious anemia, 184, 320 Perspiration, 281, 321 Petroleum, 318, 321 PH, 236, 321 Pharmaceutical Preparations, 164, 271, 288, 292, 321 Pharmaceutical Solutions, 283, 321 Pharmacokinetic, 9, 29, 142, 321 Pharmacologic, 24, 28, 184, 227, 234, 259, 294, 321, 341 Pharmacotherapy, 11, 27, 45, 51, 194, 321 Pharynx, 292, 300, 321, 344 Phenotype, 33, 321 Phenylmethylsulfonyl Fluoride, 119, 159, 321 Phobia, 29, 321 Phobic Disorders, 321 Phosphates, 321, 322 Phosphodiesterase, 169, 321 Phospholipases, 321, 334 Phospholipids, 289, 309, 321 Phosphoric Acids, 122, 322 Phosphorus, 268, 322 Photophobia, 118, 121, 129, 133, 148, 158, 166, 175, 322 Photosensitization, 23, 322 Physical Examination, 184, 322 Physical Fitness, 289, 322 Physical Therapy, 14, 124, 322 Physiologic, 28, 257, 294, 309, 313, 322, 329, 334, 342 Physiology, 16, 23, 69, 129, 130, 136, 177, 179, 181, 189, 285, 292, 322 Pigment, 188, 265, 308, 309, 322 Pigmentation, 322, 346 Pilot study, 31, 69, 73, 149, 322 Piroxicam, 100, 141, 322 Pituitary Gland, 277, 322 Placebo Effect, 14, 322

363

Placenta, 262, 288, 322, 325 Plana, 322, 333 Plants, 175, 258, 263, 265, 269, 272, 273, 293, 304, 310, 311, 315, 322, 323, 332, 341, 342 Plasma protein, 257, 286, 323, 334 Platelet Activation, 323, 334 Platelet Aggregation, 287, 298, 315, 323 Platelet Count, 5, 323 Platelet Transfusion, 5, 323 Platelets, 19, 315, 323, 340, 341 Platinum, 273, 306, 323 Plexus, 169, 267, 323 Poison Control Centers, 175, 323 Poisoning, 82, 173, 222, 262, 279, 287, 291, 292, 302, 313, 323 Pollen, 139, 323 Polycystic, 219, 323 Polymorphic, 160, 323 Polymorphism, 23, 48, 323 Polypeptide, 171, 258, 274, 311, 323, 325, 335, 347 Polyposis, 179, 274, 324 Polysaccharide, 261, 271, 324 Pons, 267, 324, 331 Posterior, 8, 76, 259, 263, 264, 272, 283, 293, 302, 313, 318, 324 Postherpetic Neuralgia, 175, 324 Postmenopausal, 15, 238, 324 Postnatal, 324, 337 Postprandial, 16, 21, 28, 115, 116, 169, 324 Postsynaptic, 324, 334, 339 Post-traumatic, 295, 311, 324 Potassium, 64, 193, 201, 206, 310, 324 Potentiates, 301, 324 Potentiation, 324, 334 Practice Guidelines, 216, 225, 226, 230, 231, 236, 237, 238, 239, 240, 241, 324 Precipitating Factors, 295, 324 Preclinical, 11, 324 Precursor, 262, 272, 278, 282, 284, 286, 315, 324, 325, 343 Predisposition, 9, 324 Pre-eclamptic, 284, 324 Pregnancy Outcome, 60, 325 Premedication, 51, 325, 332 Premenopausal, 15, 325 Premenstrual, 85, 166, 325 Premenstrual Syndrome, 85, 166, 325 Prenatal, 163, 285, 325 Prevalence, 16, 29, 109, 144, 166, 181, 325 Probe, 7, 162, 325

Prodrug, 325 Progeny, 12, 325 Progesterone, 20, 49, 163, 325, 337 Progression, 27, 32, 189, 259, 325 Progressive, 3, 69, 78, 165, 166, 167, 193, 270, 272, 280, 283, 288, 294, 304, 312, 313, 317, 323, 325 Projection, 315, 316, 325, 330 Prokaryotic Cells, 285, 325 Prolactin, 49, 282, 325 Proline, 274, 297, 325 Promoter, 155, 325 Propanolol, 126, 153, 325 Prophylaxis, 35, 37, 40, 43, 47, 48, 53, 71, 74, 135, 325, 344 Propofol, 52, 54, 326 Proportional, 7, 317, 326 Propulsive, 131, 161, 168, 326 Prospective study, 36, 49, 326 Prostaglandins, 8, 19, 262, 326 Prostaglandins A, 19, 326 Prostaglandins D, 326 Prostate, 26, 85, 130, 218, 326 Protease, 8, 274, 326, 332 Protein C, 138, 257, 258, 326, 344 Protein S, 116, 129, 219, 266, 285, 287, 326 Protocol, 20, 37, 56, 108, 109, 114, 228, 326 Protons, 19, 23, 258, 297, 302, 307, 326, 328 Proto-Oncogene Proteins, 317, 326 Proto-Oncogene Proteins c-mos, 317, 326 Protozoa, 174, 266, 283, 310, 327 Proximal, 6, 16, 28, 282, 327 Pruritic, 139, 280, 327 Pruritus, 50, 131, 139, 161, 168, 261, 327, 344 Psoriasis, 144, 236, 327 Psychiatric, 29, 30, 235, 309, 327 Psychiatry, 9, 46, 54, 117, 149, 327, 338, 345 Psychic, 305, 314, 327, 333 Psychogenic, 117, 143, 175, 327 Psychology, 22, 60, 178, 282, 327 Psychomotor, 30, 144, 279, 314, 327 Psychopathology, 181, 327 Psychophysiology, 57, 327 Psychosis, 140, 154, 165, 166, 167, 261, 327 Psychotherapy, 10, 327 Psychotropic, 119, 157, 159, 327 Psychotropic Drugs, 157, 327 Public Policy, 215, 327 Publishing, 34, 120, 160, 173, 174, 178, 327 Pulmonary, 266, 272, 276, 277, 287, 303, 328, 345

Nausea

Pulmonary Artery, 266, 328, 345 Pulmonary Edema, 272, 303, 328 Pulmonary hypertension, 277, 287, 328 Pulse, 5, 23, 123, 125, 151, 310, 328 Pupil, 123, 281, 312, 328 Purulent, 328, 344 Pustular, 154, 328 Pyloric Sphincter, 21, 328 Pyoderma, 165, 166, 167, 328 Pyoderma Gangrenosum, 165, 166, 167, 328 Pyridoxal, 328, 342 Q Quality of Life, 6, 13, 16, 25, 26, 29, 30, 32, 33, 34, 108, 109, 130, 135, 176, 328, 338 Quaternary, 122, 328, 332 R Race, 132, 137, 328 Radiation therapy, 12, 15, 110, 122, 132, 177, 224, 227, 289, 291, 301, 303, 328, 332, 347 Radioactive, 294, 297, 299, 301, 303, 315, 328, 329, 347 Radioimmunotherapy, 328, 329 Radiolabeled, 303, 328, 329, 347 Radiopharmaceuticals, 236, 329 Radiotherapy, 11, 25, 160, 162, 166, 225, 236, 240, 267, 303, 328, 329, 347 Random Allocation, 329 Randomization, 31, 329 Randomized clinical trial, 16, 24, 32, 33, 329 Randomized Controlled Trials, 43, 54, 77, 329 Reactive Oxygen Species, 18, 329 Reagent, 272, 297, 329 Reality Testing, 327, 329 Receptors, Serotonin, 330, 333 Reconstitution, 31, 330 Recovery Room, 24, 122, 189, 330 Rectal, 175, 178, 330 Rectum, 260, 262, 264, 267, 274, 281, 290, 291, 299, 300, 304, 326, 330, 338 Recurrence, 123, 266, 273, 308, 330 Red blood cells, 5, 193, 287, 330, 332 Red Nucleus, 263, 330 Reductase, 11, 262, 330 Refer, 1, 274, 282, 296, 305, 306, 314, 327, 329, 330, 345 Reflex, 18, 28, 33, 143, 228, 237, 330 Reflux, 116, 163, 292, 330 Refraction, 330, 336

364

Refractory, 6, 49, 149, 330 Regeneration, 330 Regimen, 31, 33, 123, 126, 150, 167, 284, 319, 321, 322, 330 Registries, 15, 330 Regurgitation, 116, 163, 176, 292, 295, 330 Remission, 266, 308, 330 Renal pelvis, 304, 330, 342 Reperfusion, 18, 330, 331 Reperfusion Injury, 331 Reproduction Techniques, 325, 331 Resection, 331, 334 Respiration, 157, 262, 269, 272, 310, 331 Respiratory Physiology, 331, 345 Restoration, 322, 330, 331, 347 Retching, 45, 331 Retina, 134, 272, 316, 331, 332, 333, 346 Retinal, 298, 316, 331, 346 Retinal Hemorrhage, 298, 331 Retinoblastoma, 218, 331 Retrobulbar, 48, 331 Retroviral vector, 12, 331 Rheumatic Diseases, 37, 71, 331 Rheumatism, 298, 331 Rheumatoid, 154, 233, 274, 288, 303, 322, 331 Rheumatoid arthritis, 154, 233, 274, 288, 303, 322, 331 Ribose, 256, 331 Rigidity, 143, 147, 302, 319, 323, 331 Risk factor, 24, 38, 42, 175, 188, 228, 326, 331 Ritonavir, 8, 332 Rod, 273, 332 Rye, 287, 332 S Saccharin, 7, 332 Salicylate, 118, 281, 332 Salicylic, 122, 332 Saline, 10, 332 Saliva, 332 Salivary, 31, 281, 318, 332 Salivary glands, 281, 332 Salvage Therapy, 12, 332 Saponins, 332, 337 Sarcoidosis, 193, 332 Sarcoma, 107, 154, 180, 332, 335 Schizoid, 332, 347 Schizophrenia, 117, 121, 122, 128, 132, 140, 150, 165, 166, 167, 261, 284, 332, 347 Schizotypal Personality Disorder, 280, 332, 347

365

Sclerosis, 3, 149, 165, 166, 167, 218, 274, 311, 332 Scopolamine, 57, 265, 332 Screening, 19, 181, 228, 237, 273, 319, 333 Second Messenger Systems, 314, 333 Secretion, 115, 169, 255, 273, 278, 296, 297, 301, 304, 310, 311, 316, 321, 333, 344 Secretory, 28, 179, 333, 339, 346 Sedative, 157, 189, 273, 299, 333, 345 Sedatives, Barbiturate, 264, 333 Seizures, 136, 170, 176, 279, 298, 319, 333 Selective estrogen receptor modulator, 333, 339 Self Care, 256, 333 Semen, 88, 284, 326, 333 Semicircular canal, 34, 300, 333 Senescence, 11, 333 Senile, 165, 166, 167, 261, 333 Sensibility, 259, 297, 333 Serous, 286, 333 Serrata, 92, 272, 333 Serrated, 333 Serum, 86, 129, 257, 266, 274, 293, 299, 304, 310, 330, 333, 334, 343 Serum Albumin, 266, 334 Sex Determination, 219, 334 Sexually Transmitted Diseases, 179, 334 Shivering, 123, 334 Shock, 43, 139, 140, 270, 305, 334, 342 Shock, Septic, 140, 334 Short Bowel Syndrome, 179, 184, 334 Signal Transduction, 138, 334 Single-agent, 133, 158, 334 Skeletal, 259, 273, 312, 334, 335 Skeleton, 5, 256, 303, 334 Skull, 278, 302, 316, 334, 340 Sleep apnea, 115, 121, 122, 334 Small cell lung cancer, 334 Small intestine, 28, 179, 265, 283, 286, 296, 298, 302, 303, 328, 334 Smooth muscle, 8, 16, 143, 163, 169, 268, 287, 296, 297, 311, 318, 335, 338 Social Environment, 328, 335 Social Isolation, 26, 332, 335 Social Support, 25, 335, 337 Sodium, 118, 126, 152, 287, 294, 310, 335, 338 Sodium Bicarbonate, 118, 335 Soft tissue, 175, 230, 267, 334, 335 Soft tissue sarcoma, 230, 335 Solid tumor, 12, 108, 109, 283, 335 Solitary Nucleus, 33, 264, 335

Solvent, 126, 152, 265, 288, 317, 321, 335 Somatostatin, 316, 335 Somnolence, 23, 29, 137, 146, 335 Sound wave, 276, 335 Spasm, 170, 261, 296, 335 Spasmodic, 255, 335 Spastic, 83, 165, 166, 167, 303, 336 Spasticity, 140, 149, 336 Spatial disorientation, 282, 336 Specialist, 243, 281, 336 Species, 103, 265, 287, 292, 297, 302, 307, 310, 311, 318, 328, 329, 336, 338, 342, 343, 346, 347 Specificity, 30, 257, 336, 338 Spectrophotometry, 129, 336 Spectrum, 121, 336 Sperm, 127, 259, 272, 323, 336, 340 Sphincter, 163, 336 Spinal cord, 153, 263, 267, 271, 272, 286, 291, 302, 308, 309, 313, 314, 320, 330, 336, 339 Spinal tap, 306, 336 Spleen, 159, 193, 306, 332, 336 Spondylitis, 288, 336 Spontaneous Abortion, 325, 336 Sporadic, 313, 331, 336 Sprains and Strains, 179, 306, 336 Sprue, 165, 166, 167, 336 Squamous, 315, 336, 337 Squamous cell carcinoma, 315, 336, 337 Stabilization, 129, 337 Stabilizer, 269, 337 Stasis, 10, 32, 141, 168, 184, 337 Steel, 273, 337 Stem Cells, 5, 337 Sterility, 278, 337 Steroid, 135, 262, 265, 278, 287, 332, 337 Stillbirth, 325, 337 Stimulant, 101, 114, 118, 189, 258, 268, 296, 337 Stimulus, 7, 124, 150, 283, 284, 289, 300, 302, 304, 319, 321, 330, 337, 340 Stomach, 4, 6, 16, 30, 32, 86, 88, 120, 159, 160, 162, 163, 166, 168, 169, 175, 176, 177, 178, 179, 182, 224, 252, 253, 255, 263, 264, 281, 288, 291, 292, 293, 296, 306, 312, 320, 321, 328, 330, 334, 336, 337 Stool, 299, 303, 304, 337, 340 Strabismus, 50, 58, 337 Stress, 25, 31, 68, 85, 174, 178, 264, 270, 278, 290, 291, 292, 303, 313, 324, 331, 337 Stress management, 25, 337

Nausea

Stroke, 18, 68, 69, 111, 139, 140, 165, 166, 167, 179, 214, 269, 337, 338 Stroke Volume, 18, 269, 338 Stupor, 305, 312, 338 Subacute, 3, 300, 338 Subarachnoid, 295, 322, 338 Subclinical, 300, 333, 338 Subcutaneous, 284, 318, 338 Subspecies, 336, 338 Substance P, 287, 309, 330, 333, 338 Subtilisin, 321, 338 Suction, 290, 338 Sulfonic Acids, 122, 338 Sulfur, 304, 309, 338 Supportive care, 319, 338 Suppositories, 292, 338 Suppression, 33, 77, 278, 338, 347 Supraspinal, 27, 338 Supratentorial, 53, 338 Sweat, 47, 75, 136, 137, 321, 338 Sweat Glands, 338 Sympathectomy, 18, 338 Sympathetic Nervous System, 264, 338, 339 Sympathomimetic, 256, 258, 282, 287, 315, 339, 343 Symphysis, 326, 339 Symptomatic, 14, 117, 121, 122, 176, 184, 260, 318, 339 Symptomatic treatment, 121, 122, 260, 339 Symptomatology, 334, 339 Synapses, 314, 339 Synaptic, 315, 334, 339 Synaptic Transmission, 315, 339 Synergistic, 9, 11, 141, 146, 171, 325, 339 Systemic, 10, 18, 21, 22, 86, 135, 155, 193, 198, 199, 200, 201, 202, 203, 204, 205, 206, 207, 208, 226, 266, 267, 269, 274, 279, 287, 295, 300, 303, 328, 332, 335, 339, 342, 343, 345, 347 Systemic therapy, 155, 226, 339 Systolic, 298, 339 T Tachycardia, 154, 157, 264, 339 Tamoxifen, 130, 207, 333, 339 Tapeworm, 173, 339 Tardive, 165, 166, 167, 261, 339 Telangiectasia, 219, 340 Temporal, 19, 30, 175, 295, 340 Tenesmus, 283, 340 Tennis Elbow, 68, 340 Terminator, 340, 347

366

Testicles, 316, 340 Testicular, 262, 340 Testis, 288, 340 Testosterone, 330, 340 Tetrahydrocannabinol, 114, 119, 148, 149, 159, 269, 283, 340 Thalamic, 263, 340 Thalamic Diseases, 263, 340 Therapeutics, 35, 45, 115, 131, 157, 161, 209, 311, 340 Thermal, 22, 282, 314, 340 Thermoregulation, 130, 340 Thoracic, 264, 267, 281, 308, 340, 347 Thorax, 255, 306, 340, 344 Threshold, 288, 297, 298, 340 Thrombin, 323, 326, 340 Thrombocytes, 323, 340 Thrombomodulin, 326, 340 Thrombosis, 326, 337, 340 Thrombus, 277, 300, 312, 323, 341 Thymus, 299, 306, 341 Thyroid, 226, 341, 343 Thyroxine, 257, 341 Time Management, 337, 341 Tin, 176, 270, 323, 341 Tolerance, 7, 29, 31, 146, 162, 256, 268, 293, 341 Tomography, 307, 341 Tonic, 16, 341 Tonicity, 284, 295, 341 Topical, 48, 142, 155, 288, 297, 318, 335, 341 Topoisomerase inhibitors, 302, 341 Toxicity, 5, 11, 12, 119, 120, 154, 159, 160, 171, 194, 269, 283, 341 Toxicology, 21, 27, 29, 39, 216, 341 Toxins, 193, 261, 300, 328, 341 Trace element, 290, 341 Trachea, 268, 289, 321, 341 Traction, 273, 341 Tramadol, 51, 137, 146, 341 Tranquilizing Agents, 327, 342 Transaminase, 132, 342 Transcriptase, 304, 342, 347 Transcutaneous, 6, 79, 342 Transdermal, 153, 156, 342 Transduction, 334, 342 Transfection, 266, 342 Transfer Factor, 299, 342 Transfusion, 5, 342 Transitional cell carcinoma, 239, 342 Translation, 287, 342

367

Translational, 28, 342 Translocation, 287, 342 Transmitter, 255, 263, 282, 302, 308, 315, 339, 342, 343 Transplantation, 194, 272, 285, 299, 307, 342 Trauma, 32, 131, 139, 142, 144, 161, 175, 179, 183, 193, 279, 288, 313, 318, 342 Trees, 287, 342 Tremor, 123, 136, 149, 157, 319, 342 Tricuspid Atresia, 277, 342 Tricyclic, 157, 260, 298, 343 Trigeminal, 175, 289, 307, 343 Trigger zone, 117, 122, 164, 261, 302, 343 Tryptophan, 274, 333, 343 Tuberculosis, 276, 303, 306, 332, 343 Tuberous Sclerosis, 219, 343 Tumor Necrosis Factor, 32, 343 Type 2 diabetes, 233, 343 Tyramine, 65, 311, 343 Tyrosine, 102, 282, 343 U Ulcer, 283, 315, 343 Ulceration, 320, 343 Ulcerative colitis, 165, 166, 167, 179, 300, 328, 343 Unconscious, 259, 298, 343 Univalent, 297, 317, 343 Universal Precautions, 188, 343 Unresectable, 12, 343 Uraemia, 318, 343 Urea, 194, 304, 338, 343, 344 Uremia, 122, 303, 344 Ureter, 305, 330, 342, 344 Urethra, 320, 326, 344 Uric, 294, 298, 344 Urinary, 26, 80, 86, 176, 179, 239, 268, 278, 299, 316, 332, 344 Urinary tract, 179, 239, 344 Urinary tract infection, 179, 239, 344 Urine, 129, 193, 252, 255, 261, 266, 278, 282, 287, 288, 295, 299, 304, 316, 330, 344 Uterus, 271, 277, 285, 298, 309, 317, 325, 344 V Vaccination, 238, 344 Vaccine, 188, 256, 326, 344 Vacuoles, 285, 317, 344 Vagal, 16, 18, 32, 344 Vagina, 127, 155, 269, 271, 298, 309, 344 Vaginal, 127, 155, 230, 344 Vaginal Discharge, 230, 344

Vaginitis, 179, 269, 344 Vaginosis, 237, 344 Vagus Nerve, 335, 344 Valerian, 102, 175, 345 Vascular, 8, 18, 71, 125, 134, 143, 144, 151, 175, 272, 286, 287, 295, 297, 300, 315, 322, 341, 345 Vascular Resistance, 18, 345 Vasculitis, 318, 345 Vasoconstriction, 8, 134, 165, 166, 167, 287, 345 Vasodilation, 134, 143, 258, 298, 318, 345 Vasodilator, 267, 282, 296, 318, 345 Vasomotor, 129, 345 Vector, 318, 342, 345 Vein, 259, 302, 315, 319, 345 Venlafaxine, 125, 126, 152, 345 Venous, 18, 143, 266, 267, 295, 323, 326, 343, 345 Venous blood, 266, 267, 323, 345 Ventilation, 137, 345 Ventral, 125, 151, 298, 316, 324, 345 Ventricle, 263, 277, 298, 328, 339, 342, 345 Ventricular, 277, 343, 345 Venules, 266, 286, 345 Vertebrae, 301, 336, 345 Vertigo, 7, 12, 34, 87, 115, 134, 135, 183, 345 Vesicular, 280, 296, 345 Vestibular, 7, 12, 134, 183, 294, 345, 346 Vestibular Nerve, 134, 346 Vestibule, 273, 300, 333, 345, 346 Vestibulocochlear Nerve, 346 Veterinary Medicine, 128, 215, 346 Vinca Alkaloids, 346 Vinorelbine, 208, 241, 346 Viral, 8, 181, 241, 293, 300, 342, 346, 347 Viral Hepatitis, 181, 346 Viral Load, 8, 346 Viremia, 334, 346 Virulence, 341, 346 Virus, 30, 180, 188, 190, 224, 255, 271, 286, 293, 301, 331, 342, 346 Viscera, 122, 346 Visceral, 7, 87, 138, 176, 264, 293, 320, 344, 346 Vitamin U, 54, 77, 346 Vitreoretinal, 36, 346 Vitreous Body, 331, 346 Vitro, 22, 346 Vivo, 118, 159, 347 Voltage-gated, 130, 347

Nausea

W Weight Gain, 24, 178, 347 White blood cell, 260, 294, 305, 306, 307, 311, 312, 314, 347 Windpipe, 321, 341, 347 Withdrawal, 27, 123, 132, 136, 279, 347 Wound Healing, 32, 347 X Xenograft, 259, 347

368

X-ray, 189, 253, 264, 275, 291, 302, 315, 328, 329, 337, 347 X-ray therapy, 303, 347 Y Yawning, 117, 347 Yeasts, 269, 291, 321, 347 Z Zalcitabine, 208, 304, 347 Zidovudine, 9, 144, 347 Zymogen, 326, 347

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