DYSPNEA 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., 1960Dyspnea: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00389-9 1. Dyspnea-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on dyspnea. 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 DYSPNEA ................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Dyspnea ........................................................................................ 5 E-Journals: PubMed Central ....................................................................................................... 31 The National Library of Medicine: PubMed ................................................................................ 32 CHAPTER 2. NUTRITION AND DYSPNEA ......................................................................................... 75 Overview...................................................................................................................................... 75 Finding Nutrition Studies on Dyspnea ....................................................................................... 75 Federal Resources on Nutrition ................................................................................................... 76 Additional Web Resources ........................................................................................................... 77 CHAPTER 3. ALTERNATIVE MEDICINE AND DYSPNEA................................................................... 79 Overview...................................................................................................................................... 79 National Center for Complementary and Alternative Medicine.................................................. 79 Additional Web Resources ........................................................................................................... 86 General References ....................................................................................................................... 97 CHAPTER 4. DISSERTATIONS ON DYSPNEA..................................................................................... 99 Overview...................................................................................................................................... 99 Dissertations on Dyspnea ............................................................................................................ 99 Keeping Current .......................................................................................................................... 99 CHAPTER 5. PATENTS ON DYSPNEA ............................................................................................. 101 Overview.................................................................................................................................... 101 Patents on Dyspnea ................................................................................................................... 101 Patent Applications on Dyspnea................................................................................................ 104 Keeping Current ........................................................................................................................ 106 CHAPTER 6. BOOKS ON DYSPNEA ................................................................................................. 107 Overview.................................................................................................................................... 107 Book Summaries: Federal Agencies............................................................................................ 107 Book Summaries: Online Booksellers......................................................................................... 108 The National Library of Medicine Book Index ........................................................................... 108 Chapters on Dyspnea ................................................................................................................. 108 CHAPTER 7. PERIODICALS AND NEWS ON DYSPNEA ................................................................... 111 Overview.................................................................................................................................... 111 News Services and Press Releases.............................................................................................. 111 Academic Periodicals covering Dyspnea.................................................................................... 113 CHAPTER 8. RESEARCHING MEDICATIONS .................................................................................. 115 Overview.................................................................................................................................... 115 U.S. Pharmacopeia..................................................................................................................... 115 Commercial Databases ............................................................................................................... 117 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 121 Overview.................................................................................................................................... 121 NIH Guidelines.......................................................................................................................... 121 NIH Databases........................................................................................................................... 123 Other Commercial Databases..................................................................................................... 125 APPENDIX B. PATIENT RESOURCES ............................................................................................... 127 Overview.................................................................................................................................... 127 Patient Guideline Sources.......................................................................................................... 127 Finding Associations.................................................................................................................. 130 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 133 Overview.................................................................................................................................... 133
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Preparation................................................................................................................................. 133 Finding a Local Medical Library................................................................................................ 133 Medical Libraries in the U.S. and Canada ................................................................................. 133 ONLINE GLOSSARIES................................................................................................................ 139 Online Dictionary Directories ................................................................................................... 139 DYSPNEA DICTIONARY............................................................................................................ 141 INDEX .............................................................................................................................................. 191
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with dyspnea is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about dyspnea, 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 dyspnea, 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 dyspnea. 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 dyspnea, 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 dyspnea. 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 DYSPNEA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on dyspnea.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and dyspnea, 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 “dyspnea” (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: •
Relieving Anorexia in the Dying Patient: Palliative Care at Home Source: Senior Patient. 2(6): 44-47. June 1990. Summary: This article argues that physicians may be able to control the symptoms that contribute to terminal patients' anorexia by boosting caloric intake; this may improve the quality of their final days and help them avoid needless complications. Particular attention is given to the alleviation of varied symptoms (nausea and vomiting; constipation; mouth pain or dryness; depression; dysphagia; dyspnea), which will often restore terminal patients' interest in food. Increasing the dying patient's calorie intake can help make him/her more comfortable during the final stages of their lives. The authors conclude that loss of appetite and difficulty eating need not be regarded as inevitable features of the terminal state; nutrition therapy can provide much-needed emotional support at a critical juncture in care, assuring physicians' terminally ill
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patients and their caregivers that the maintenance of their dignity and comfort are paramount. 1 reference. •
Acute Upper-Airway Obstruction in a Patient with Achalasia Source: Annals of Emergency Medicine. 29(5): 687-689. May 1997. Contact: Available from American College of Emergency Physicians. P.O. Box 619911, Dallas, TX 75261-9911. (800) 798-1822. Fax (972) 580-2816. Summary: This article reports a case that highlights the need for emergency physicians to consider esophageal disease in the differential diagnosis of respiratory distress. The authors note that the most common presenting symptoms of achalasia are dysphagia (difficulty swallowing), recurrent regurgitation, and gradual weight loss. In very few cases is respiratory distress the only presenting symptom of achalasia. Achalasia is a motor disorder of the esophageal smooth muscle characterized by increased lower esophageal sphincter pressure, failure of proper sphincter relaxation on swallowing, and replacement of normal peristalsis with abnormal contractions. In this case, a 59 year old woman presented to the emergency department with acute dyspnea. Her symptoms had begun 15 minutes earlier, while she was eating, with the onset of hoarseness followed by increasing difficulty breathing. After emergency treatment, a nasogastric tube was passed, with remarkable audible air decompression and evacuation of 250 mL of food content. The patient reported episodes of similar symptoms over the preceding 8 years. To assess esophageal function, the physicians performed fiberoptic esophagoscopy, which showed massive dilation of the esophagus with a large collection of food. No esophageal stricture was noted. The authors conclude that this patient's acute stridor (respiratory distress) was due to tracheal compression resulting from massive esophageal dilation. They note that, although it is a rare complication of achalasia, this entity should be included in the differential diagnosis of acute respiratory distress and failure. 1 figure. 9 references. (AA-M).
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Laparoscopic Repair of Paraesophageal Hiatal Hernias Source: Journal of the American College of Surgeons. 186(4): 428-432. April 1998. Summary: This article reports the University of California (UC) at San Francisco's experience with laparoscopic repair of paraesophageal hiatal hernias, emphasizing the technical steps essential for good results. From May 1993 to September 1997, 55 patients (27 women, 28 men, mean age 67 years) underwent laparoscopic repair of paraesophageal hernias at the UC facility. Symptoms, which had been present an average of 85 months before surgery, consisted mainly of pain (55 percent), heartburn (52 percent), dysphagia (45 percent), and regurgitation (41 percent). Of the four patients who presented with acute illness, two had gastric obstruction, one had severe dyspnea, and one had gastric bleeding. Endoscopy demonstrated esophagitis in 25 (69 percent) of 36 patients, and 24 hour pH monitoring demonstrated acid reflux in 22 (67 percent) of 33 patients. Manometry detected severely impaired distal esophageal peristalsis in 17 (52 percent) of 33 patients. The preferred operation consisted of reduction of the hernia, excision of the sack and the gastric fat pad, closure of the enlarged hiatus without mesh, and construction of a fundoplication anchored by sutures within the abdomen. Of the 55 patients, the operations of 49 were completed laparoscopically; five (9 percent) were converted to laparotomies. The average operating time was 219 minutes; the average blood loss was less than 25 mL; resumption of an unrestricted diet occurred after 27 hours; and mean hospital stay was 58 hours. Intraoperative technical complications occurred in five (9 percent) patients. One patient died during surgery from a sudden
Studies
5
pulmonary embolus; two patients (4 percent) required a second operation for recurrent paraesophageal hernias. The authors conclude that laparoscopic repair of paraesophageal hiatal hernias is safe and effective, but the operation is difficult and good results hinge on details of the operative technique and the surgeon's experience. 2 figures. 1 table. 21 references. (AA-M).
Federally Funded Research on Dyspnea The U.S. Government supports a variety of research studies relating to dyspnea. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to dyspnea. 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 dyspnea. The following is typical of the type of information found when searching the CRISP database for dyspnea: •
Project Title: OUTCOMES
A
CAREGIVER
INTERVENTION
TO
IMPROVE
HOSPICE
Principal Investigator & Institution: Mcmillan, Susan C.; Professor; None; University of South Florida 4202 E Fowler Ave Tampa, Fl 33620 Timing: Fiscal Year 2002; Project Start 01-SEP-1999; Project End 30-JUN-2004 Summary: Although hospice family caregivers receive support from the hospice team, research indicates that a greater level of support and education are needed to assist them with the enormous responsibility they bear for physical and emotional care. If the caregiver is not adequately prepared to assess patients and provide needed care, the patient's quality of life may suffer, and the caregiver may experience feelings of inadequacy, anxiety, and depression leading to decreased caregiver quality of life. The primary aim of this experimental study, based on the stress-process model, is to improve the quality of life of hospice caregivers by helping them to master the skills needed to better assess and manage specific problems experienced by cancer patients (pain, dyspnea, constipation), thus enhancing caregiver coping and self-appraisal of stressfulness of patient symptoms and quality of life for both patients and caregivers. The sample of 480 patient/caregiver dyads will be drawn from a large hospice in the local area and screened using measures of functional status and mental status. After consenting, subjects will be randomly divided into three groups, a control group receiving standard care (Group I), a group receiving standard care plus friendly visits (Group II), and a group receiving standard care plus the intervention (Group III). The intervention will be based on the COPE method (Creativity, Optimism, Planning, Expert 2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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Information). Groups II and III will receive visits on the same schedule to control for the effects of researcher time and attention. On visit one, caregivers in Group III will be taught to use the COPE method of managing patient problems. Visit one will last approximately 90 minutes; visits two and three will reinforce and extend learning and last approximately 30 minutes each. Group III caregivers will receive a copy of the Home Care Guide for Advanced Cancer and receive two supportive telephone calls from the RA-intervention nurse, one after visit one and one after visit two. Group III caregivers will be taught how to assess patient symptom intensity and given a preformatted diary in which to record symptom intensity scores twice daily. Data will be collected from patients about symptom intensity, symptom distress, and quality of life. Caregiver data will include coping, self-appraisal, and quality of life including mastery. Data will be collected from all three groups on admission to the study, immediately post intervention (day 16), and four weeks after admission to the study (day 30). One year after admission to hospice, all caregivers again will be contacted for data collection (patients are expected to be deceased). Quantitative data will be analyzed using repeated measures multivariate analysis of variance and structural equation modeling. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ACUPUNCTURE FOR SHORTNESS OF BREATH IN CANCER PATIENTS Principal Investigator & Institution: Feinstein, Marc B.; Clinical Assistant Physician; Sloan-Kettering Institute for Cancer Res New York, Ny 100216007 Timing: Fiscal Year 2002; Project Start 28-SEP-2001; Project End 31-AUG-2003 Summary: (provided by applicant): BACKGROUND: Shortness of breath, or dyspnea, is one of the most common symptoms experienced by patients with advanced cancer. It is particularly prevalent among breast and lung cancer patients. Curative treatment, such as tapping an effusion, is indicated for some patients but it is not always successful. There are only limited data from controlled trials on the value of pharmacologic approaches. Many patients do not respond to treatment and experience significant shortness of breath with consequent seriously impaired quality of life. Several randomized trials suggest that acupuncture may benefit conditions such as asthma and chronic obstructive pulmonary disorder. An uncontrolled study in advanced cancer reported immediate and clinically significant reductions in dyspnea following treatment. OBJECTIVES: We plan to conduct a randomized, blinded, placebo-controlled Phase III study of acupuncture for shortness of breath in advanced cancer. Such a study would aim to determine the immediate effect of acupuncture and the short-term effects of patient-self-administered acupressure. In this proposal, we plan to pilot such a study in order to refine accrual, treatment, placebo and data management procedures, and to determine whether a controlled trial is feasible and warranted. METHODS: Forty patients with breast or lung cancer will be accrued. Treatment consists of a single acupuncture session followed by administration of semi-permanent acupuncture needles ("studs"). Patients will be instructed on applying acupressure to the studs. Assignment to true treatment or placebo will be randomized, stratified by grade of breathlessness and cancer diagnosis. Placebo treatment consists of the "Streitberger" placebo needle, a device in which the needle retracts into the handle rather than piercing the skin, and a specially designed dummy stud. These will be placed at nonacupuncture points. Subjective breathlessness will be recorded for one hour immediately preceding and following the first acupuncture treatment and then twice a day for seven days. We will conduct a Phase III study if at least 75 percent of patients
Studies
7
provide evaluable data; if accrual is sufficiently rapid so that, after suitable sample size calculations, a controlled trial could be completed in less than four years; and if the 95 percent confidence interval for the difference between group means includes at least a 20 percent greater improvement than placebo for either acupuncture or acupressure. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: AIRWAY SENSORY NERVES AND DYSPNEA IN HUMAN SUBJECTS Principal Investigator & Institution: Burki, Nausherwan K.; Professor of Medicine; Internal Medicine; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-DEC-2004 Summary: (provided by applicant): Dyspnea, an unpleasant sensation of difficulty in breathing, is a common symptom in patients with cardiopulmonary diseases, but the underlying mechanisms are unclear. Amongst the various neural pathways, unmyelinated vagal C fibers arising from the lungs and airways have been implicated. The long-term objectives are to increase understanding of the mechanisms of dyspnea and specifically the role of pulmonary C fibers. Adenosine is a commonly used therapeutic intravenous drug for treatment of supraventricular tachycardia; it has been frequently reported to cause dyspnea. Recent studies from our laboratory reported the first evidence showing that adenosine stimulates pulmonary C fiber receptors in anesthetized rats. Preliminary human studies from our laboratory indicate that intravenous adenosine causes dyspnea and increase ventilation, and neither affect is associated with bronchoconstriction. Adenosine is known to increase ventilation by stimulating the carotid body chemoreceptors; such reflex stimulation would increase central motor command and could lead to the development of dyspnea. Our hypothesis is that adenosine causes dyspnea by direct activation of pulmonary C fiber, and it is not an indirect effect related to the increase in ventilation. The specific aims of the proposed study are: 1) to determine the latency and magnitude of dyspneic response, change in airway resistance, and ventilatory response to intravenous injection of adenosine in normal subjects and stable asthmatics; 2) to evaluate the effects of pretreatment with theophylline, and adenosine receptor antagonist, on the intensity of dyspnea and the ventilatory effects of intravenous adenosine; 3) to examine whether directly blocking pulmonary C fibers with inhaled lidocaine abolishes the sensation of dyspnea induced by adenosine in these subjects/patients; 4) to investigate if pretreatment with 100 percent O2, by reducing carotid chemoreceptor sensitivity, alters the dyspnogenic and ventilatory effects of intravenous adenosine. These studies should bring a better understanding of the underlying mechanism of adenosine-induced dyspnea and the role of bronchopulmonary C fibers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: ALVEOLITIS AND FIBROSIS IN SCLERODERMA LUNG DISEASE Principal Investigator & Institution: Goldin, Jonathan G.; Acting Section Chief; Radiology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 23-SEP-2002; Project End 31-JUL-2005 Summary: (provided by applicant): Currently bronchoalveolar lavage (Bal) evidence of alveolitis is used to diagnose active alveolitis in patients with Scleroderma Lung Disease (SLD). Detection of alveolitis may therefore have little prognostic or pathogenic relevance in the assessment of these cases. Preliminary novel quantitative image analysis (QIA) of HRCT data has been shown to correlate with BAL cellularity with the
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added ability of assessing regional heterogeneity of the entire lung not possible with BAL alone. CT Q!A can also identify manifestation of fibrosis, which is not possible with BAL or visual inspection of HRCT, thus, there is the potential for using this technique to investigate the relationship between alveolitis and fibrosis in the pathogenesis os SLD. Specifically if the progression of QIA-detected regional variation in fibrosis or alveolitis can be determined to be independent of each other the postulate that the fibrosis is due to pathways other than alveolitis can be implied. The hypothesis of this study is that the relationship of the extent and distribution of alveolitis to fibrosis in the progression of SLD can be further elucidated by the added ability of QIA techniques to assess alveolitis and fibrosis independently on a comprehensive and regional basis which is not possible with conventional techniques. The specific aims of this project are: (1) To assess the presence and severity of alveolitis and fibrosis in asymptomatic patients with mild or moderate SLD on a comprehensive (whole lung) and regional (portion of lung segment) basis; (2) to determine the interrelationship between alveolitis and fibrosis (as measured by QIA) in the progression of SLD; and (3) to determine whether interval changes of global and regional QIA features of fibrosis and alveolitis on follow up CT are predictive of outcome as assessed by symptoms (dyspnea index) and FVC in treated and untreated patients. Two experiments are proposed: Experiment 1: Comprehensive regional detection and quantitation of alveolitis and fibrosis (specific aim1); Experiment 2: Assessment of the relationship between alveolitis and fibrosis in the progression of SLD (specific aims 2 and 3). These findings will potentially improve our understanding of the relationship between alveolitis and fibrosis and to the pathogenesis of fibrosis in SLD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BIOBEHAVIORAL SUPPLEMENTATION
OUTCOMES
OF
NUTRITIONAL
Principal Investigator & Institution: Deletter, Mary; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2002 Summary: The purpose of the proposed project is to evaluate the effects of nutritional supplementation on biologic and behavioral health outcomes inundernourished persons with chronic airflow limitation (CAL). The hypothesis to be tested is: Undernourished subjects with activity-induced dyspnea and an improvement in nutritional status, exercise tolerance, and quality of life when compared to subjects who receive their usual dietr. Thirty-two undernourished subjects with stable chronic airflow limitation will be randomized into two groups: (a) control group (maintain usual diet) and (b) supplementation group. Data will be collected in a General Clinical Research Center as baseline (enrollment), 6 and 12 weeks. Changes over time in nutritional status, exercise tolerance, activity-induced dyspnea, and quality of life will be measured. The inclusion of both biological and behavioral variables allows for fully evaluating the subjects' response to dietary supplementation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CAREGIVER COPING SKILLS TRAINING FOR LUNG CANCER Principal Investigator & Institution: Keefe, Francis J.; Professor and Associate Director; Psychiatry; Duke University Durham, Nc 27710 Timing: Fiscal Year 2002; Project Start 06-JUN-2002; Project End 31-MAY-2007 Summary: (provided by investigator): Symptoms such as pain, fatigue, paroxysmal coughing, and dyspnea are major concerns of lung cancer patients and their caregivers.
Studies
9
The focus in management of such symptoms traditionally has been on the patient. Studies of caregivers, however, have documented that the psychosocial impact of providing care to family members with lung cancer is profound. The ultimate goal of this research is to develop more effective ways to help patients and caregivers cope more effectively with problematic symptoms experienced by lung cancer patients. The proposed study seeks to evaluate the efficacy of a new, caregiver assisted coping skills training protocol. 500 early stage lung cancer patients (Stages I to IIIA) and their caregivers will be randomly assigned to one of two conditions: 1) Caregiver-assisted coping skills training-systematically trains caregivers in methods for guiding the patient in use of coping skills for symptom management (i.e. relaxation training, imagery, activity pacing, and communication skills), or 2) Cancer education and support-a comparison condition that provides patients and caregivers with information on the nature of lung cancer and treatment methods and controls for attention and contact. Assessment measures to be collected before and after treatment and at 4- and 14-months follow-up will include patient reports of major symptoms (pain, fatigue, coughing, and dyspnea), quality of life, depression, anxiety, self efficacy and quality of relationship with the caregiver and caregivers' ratings of mood, strain, and quality of relationship with the patient. If caregiver-assisted CST is effective, future studies could evaluate this training in other cancer populations (e.g. breast cancer, prostate cancer). Future studies could also identify the particular caregiver-assisted CST components (e.g. relaxation training, imagery training, or activity pacing methods) that contribute most to treatment effects. By isolating the active ingredients of training, one can streamline it, making it more cost-effective and more readily available to the larger population of patients having lung cancer. The proposed study rigorously evaluations methods for enhancing the effects of caregiver-assisted coping skills training in cancer patients and their caregivers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CAROTID DEVELOPMENT
BODY
CHEMORECEPTION:
MECHANISM
&
Principal Investigator & Institution: Donnelly, David F.; Associate Professor in Research; Pediatrics; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2003; Project Start 05-MAY-2003; Project End 30-APR-2007 Summary: (provided by applicant): The primary hypoxia sensor of the cardiorespiratory system is the carotid body, which is relatively insensitive at birth and matures over the first 1-2 weeks of life. Although the mechanism of chemotransduction remains obscure, glomus cells, secretory cells apposed to the afferent nerve endings, as well as the nerve endings themselves appear to form the critical chemoreceptive unit. Current models propose that hypoxia causes release of an excitatory transmitter, but identification of the purported excitatory transmitter has proven elusive and our previous results, as well those of other laboratories, demonstrate a dissociation between glomus cell secretion and afferent nerve activity. The proposed work outlines two steps in understanding the mechanism of transduction: firstly, to understand the mechanism of spike generation and secondly, to understand how the generation process is controlled by hypoxia. Towards the first aim, we demonstrate: i) that the spike generation process is highly sensitive to external Na+ perturbation or drugs which target Na+ channels, ii) chemoreceptor afferent neurons express a limited and consistent Na+ channel profile and iii) isolated, chemoreceptor afferent neurons are able to generate spontaneous action potentials which resemble the pattern as generated by the afferent nerve ending. Based on the preliminary results, our general hypothesis is that
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the nerve terminals are the site of action potential generation through an endogenous process, specifically, a persistent Na+ current. The proposed work: 1) uses RT-PCR and immunocytochemistry to identify Na+ channel isoforms at the soma and nerve terminals of chemoreceptor neurons; 2) examines the consequences of Na+ current perturbations on the respiratory response to hypoxia and chemoreceptor activity following drugs which target fast Na+ currents or loss (knockout) of isoforms Navl.6 and Navl.8; 3) examines the effects of disruption of Na+ channel underexpression/overexpression on the ability of the soma to generate spontaneous action potentials. The anticipated results will provide acceptance or rejection of this unique model of chemoreceptor transduction. If supported, the model should lead to a pharmacologic targeting of these processes for the improved treatment of apnea and/or dyspnea. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CEREBRAL MECHANISMS UNDERLYING DYSPNEA Principal Investigator & Institution: Banzett, Robert B.; Associate Professor; Environmental Health; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-SEP-1991; Project End 28-FEB-2005 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: CLONING OF FAMILIAL PRIMARY PULMONARY HYPERTENSION GENE Principal Investigator & Institution: Nichols, William C.; Assistant Professor; Children's Hospital Med Ctr (Cincinnati) 3333 Burnet Ave Cincinnati, Oh 452293039 Timing: Fiscal Year 2002; Project Start 01-JUL-1998; Project End 30-JUN-2003 Summary: Primary pulmonary hypertension (PPH) is characterized by elevated pulmonary artery pressures in the absence of a secondary cause. Endovascular occlusion in the smallest pulmonary arteries occurs by proliferation of cells and matrix, with thrombus and vasospasm. Because the initial symptoms of fatigue and dyspnea on exertion are non-specific, diagnosis can often by delayed. Definitive diagnosis requires invasive procedures. The average life expectancy after diagnosis is 2 to 3 years with death usually due to progressive right heart failure. The etiology of the disease remains unknown. Although most cases appear to be sporadic, approximately 6% of cases exhibit an autosomal dominant mode of inheritance with reduced penetrance. The aim of this proposal is to identify the gene(s) responsible for the familial form of the disorder. Following a genome-wide search using DNA samples from affected individuals in six families, evidence for linkage was obtained on chromosome 2q. The maximum two-point LOD score obtained was 6.97, and multipoint linkage analysis yielded a maximum LOD score of 7.86. Haplotype analysis established a minimum candidate interval of approximately 25 cM, and no significant evidence for any of these six families being unlinked to this chromosomal region was observed. Additional families will be genotyped for markers in the candidate region to narrow the interval and help identify potential candidate genes. A physical map of the minimum candidate interval will be constructed, and yeast artificial chromosome (YAC) and bacterial artificial chromosome (BAC) contigs will be assembled. Additional polymorphic markers will be identified in the YAC and Bac contigs more precisely map the critical recombinants defining the minimum interval. Once the smallest interval containing the
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familial PPH gene has been determined, candidate transcripts will be identified using both available transcript maps as well as exon-trapping methods and analyzed for tissue expression patterns. Leading candidate genes will be evaluated for DNA sequence differences between affected and normal individuals. Identification of the familial PPH gene will enable DNA diagnosis in the families and could potentially allow for the development of novel therapeutics for treatment of both the familial form as well as the more common sporadic form of this life threatening disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CONTINUOUS MEASUREMENT OF BREATHLESSNESS Principal Investigator & Institution: Baird, John C.; Psychological Applications, Llc Waterbury, Vt 05676 Timing: Fiscal Year 2003; Project Start 10-SEP-2001; Project End 31-JAN-2005 Summary: (provided by applicant): The objective of this research is to evaluate a computer-assisted, continuous method for measuring breathlessness during exercise. The method represents a new approach to obtain subjective ratings from patients exercising on a cycle ergometer or treadmill. Whereas the "gold standard" Borg scale for measuring breathlessness is employed in over one million patients per year, it is limited by the fact that each estimate occurs at a discrete point in time cued or signaled by the health professional, rather than when the patient senses a change in symptom intensity. Moreover, if the patient cannot verbalize a response (e.g., while breathing through a mouthpiece), the rating must be indicated on the scale by finger pointing. During exercise this can lead to uncertainty on the part of the clinician as to exactly where the patient is pointing. The continuous method for obtaining patient-initiated ratings is unencumbered by these limitations, while also providing a direct measure of the absolute threshold and peak of breathlessness. The software to obtain such ratings has been shown to be reliable, valid, and easy to use. Thus far, the method has been successfully applied in patients with chronic obstructive pulmonary disease. The goal of Phase II is to evaluate the new methodology with a wider sample of adult patients afflicted with asthma, interstitial lung disease, respiratory muscle weakness, and pulmonary vascular disease, as well as with a group of children with asthma. Tests will also be conducted to investigate the responsiveness of the continuous method to track the effects of bronchodilator therapy and respiratory load. PROPOSED COMMERCIAL APPLICATION. The commercial goal is to replace the discrete scale with a computeradministered continuous method for measuring breathlessness during exercise. The product marketed in Phase III will be a computer software package that will be purchased by physicians, clinics and hospitals throughout the world. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: COPD CLINICAL RESEARCH NETWORK Principal Investigator & Institution: Lazarus, Stephen C.; Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2008 Summary: (provided by applicant): Investigators in the Division of Pulmonary and Critical Care Medicine at the University of California, San Francisco hereby apply to participate in a cooperative COPD Clinical Research Network, to examine existing and novel therapies and management strategies for COPD, and to rapidly disseminate the findings of this Network to the medical community. COPD is the 4th leading cause of death in the United States, and the associated financial and social burden is enormous.
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As new information on the pathobiology of COPD and new approaches for management appear, large, carefully conducted, collaborative multicenter studies are required to define the position of these new strategies in our therapeutic algorithm. Two specific protocols are included in this application; both test novel therapeutic approaches to important clinical problems associated with COPD. The first proposal, "The Effects of TNF-alpha Inhibition in COPD", examines the ability of a monoclonal antibody against the potent proinflammatory cytokine TNF-alpha to reduce the rate of exacerbations in patients with moderate-to-severe COPD. Exacerbations account for most of the emergency department visits, hospitalizations, and deaths associated with COPD. This proposal will examine the effect of anti-TNF-alpha therapy on exacerbations, and the relationship between exacerbations, symptoms, lung function, quality of life, markers of inflammation in airway secretions, and expression of epithelial cell genes related to mucus production. The second project, "Inhibition of Endothelin-1 in COPD-related Pulmonary Arterial Hypertension" will examine whether treatment with the Endothelin A and B receptor antagonist bosentan improves capacity in patients with pulmonary arterial hypertension, and the prognosis for these patients is poor. Evidence suggests that the pulmonary artery lesion is not due solely to hypoxemia, and that vasodilator therapy may be beneficial. This study will test an orally-administered therapy with bosentan, and clinically-important endpoints including exercise capacity, functional class, dyspnea, quality of life, and overall clinical status. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DEHYDROEPIANDROSTERONE THERAPY IN ACUTE ASTHMA Principal Investigator & Institution: Mcfadden, Edward R.; Professor; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: This project is directed toward testing the hypothesis that Dehydroepiandrosterone Sulfate (DHEAS, PB005) administered as a sterile, nonpyrogenic, lyophilized, single-dose intravenous infusion in a dose escalation fashion is safe and efficacious as an adjunct treatment to the standard therapy regimen of patients presenting to an Emergency Room with acute exacerbations of asthma. The specific aim is to determine the benefits of adding PB005 to the standard therapy regimen. This study will be conducted in a dose-escalation fashion, with the primary purpose of establishing the safety of administering PB005 versus placebo in this patient population. Patients presenting to an Emergency Room with an acute exacerbation of asthma (>6hrs) will be eligible for screening for this study. Patients consenting to participate will receive a single 30-minute intravenous infusion of Test Drug that will be initiated between the second and third doses of beta2-agonist therapy. The Test Drug will be administered via an intravenous infusion using standard sterile technique over a period of at least 30 minutes. Standard beta2-agonist therapy will be administered to all study patients with the first three doses given at 20-minute intervals, followed by hourly doses for four hours. Intravenous corticosteroids will be administered to all study patients, prior to the start of the Test Drug infusion. In addition, patients will be prescribed a 5-day course of oral steroids (20 mg, twice a day) when they are released from the hospital following the 24-hour safety assessment. Safety assessments will be performed during the Screening evaluation (12 hour period), continuing through the 24hour period after initiation of the Test Drug infusion, and at the Day 7 follow-up visit. Scheduled assessments will consist of medical history, asthma symptom evaluation, physical exams, cardiac monitoring (ECGs and Holter Monitoring), measurement of vital signs, spirometry, pulse oximetry, laboratory evaluations, and adverse experience
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reports. Asthma symptoms (dyspnea and wheezing) scores will be solicited from the patient at prescribed intervals. Patients will also be instructed to record asthma symptoms on a patient diary twice daily (a.m. and p.m.) during the one-week follow-up period, and will be asked to score symptoms during the Day 7 follow-up visit. Blood pressure, pulse, and respiratory rate will be recorded. Patients will be fitted with a Holter monitor from prior to initiation of the Test drug infusion through the 24 hour safety assessment. A baseline 12-lead ECG will be performed prior to the start of the Test Drug infusion at 30-45 minutes after completion of the Test Drug infusion, and at the 12-hour evaluation, just prior to patients release from the hospital. Serial spirometry will performed to assess study eligibility, safety, and drug efficacy. Oxygen saturation (O2 sat.) levels will be continuously monitored via pulse oximetry from the initial presentation to the Emergency Room until 12 hours after initiation of the Test Drug infusion. Bloom samples (15mL) for hematology and chemistry, and urine samples for urinalysis will be obtained upon presentation to the Emergency Room, at the 12-hour safety assessment, and during the Day 7 follow-up safety assessment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DIAGNOSIS & PATHOGENESIS OF TUBERCULOSIS: AIDS OPPORTUNISTIC INFECTION Principal Investigator & Institution: Didier, Peter J.; Tulane University of Louisiana New Orleans, La New Orleans, La 70112 Timing: Fiscal Year 2002 Summary: The objective of this pilot project is to continue the characterization of the tuberculosis model in rhesus monkeys. We previously found that high dose inoculation (six million bacteria) of Mycobacterium tuberculosis H37Rv and Erdman strains produced lethal lung disease within five to ten weeks. Monkeys developed clinical signs of dyspnea, coughing, anorexia, and weight loss 4-6 weeks after inoculation. Skin testing with Old tuberculin became mildly positive after 5 weeks while PPD skin tests remained negative. Animals developed extensive necrotizing granulomatous lesions in the inoculated half of the lung with spread to the contralateral lung and bronchial lymph node in animals with H37Rv, and to the liver and kidney in animals with the Erdman strain. Animals vaccinated with culture filtrate from H37Rv and challenged with two million bacteria developed the same clinical disease as unvaccinated controls. However, low dosage inoculation of a pair of animals with each strain (<300 Erdma n, <30 H37Rv) failed to produce clinical disease within 18 weeks. Lesions in three of four animals were confined to the bronchial lymph node. To confirm this finding, four more animals per strain have been inoculated with low dosages of bacteria. All animals have strongly positive skin tests but remain clinically normal four weeks after inoculation. Characterization of this model by culture, blastogenesis, flow cytometry, and cytokine detection continues. Results contradict old literature and indicate that tuberculosis in rhesus monkeys may present as a chronic disease based on the dose of the inoculum. This suggests that future studies using low dose inoculation will be feasible in SIVinfected monkeys to study tuberculosis as an opportunistic infection. FUNDING Venture Research PUBLICATIONS Scollard DM, Didier PJ, Dietrich MA, Bohm Jr RP. Selective increases in CD45RO(+) CD38(+) T cells in 1? and 2? responses to BCG in rhesus macaques. [Abstract]. Proceedings of the 9th International Immunology Congress, San Francisco, CA, July 23-29, 1995. Scollard DL, Didier PJ, Bohm Jr RP. A method to assess changes in rhesus lymphatic T cells in vivo during local immune responses. [Abstract]. Second Annual Molecular Biology and Biotechnology Conference, Baton Rouge, LA, February 9-10, 1996. Didier PJ, Blanchard JL, Gormus BJ. Pulmonary
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tuberculosis in normal rhesus monkeys infected with Mycobacterium tuberculosis H37Rv. [Abstract #159]. Amer Soc Trop Med Hygiene, 57(3):156, 1997. Didier PJ, Blanchard JL. Chronic tuberculosis produced by low dosage of M. tuberculosis (Erdman) in rhesus monkeys. [Abstract #734]. Amer Soc Trop Med Hygiene 59(3):361, 1998. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EFFICACY OF YOGA FOR SELF-MANAGEMENT OF DYSPNEA IN COPD Principal Investigator & Institution: Carrieri-Kohlman, Virginia L.; Professor; Physiological Nursing; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 15-SEP-2002; Project End 31-MAY-2004 Summary: (provided by applicant): Management of dyspnea (shortness of breath) is a major problem for patients with chronic obstructive lung diseases (COPD). The effectiveness of traditional supervised and home-based exercise programs for decreasing dyspnea is well established. The remaining knowledge gap is the efficacy of complementary exercises that patients report they are using to manage dyspnea, that may be more congruent with pulmonary patients' lifestyles and values, and that can be adapted to changes in illness severity and disability. Yoga practice is a complementary therapy that people use to manage their dyspnea. Previous studies lack controlled designs, large samples, protocol descriptions, or valid instruments for measuring dyspnea. The aims of this exploratory study are: 1) to develop a safe and feasible yoga program for patients with COPD; 2) to test the efficacy of this program, while establishing the decrease in dyspnea that may be expected with such a program; 3) to determine whether secondary outcomes of physical performance, psychological well being, and health related quality of life (HRQL) are positively affected by yoga practice; 4) to identify and contact community resources including physicians, nurses, yoga practitioners and facilities to support the testing of yoga training for patients with COPD in targeted communities. In a prospective randomized controlled trial three cohorts of subjects with moderate to severe COPD (N=36) will be randomly assigned to either an experimental yoga training or a usual care control for12 weeks. Outcomes will be measured at baseline, after each session, and immediately after the training program. If yoga is shown to affect dyspnea in patients with COPD, the findings of this exploratory study will serve as a foundation for the writing of a multi-center controlled trial to compare the effect of yoga training on dyspnea and multivariate outcomes to an attention control group and a usual care group with a larger sample of patients with moderate to severe COPD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ELECTROCHEMICAL OXYGEN CONCENTRATOR FOR HOME THERAPY Principal Investigator & Institution: Andrews, Craig C.; Lynntech, Inc. College Station, Tx 77840 Timing: Fiscal Year 2003; Project Start 01-MAY-2000; Project End 31-MAR-2005 Summary: (provided by applicant): The beneficial effects of Long-term Oxygen Therapy (LTOT) in the home for patients with Chronic Obstructive Pulmonary Disease (COPD), and other lung diseases causing hypoxemia, are well known. The number of patients with COPD is increasing in most countries, and in the U.S., it is now one of the leading
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causes of death. LTOT increases a patient's survival rate and also has the potential to improve considerably a patient's quality of life. Since LTOT must be given for as long as possible during the day, it is important to extend daily hours of oxygen therapy into the mobile period of the day. This can be achieved through the use of compact, lightweight, portable sources of oxygen gas. Thus, there exists a clear need for a new technologybased oxygen generator that satisfies all the requirements for LTOT both within and outside the home. Currently, providing ambulatory oxygen with LOX systems is problematic because of the cost of LOX and hence lower profit margins for suppliers. The aims of portable oxygen are to increase exercise tolerance, reduce exercise dyspnea, improve quality of life, and extend the daily hours of LTOT. In response to the identified need, this project is specifically aimed at improving the delivery of oxygen to ambulatory patients in the home and office setting using an innovative electrochemical life support system. The technology will have a dramatic improvement in clinical benefits, patient convenience and delivery costs. The portable electrochemical system will produce on demand a supply of humidified, but otherwise pure, oxygen gas, while having a system weight less than 10 Ib and system power requirements less than 600 Watts. The system will provide instantaneous start-up and it is estimated that the oxygen generator will cost less than $1,000. A dual-use development approach will be adopted because the portable electrochemical oxygen generator technology has both government and other commercial applications such as battlefield life support, forward medical treatment areas, casualty transport vehicles, "oxygen trickle charger" for commercial and military aircraft, and hyperbaric oxygen therapy for decompression sickness, air embolism, and carbon monoxide poisoning. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GENETIC REGULATION OF OZONE INDUCED INFLAMMA Principal Investigator & Institution: Foster, W Michael.; Research Professor; Duke University Durham, Nc 27710 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2008 Summary: Despite significant improvements in ambient air quality over the past 30 yr, air pollution continues to pose a challenge to public health. Case control studies associate ambient ozone (03) levels with reduced lung growth in children, and retrospective review of hospital ER records suggest visits by young and elderly asthmatics are increased due to dyspnea and exacerbation of their airway disease, following increases in ambient 03 levels. The overall objective of this project is to characterize the ozone response phenotype (epithelial permeability and airway hyperreactivity) in healthy and asthmatic subjects and evaluate the association of these selected phenotype(s) with polymorphisms i n candidate susceptibility genes. Based on inflammatory cell influx after 03, published reports have described both high and low responder populations. Our preliminary data also demonstrate after 03 a betweensubject differential increase in airway hyperresponsiveness for asthmatic and healthy subjects. Based on these observations, we hypothesize that specific gene polymorphisms/mutations contribute to differential sensitivity of humans to 03induced airway hyper-responsiveness and loss of epithelial integrity. Aim 1: Determine the inter-relatedness of response parameters (airway hyper-responsiveness and epithelial permeability), and to assess if asthmatic airways are differentially responsive to 03. Aim 2: Assess whether acute lung responses to 03 adapt during re-exposure to 03. We will evaluate subjects with differential sensitivity t o O 3 and r elate t he "acute exposure" p henotype t o the chronic exposure p henotype and determine if these are related or distinct response phenotypes. Aim 3: Determine if selected genetic markers
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are associated with response by lung airways to 03. The goal is to assess if polymorphic alleles on specific candidate 03 susceptibility genes as determined by mouse modeling and human studies, associate in selected, differentially O3-responsible subjects. The proposed research is applied and our approach has good potential to identify elements intrinsic to lung injury and asthma that are associated with host factors. We have selected loci on 3 candidate susceptibility genes: TNF-alpha on chromosome 6, TLR-4 on chromosome 9, and NOS2 on chromosome 17, and will determine if they associate with sensitivity of healthy and asthmatic subjects to phenotypes of airway reactivity and epithelial permeability. The research aims are innovative in that they represent the interface between epidemiology, population responses, molecular genetics, and environmental toxicology. Since O3-airway epithelial interactions in vivo in the human have only been identified to a limited extent, new information will be gained. The proposed research adheres closely to the theme of the Program Project to investigate the genetic basis of differential responsiveness of the lung to air pollution as a factor in the susceptibility and development and exacerbation of asthmatic airway disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPERPOLARIZED ASTHMATICS
HELIUM-3
MRI
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Principal Investigator & Institution: De Lange, Eduard E.; Professor of Radiology; Radiology; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2002; Project Start 01-JUL-2001; Project End 31-MAY-2004 Summary: (Verbatim from the Applicant's Abstract): Asthma is an important public health concern affecting more than l4 million people in the United States including over 4.8 million children. Epidemiological studies show a trend toward increasing prevalence and morbidity, but the reasons for these increases remain unclear. Asthma is a chronic disease defined by reversible obstruction of the small airways, inflammation, and increased airway responsiveness to a variety of stimuli: a process that disrupts adequate ventilation of the alveoli causing dyspnea and hypoxia. Existing methods of small airways disease are either indirect or imprecise. Hyperpolarized helium-3 (H3He) gas MR lung imaging is a new technology which allows direct visualization of the lung airspaces, the ventilation and small airway disease, enabling assessment of disease activity at a level that was previously impossible to evaluate. Thus, H3He MR imaging has the potential to provide insight into the pathophysiology of asthma and to contribute to improved clinical management. Preliminary studies with H3He MR have demonstrated ventilation defects in asthmatics, even when they were asymptomatic and had normal lung function tests, and the findings suggest that this new technology is capable of detecting subclinical disease. The goal of the proposed research is to gain a better insight into the H3He MR imaging characteristics in asthmatics (Specific Aim # 1) and to determine how these findings correlate with disease activity and severity (Specific Aim #2). In order to obtain information on the imaging characteristics, we will evaluate the H3He MR imaging findings in populations of symptomatic and asymptomatic asthmatics, using healthy, non-asthmatics as controls. In addition, we will determine in small subgroups of patients how these findings compare to those obtained with two existing lung imaging modalities, nuclear medicine ventilation scanning and computed tomography (CT). To determine the ability of H3He lung MR in assessing disease activity, we will evaluate the imaging changes that occur during tests that provoke (worsen) and treat (improve) asthma. Provocation tests include inhalation of methacholine, exercise, administration of endobronchial allergen and viral inoculation, and treatments include inhaled of p2agonist (albuterol) and steroids (asthmacort). The
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results of the studies proposed in this research will serve as a foundation for developing future clinical and basic research applications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPOXIC EFFECTS ON MAMMALIAN RESPIRATORY NEURAL NETWORK Principal Investigator & Institution: Ramirez, Jan M.; Associate Professor; None; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 Timing: Fiscal Year 2002; Project Start 07-DEC-1998; Project End 30-NOV-2002 Summary: (Adapted from the applicant's abstract): Every year numerous victims suffer brain damage from hypoxic and anoxic insults. To understand the underlying cellular mechanisms this project examines the anoxic effects on the central respiratory network of mice. This network can be isolated in a brainstem slice preparation which generates spontaneously respiratory rhythmic activity. Slices obtained from mice older than one week respond to anoxia in a very similar way as the chemoafferent-denervated but otherwise intact respiratory system. Therefore this preparation will be employed as a model to study the anoxic response of the central respiratory network. The research plan bridges the network, cellular and molecular level using various electrophysiological and pharmacological techniques. Extra and intracellular recording techniques as well as mapping and lesion experiments are performed to identify and characterize different portions of the respiratory system: a network in the so called pre- Boetzinger complex (pBC) which is responsible for generating normal respiration and its anoxia-induced interaction with a neural network which may be responsible for gasping. A model is proposed how the interaction between these neuronal networks leads to the biphasic response to anoxia, which includes an initial augmentation, depression, apnea and then gasping. To understand the neural mechanisms underlying this biphasic response, whole cell, cell attached, outside-out and inside-out patch clamp recording techniques are used. The planned experiments aim at characterizing in great detail the direct anoxic effects on different calcium and potassium channel subtypes. However, this characterization will be supplemented with an analysis of how these direct cellular changes affect indirectly the activation of other cellular properties that are involved in the generation of the respiratory rhythm. Thus, it is only possible to understand the biphasic response in an integrated multi-level approach. A hypothetical model is proposed as to how a suppression of the N-type calcium channel leads indirectly to changes in synaptic transmission and the open probability of calcium-dependent potassium channels. In this model, these alterations result in a decreased activation of the Ih current which will alter the mechanisms of respiratory rhythm generation. To examine this hypothesis, the cascade of these cellular and network events will be analyzed. A better understanding of these neural mechanisms will provide an important foundation for a more rational treatment of various breathing disorders that result in a cessation of breathing such as sleep apnea, recurrent apnea of the newborn and sudden infant death syndrome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IMPROVING CARE FOR CHILDREN WITH ADVANCED CANCER Principal Investigator & Institution: Wolfe, Joanne E.; Dana-Farber Cancer Institute 44 Binney St Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 30-JUN-2007
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Summary: (provided by applicant): One quarter of children with cancer do not survive and they experience substantial suffering in the last month of life. For example, over fifty percent of children suffer from pain and dyspnea, symptoms known to be amenable to effective palliation. Retrospective studies have suggested that parent and physician communication during this period is poor, with parents lagging behind physicians by over three months in their understanding that the child has no realistic chance of being cured. Yet, earlier recognition of a child's terminal prognosis by both the physician and parents is associated with better integration of palliative care. Using a prospective cohort design we will perform a pilot project in 117 children with advanced cancer to ascertain parent and physician perceptions about the child's prognosis and treatment goals over time (using a paper and pencil survey instrument). In addition, we will use Pediatric Quality of Life Evaluation of Symptoms Technology (PediQUEST), a hand-held, computer-based system to routinely evaluate quality of life and symptoms experienced by children with advanced cancer. In the intervention phase of this project we will introduce immediate feedback of PediQUEST results to providers. In addition, electronic mail messages will be automatically generated if a patient's symptoms surpass a predetermined threshold. We will preliminarily assess the impact of this system on the natural history of symptoms and suffering, satisfaction, and the timing and quality of end-of-life discussions in order to generate data for sample size calculations for a future randomized controlled clinical trial. Mentored research activities during the award period will be complimented by a career development plan including coursework, seminars, teaching, committee work and clinical responsibilities which will ensure that the candidate makes a successful transition into an independent investigator and becomes a leader in pediatric oncology and palliative care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMPROVING HEALTH-RELATED QUALITY OF LIFE OUTCOMES Principal Investigator & Institution: Yeaw, Evelyn M.; None; University of Rhode Island 70 Lower College Road, Suite 2 Kingston, Ri 028810811 Timing: Fiscal Year 2001; Project Start 15-SEP-2001; Project End 14-SEP-2004 Summary: Congestive heart failure (CHF) is a major cause of functional disability and decreased quality of life (QOL). People with CHF are living longer, but with disabling symptoms, in particular dyspnea, that erode health-related quality of life (HRQOL). Nursing interventions that can reduce adverse outcomes and/or improve HRQOL outcomes are needed. The purpose of this study is to determine the effects of homebased, nurse-coached inspiratory muscle training (IMT) in people with CHF. Selective IMT is a safe, cost-effective, low technology, non-invasive intervention that can be implemented easily in the home. It is postulated that if IMT is successful there will be a decrease in dyspnea, enhanced self-efficacy, and improved physical/functional and psychosocial dimensions of HTQOL. Therefore, the goals of this study are primarily to determine the effects of a three-month, home-based, nurse-coached IMT in relation to inspiratory muscle strength and dyspnea, and secondly, to determine the effects of IMT with respect to self-efficacy and physical/functional, psychosocial dimensions of HRQOL. The framework for this study is based on Bandura's Self-Efficacy Theory. The study is a two-group, randomized study with repeated measures in which data will be collected four times over a period of 12 weeks with home visits and telephone followup. The experimental group will receive IMT while the comparison group will receive an educational program. Accounting for a 25 percent attrition, a sample of 64 subjects will be recruited from physicians' offices and health clinics. The proposed project will target older adults, 60 years or older, community dwelling, with Class II or III CHF,
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with an ejection fraction of <40 percent. Data will be analyzed using MANOCA (MANOVA?) with repeated measures. The outcome variables are: inspiratory muscle strength, dyspnea, self-efficacy, and physical/functional and psychosocial dimensions of HRQOL. The outcome measures will include: PImax, Perceived Exertion Scale (Borg), Chronic Respiratory Questionnaire Dyspnea Scale (Guyatt), COPD Self-Efficacy Scale (Wigal), and the MOS SF 36 (Ware & Sherbourne). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: IMPROVING INPATIENT PALLIATIVE CARE FOR OLDER ADULTS Principal Investigator & Institution: Pantilat, Steven Z.; Medicine; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 15-AUG-2000; Project End 31-JUL-2005 Summary: (From application) The applicant states that most elders in the US die in acute care hospitals where serious shortcomings in end-of-life care are endemic. Palliative care has made substantial improvements in the care of older Americans at the end of life, but these advances have been largely limited to the outpatient setting. The American Geriatrics Society (AGS) position statement on the care of dying patients outlines specific issues that should be addressed in palliative care, including relief of symptoms such as pain, dyspnea, and anxiety, as well as attention to the emotional, psychological and spiritual needs of the patient and family. The applicant has developed a novel approach to addressing the issues raised in the AGS position statement. This grant application has two complementary long-term goals: 1) to improve palliative care for hospitalized elders, and 2) to provide an experience for the applicant, leading him to a career as an independent investigator in aging by supporting an incremental research and training program. During the first three years of the proposed award, the applicant plans to conduct a clinical trial whose aim is to determine whether a multidisciplinary palliative care consultation will improve management of three critical symptoms (pain, dyspnea, and anxiety), advance care planning, and spiritual issues for seriously-ill, hospitalized older patients. The proposed program of palliative care consultation is based on a conceptual model of terminal illness in which biological, psychological, spiritual, and social factors lead to suffering and death. The proposed research will test the following five specific hypotheses: Compared with usual care, seriously ill, hospitalized older patients who receive a daily, multidisciplinary palliative care consultation will: 1) have lower pain scores; 2) have lower dyspnea scores; 3) have lower anxiety scores; 4) be more likely to have their choice of a surrogate decision-maker documented by the primary teams; 5) be more likely to have the offer of chaplain services documented by the primary team. This proposal incorporates mentoredresearch experience, tutorials, structured reading, and courses that will develop the applicant's research skills necessary to design and conduct clinical trials and other patient-based research. In addition, it is anticipated that the proposed research will develop the UCSF palliative care service into a unit for conducting clinical research focused on improving inpatient palliative care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: IMPROVING LONG-TERM OUTCOMES IN SURVIVORS OF ALIARDS Principal Investigator & Institution: Rubenfeld, Gordon D.; University of Washington Grant & Contract Services Seattle, Wa 98105 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 30-JUN-2008
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Summary: The overall objective of this project is to create an effective multi-disciplinary intervention that improves health related quality of life, reduces post-traumatic stress, and increases functional status in survivors of acute lung injury. Current estimates suggest that over 200,000 people in the U.S. each year are afflicted with acute lung injury and the acute respiratory distress syndrome (ALI/ARDS) and that this number will increase as the population ages. Modern intensive care has reduced hospital mortality in acute lung injury creating more survivors who suffer from depression, post-traumatic stress, weakness, and dyspnea that impair their health related quality of life. Currently, there is little evidence to guide clinicians on techniques to reduce the morbidity suffered by ALI/ARDS survivors. The specific aims of this project are (1) To refine and validate a case-management tool to improve the health related quality of life, reduce psychological symptom burden, and increase functional status in survivors of acute lung injury; (2) To evaluate the effectiveness of a case-manager based intervention implementing the tool developed in Aim 1 to improve the health related quality of life, reduce psychological symptom burden, and increase functional status in survivors of acute lung injury; and (3) To identify risk factors for reduced health related quality of life, increased psychological symptom burden, and poor functional status in survivors of acute lung injury. The experimental approach is a randomized clinical trial of an intervention consisting of a nurse practitioner and social worker supported by a pulmonologist, psychiatrist, and physiatrist who will employ the post-ALI/ARDS case-management tool to identify and treat complications of ALI/ARDS and critical illness. Treatment will consist of specific therapies provided by the intervention team as well as treatments that are provided within the existing healthcare system by targeted patient referral and follow-up that is managed by the intervention team. The healthcare needs of survivors of ALI/ARDS have not been addressed. An effective intervention developed by this project could improve the health related quality of life for thousands of ALI/ARDS survivors and their families each year. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INHALED LOOP DIURETICS FOR CONGESTIVE HEART FAILURE Principal Investigator & Institution: Myers, Daniel J.; Alexza Molecular Delivery Corporation 1001 E Meadow Cir Palo Alto, Ca 94303 Timing: Fiscal Year 2004; Project Start 05-JUL-2004; Project End 31-JAN-2005 Summary: (provided by applicant): Congestive heart failure (CHF) is a complex syndrome characterized by multiple symptoms including fluid retention and shortness of breath (dyspnea). Although these symptoms are currently generally treated by oral loop diuretics, intravenous (IV) delivery of loop diuretics provides more rapid and complete relief, with many hospital visits primarily to obtain this benefit. The goal of this proposal is to develop a device that rapidly delivers loop diuretics into systemic circulation via deep lung inhalation, providing the benefits of IV loop diuretics to outpatients. Our company has developed an aerosol generation technology that enables rapid and reproducible delivery of many FDA-approved drugs to the systemic circulation using a compact, disposable inhaler. In this Phase I grant application we will prove the feasibility of using this technology to deliver one loop diuretic. In a subsequent Phase II grant application, we will optimize the inhaler for use by patients with CHF and complete the inhalation toxicology studies necessary for filing an Investigational New Drug Application (IND) with the FDA. Clinical development of the new treatment of dyspnea in patients with CHF would then be funded by outside investors or through a partnership with a major pharmaceutical company. Development and eventual FDA-approval of this product will enable patients with CHF to treat their
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dyspnea more effectively in out-of-hospital setting, thus decreasing burden on the health care system and improving quality of life for patients with CHF. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTERNET SUPPORT FOR DYSPNEA SELF-MANAGEMENT Principal Investigator & Institution: Nguyen, Huong Q.; Assistant Professor; Physiological Nursing; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2002; Project Start 14-AUG-2002 Summary: A three-year plan of research and training is proposed to study the effects of an Internet based dyspnea management (IDSM) program for long-term seamless support of self-care management for people with chronic obstructive pulmonary disease (COPD). The specific aims are: 1) To develop, pilot test, and determine the feasibility of a nurse facilitated and peer supported IDSM for people with advanced COPD and 2) To determine if the change in the number of perceived available dyspnea management strategies, frequency of use, confidence in use of strategies, the frequency of exercise, the intensity of dyspnea, the impact of dyspnea on functioning, the perception of social support (informational, emotional, and support specific for exercise), mood and health resources utilization differs between the group receiving IDSM and a control group. In this proposed study, subjects will be recruited from a pool of subjects who have recently completed a disease management program. Data will be collected at baseline and at 4 months. The overall goal of this pre-doctoral training is to pilot test an Internet-based dyspnea management support program for patients with COPD as a basis for future investigations in the use of Internet media technology for the management of symptoms for people with chronic illnesses. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: LUNG FIBROSIS: TREATMENT AND MYOFIBROBLAST CONTROL Principal Investigator & Institution: Schwarz, Marvin I.; Professor of Medicine; National Jewish Medical & Res Ctr and Research Center Denver, Co 80206 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2003 Summary: (Applicant's Abstract) In Project 5 we propose to define the role of the fibroblastic foci and myofibroblast presence in IPF/UIP pathogenesis, to test an antiproliferative therapy for this disorder, and develop surrogate markers which predict outcome. Because of its antiproliferative properties and antagonism of transforming growth factor-beta-1 (TGF-b1) functions in vitro, as well as TGFb-1 driven myofibroblast generation, we propose to study the efficacy of interferon gamma (IFN) (subcutaneous and inhaled) in idiopathic pulmonary fibrosis/usual interstitial pneumonia (IPF/UIP). In the recently initiated phase III trial, we will define surrogate markers of outcome; to include dyspnea scores, physiologic tests, quantitative image analysis of the high resolution computed tomographic images, and fibroproliferative biomarkers. Recently, we were instrumental in organizing an NHLBI workshop which proposed systematic evaluation of several available novel therapeutic agents that could abrogate the fibroproliferative response. Myofibroblast apoptosis, proliferation, clonality and structure of fibroblastic foci will be compared to bronchiolitis obliterans organizing pneumonia (BOOP), a disease whose positive outcome exceeds IPF/UIP. Gene expression patterns of whole IPF[UIP lung will be analyzed by microarray and compared to normals and BOOP to determine differences and characteristic patterns. Microdissection of fibroblastic foci in IPF1UIP and Masson's bodies of BOOP will be
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performed. Based on this and utilizing laser capture microdissection BOOP will be performed to determine diagnostic patterns. The goal is to determine gene expression patterns of IPF/UIP and BOOP, which predict clinical behavior and are typical for that particular disease. We will also determine within the IPFIUIP group which genes reflect a bad vs. improved prognosis and the differential gene expression pattern between Fibroblastic foci (IPF/IJIP) and Masson's bodies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LUNG RADIATION PROTECTION BY MNSOD TRANSGENE THERAPY Principal Investigator & Institution: Greenberger, Joel S.; Professor and Chairman; Radiation Oncology; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-DEC-1998; Project End 31-JAN-2006 Summary: (provided by applicant): Thoracic radiotherapy (RT) is often limited by lung toxicity (pulmonary fibrosis). Pulmonary fibrosis ensues after an unexplained latent period which follows the acute reaction and is characterized by reduction in pulmonary vital capacity and exertional dyspnea. Elevation of fibrogenic cytokines, most notably, TGF-B1 and B2 (TGF-B1-B2), and fibroblast proliferation that extends from irradiated to adjacent lung, are features at the molecular and cellular levels. The principal investigator recently demonstrated that intratracheal (IT) injection of manganese superoxide dismutase-plasmid/liposomes (MnSOD-PL) protects the murine lung from irradiation-induced organizing alveolitis/fibrosis induced by single dose or fractionated irradiation. The proposed research will use validated, genetically modified animal models along with quantitative molecular methods to elucidate the cellular mechanism of irradiation lung fibrosis and the level(s) at which epitope-hemagglutinin (HA)-tagged MnSOD transgene therapy protects. The first specific aim tests the hypothesis that organizing alveolitis/fibrosis is initiated by accumulation of macrophage attractant, VCAM-1 in endothelial cells at 80-100 days after irradiation. The second specific aim tests the hypothesis that TGF-B1-B2 production by bone marrow-derived bronchoalveolar macrophages (BAMs) mediates fibroblast recruitment and proliferation. The third specific aim tests the hypothesis that circulating fibroblast progenitor cells, also of bone marrow origin, home to, and proliferate in irradiated lung to produce organizing alveolitis/fibrosis. Methods include BrdU in situ labelling, histopathology, green fluorescent protein-positive (GFP+) male hematopoietic stem cell (macrophage progenitor) engraftment to GFP- female mice and transplantation of GFP+ purified bone marrow stromal cells (BMSCs), continuous anti-TGF-B antibody or soluble TGF-B receptor (TGF-B-R) delivery, injection of HA-MnSOD-PL, fractionated irradiation, and in situ assays of DNA damage. These experiments will provide substantial, new insight into the basic pathogenesis of the pulmonary irradiation response. A comprehensive understanding of the underlying mechanisms is critical for identifying novel targets for intervention. This project may facilitate development of specific strategies to minimize pulmonary irradiation toxicity, thereby making RT safer and more effective. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MAST CELL NERVE INTERACTIONS IN AIRWAYS Principal Investigator & Institution: Undem, Bradley J.; Professor; Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218
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Timing: Fiscal Year 2003; Project Start 01-MAR-1988; Project End 30-NOV-2006 Summary: (provided by applicant): Both the irritating as well as the potentially debilitating symptoms of allergic airway disease are due in large part to perturbation is neuronal activity. Thus sneezing, non-productive coughing, increases mucus secretion, reversible bronchospasm, and inordinate sensations of dyspnea are a consequence of abnormal afferent (sensory) input to the central nervous system, alterations in signal processing within the CNS, and/or alterations in the function of parasympathetic nerves. There has been much knowledge gained in the past two decades regarding the immunological and biochemical basis of the inflammation that accompanies allergic airway disease. Relatively little remains known, however, about how this inflammation modulates airway sensory and autonomic innervation such that the symptoms of disease occur. The long-range goal of this proposal is to develop at a better understanding of the mechanism and mediators involved in allergen-induced neuromodulation of the airways. The effect of allergen challenge on sensory afferent nerves and autonomic parasympathetic nerves innervating the airways will be investigated. Standard electrophysiological and immunohistochemical methods on airways isolated from guinea pigs and human tissue donors to directly address the mechanisms by which antigen challenge modulates neuronal function at a single cell level in the airways. The results from this multidisciplinary approach should be of intrinsic value in providing new knowledge regarding the cellular neurophysiology of the airways. The results may also shed new light on the complex pathophysiology of allergic airway diseases such as asthma, and ultimately suggest new therapeutic strategies for treatment of these complex diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ORAL CYCLOPHOSPHAMIDE VS ORAL PLACEBO IN SSC ALVEOLITIS Principal Investigator & Institution: Read, Charles; Medicine; Georgetown University Washington, Dc 20057 Timing: Fiscal Year 2002; Project Start 10-AUG-1999; Project End 30-JUN-2004 Summary: In Systemic Sclerosis (SSc), interstitial pulmonary fibrosis is frequent (80%) and is now the leading cause of death. The mortality rate of patients with a forced vital capacity (FVC) 2.0% eosinophils in BAL fluid. Secondarily, we will assess the impact of CYC on quality of life (SF36), functional activity (SSc Health Assessment Questionnaire), dyspnea (Mahler Transition Dyspnea Index) and diffusing capacity for carbon monoxide (DLCO) in these patients. Patients will be recruited for study during the first 3 years (from 6 mos. to 2 yrs, 9 mos) of the 5-year project period. Randomized participants will be treated with study drug for 1 year and followed at 3-month intervals for 2 years. Overall study coordination and data collection, management and analysis will be centralized at UCLA. Proven methods for analyzing time-oriented data employed by the investigators in previous controlled studies of scleroderma will be used to evaluate whether oral CYC (1-2 mg/kg/day) is better than placebo a) in improving or preventing worsening of FVC (the primary outcome variable) and b) in improving or preventing worsening of quality of life, functional ability, breathlessness and DLCO (secondary outcome variables). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PREDICTORS OF QUALITY OF LIFE: LUNG TRANSPLANT PATIENTS Principal Investigator & Institution: Lanuza, Dorothy M.; Visiting Professor; None; Loyola University Chicago Lewis Towers, 13Th Fl Chicago, Il 60611 Timing: Fiscal Year 2002; Project Start 01-AUG-2000; Project End 30-APR-2005 Summary: The quality of the lung transplant recipient's life over time remains relatively unexplored. To date, the majority of the studies on QOL of lung transplant patients can be characterized as primarily cross-sectional, limited in scope, and lacking congruence between conceptualization and measurement of QOL, making comparisons within and between studies difficult. Overall Aims: To examine the QOL of lung transplant patients before and up to 1 year after lung transplantation, as measured by indicators of both physical and psychological functioning; and to identify factors that are predictive of QOL outcomes during the first year post-transplant. The specific aims of this study preand during the first year post transplant are: I. To ascertain the impact of lung transplantation on subjects' physical functioning as reflected by: 1) physiologic variables (e.g., forced expiratory volume in 1 second [FEV1], blood pressure [BP], heart rate [HR]); 2) distance walked in 6-minute walk test; 3) number of infection and rejection episodes; 4) perceived physical functioning (physical functioning subscales of Sickness Impact Profile [SIP] and Quality of Life Index [QOLI]); and 5) satisfaction with perceived physical functioning (General Health Satisfaction Scale). II. To ascertain the impact of lung transplantation on subjects' psychosocial functioning as reflected by: 1) psychosocial and emotional well-being (e.g., Brief Symptom Inventory [BSI] and psychosocial subscales of SIP and QOLI); 2) symptoms (e.g., Transplant Symptom Inventory, Dyspnea Visual Analogue Scale); 3) treatment adherence (Treatment Adherence Scale); 4) satisfaction with general health (General Health Satisfaction Scale). III. To identify predictors (e.g., gender) of QOL outcomes and survival during the first year post-transplant. IV. To investigate lung transplant sub-group differences (e.g., gender) in QOL outcomes and symptom experiences. V. To delineate the role of select circadian rhythms (BP and HR) as independent predictors of QOL post-transplant. Statistical Analysis: Descriptive and inferential statistics (e.g., repeated measures ANOVA, McNemar, and Wilcoxon rank sum test), and co-sinor and harmonic analysis for circadian rhythms will be used. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PROTEASES IN LUNG INFLAMMATION & REMODELING Principal Investigator & Institution: Kheradmand, Farrah; Assistant Professor; Medicine; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2003; Project Start 08-MAY-2003; Project End 30-APR-2008 Summary: (provided by applicant): Episodic dyspnea, lung inflammation, and in some patients, progressive irreversible airway dysfunction are characteristic of asthma. Experimental models that share many features in common with human asthma have shed much light on the mechanisms of these pathologic processes. Matrix metalloproteinases (MMPs) and serine proteases are up-regulated in asthma, thus understanding their roles as disease modifiers can potentially offer new opportunities for therapeutic intervention. This proposal will define the role of proteases in an acute asthma model and extend these observations to understand the cross-talk between immune and nonimmune cells in orchestrating inflammatory cell clearance from lung. We will address the functional significance of proteases by combined in rive and in vitro approaches. Specifically, the first aim will determine spatio-temporal regulation of
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proteases synthesized in the lung of mice exhibiting the asthma phenotype. We hypothesize a reciprocal relationship in which endogenous protease expression is essential for efficient Th2 cell development and recruitment and Th2 cells in turn determine airway protease expression. The second aim wilt determine the role of endogenous proteases in the progression of reactive stroma. Expression of proteases and airway inflammation, independent of the acute asthma phenotype, elicits reactive stroma formation, collagen deposition, and airway remodeling. We hypothesize that dysregulated airway protease activity modifies the asthma phenotype by accelerating, or preventing resolution of, airway matrix remodeling. Airway collagen synthesis, AHR, and goblet cell metaplasia in mice chronically challenged with antigen and protease inhibitors will be determined. Finally, in our expanded specific aim we propose to determine the role of MMPs in mediating inflammatory cell clearance in allergic lung disease. We have found that treatment of antigen challenged mice with a synthetic classspecific inhibitor of MMPs, result in massive accumulation of inflammatory cells concomitant with an increase in Th2 cytokines in the lung parenchyma. We hypothesize that MMPs modify the availability of chemoattractants and/or modify chemokine receptor expression, resulting in accumulation of inflammatory cells in the lung parenchyma. We will explore the novel concept that MMPs are required to establish such parenchyma-to-airway ("inside-out") chemotactic gradients and the functional consequences of the failure of these responses in allergic inflammatory lung diseases. Insight into this area of allergic inflammation will answer important questions on mechanisms of allergic airway disease. This work may serve as the foundation for future therapeutic studies that target a broad range of asthmatic patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PSYCHOBIOLOGY OF IV NALOXONE & LACTATE IN NORMALS Principal Investigator & Institution: Klein, Donald F.; Professor of Psychiatry; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 100321098 Timing: Fiscal Year 2004; Project Start 01-DEC-2003; Project End 30-NOV-2005 Summary: (provided by applicant): Panic disorder (PD) is a serious public health burden. It is enmeshed with depression, alcoholism, tobacco dependence, pulmonary disease and has been linked to sudden cardiac death and stroke. The panic attack is distinctively characterized by acute dyspnea, tidal volume hyperventilation and surprising lack of HPA activation. Risk for developing PD is markedly increased by childhood Separation Anxiety Disorder. Both CO2 sensitivity and separation anxiety are regulated by the endogenous opioid system that I hypothesize malfunctions in PD. Normal unresponsiveness to I.V. lactate may stem from an intact endogenous opioid system. When a naloxone infusion preceded intravenous lactate, a pilot study of twelve normal subjects demonstrated a sharp increase in tidal volume and dyspneic distress. Extensive experience indicates that normal subjects do not have this reaction to I.V. lactate alone. Further, this paradigmatic increase in tidal volume and dyspneic distress was not reinstated when subjects were reinfused with naloxone alone. Therefore, we propose to extend this pilot study to definitively demonstrate that naloxone pretreatment is necessary for normal subjects to react as PD subjects do to I.V. lactate. We propose a double blind, randomized three group design in 90 normal subjects: 1) naloxone preceding lactate, 2) saline preceding lactate, 3) naloxone preceding saline. Measures of panic symptoms, air hunger, respiratory and cardiac variables will be analyzed. It is known that PD has a low heart rate variability (HRV) that is lowered further during a lactate induced panic. This feature of PD has been considered an important cardiac risk factor. To further validate our model we will analyze its effects on
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normal HRV. Positive findings would provide the basis for a controlled study of specific anti-panic agents to test whether they can blockade this reaction. This would further validate this model. It may also suggest new approaches to anti-panic agents, such as mixed opiate agonist-antagonist. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PULMONARY EFFECTS OF IV ADENOSINE IN PATIENTS W/ MILD ASTHMA Principal Investigator & Institution: Burki, Nash K.; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2002 Summary: This study evaluates the efficacy of adenosine given IV in patients with mild asthma. It also quantifies the dyspneic sensation (shortness of breath) in these subjects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: REFLEXES IN LEFT VENTRICULAR DYSFUNCTION Principal Investigator & Institution: Kappagoda, Chulani T.; Professor; Internal Medicine; University of California Davis Sponsored Programs, 118 Everson Hall Davis, Ca 956165200 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 31-JUL-2004 Summary: (Adapted from the applicant's abstract):Left ventricular dysfunction (LVD) is a syndrome which presents as dyspnea on exertion, wheezing, a rapid respiratory rate, and increased secretion of mucus. These features are the result of pulmonary venous congestion (PVC) which activates reflexes originating from the airways. Renal functions are also altered. As LVD progresses, PVC evolves into pulmonary edema. This application addresses two issues: (1) the activity of sensory receptors in the lung when the pulmonary circulation is altered chronically by LVD and (2) the reflex effects of activating these receptors on renal function. The majority of these sensory receptors transmit in the cervical vagi and they are classified into myelinated and non-myelinated afferents. The former are composed of pulmonary stretch receptors (PSR) and rapidly adapting receptors (RAR) and the latter of C fiber afferents. Discussions of reflex mechanisms in disease states such as chronic PVC are based on the unsubstantiated assumption that observations made in intact acutely anesthetized animals can be extrapolated directly to animals with chronic disturbances of the circulation. The following hypotheses will be tested in rabbits in a state of chronic pulmonary venous congestion: a) acute pulmonary edema activates pulmonary C fiber afferents, b) acute pulmonary edema increases tone of airway smooth muscle by activation of C fibers and/or RAR, c) acute pulmonary edema increases phrenic nerve activity by activation of C fibers and/or RAR, d) acute pulmonary edema causes a reflex increase in renal blood flow by activation of renal C fiber afferents, and e) the diuresis is associated with obstruction of pulmonary lymph drainage is absent. The following hypotheses will be tested in intact, anesthetized rabbits: a) the diuretic response to pulmonary lymphatic obstruction is not mediated by a change in renal cortico-medullary blood flow and b) the renal response to pulmonary lymphatic obstruction is mediated by nitric oxide related mechanisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: RESPIRATORY MUSCLE TRAINING IN HEART FAILURE Principal Investigator & Institution: Mancini, Donna; Columbia University Health Sciences Po Box 49 New York, Ny 10032 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: ROLE OF INTEGRINS IN PULMONARY FIBROSIS Principal Investigator & Institution: White, Eric S.; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2007 Summary: (provided by applicant): Patients with pulmonary fibrosis develop significant dyspnea and debilitation. Most patients demonstrate significant progression of their disease and ultimately die of respiratory failure. Current therapy for pulmonary fibrosis is largely ineffective. While the exact mechanisms of fibrosis formation are unclear, fibroblasts are thought to play a central role in fibrosis development. Fibroblasts interact with fibronectin via both alpha 4 beta 1- and alpha 5 beta 1 - integrins. Data suggests that fibronectin signals through alpha 5 beta 1 to induce a cellular invasive phenotype, and through alpha 4 beta 1 to inhibit this phenotype. Therefore, the hypothesis of this proposal is that the invasive fibroblast phenotype in human pulmonary fibrosis is regulated by an imbalance in alpha 4 and alpha 5 integrin-mediated signaling; specifically, decreased alpha 4 expression or signaling is associated with an increase in fibroblast invasion of basement membranes. In vitro and in vivo studies will be performed to address the following Specific Aims: I) to demonstrate decreased alpha 4 integrin expression relative to alpha 5 integrin expression on human fibrotic-lung fibroblasts compared to normal human lung fibroblsts and establish that increased ivasion of basement membranes correlates with decreased alpha 4 integrin expression. II) to demonstrate that the increased basement membrane invasive activity of fibroticlung fibroblasts results from a deficiency in intracellular PTEN activity. III) to establish that fibroblastic foci from human specimens of pulmonary fibrosis display diminished PTEN expression compared to normal human lung fibroblasts in vivo, and IV) to demonstrate that restoration of alpha 4 beta 1 and alpha 5 beta 1 integrin signaling balance in vivo by blocking fibronectin stimulated alpha 5 beta 1 integrin signaling attenuates experimental pulmonary fibrosis. Successful completion of the studies outlined in this proposal may help to define mechanisms that lead to development of pulmonary fibrosis, and may lead to the identification of more effective and specific therapies to be employed in the treatment of patients with this disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: ROLE OF VAGAL NERVES IN HYPERPNEA Principal Investigator & Institution: Yu, Jerry J.; Medicine; University of Louisville Jouett Hall, Belknap Campus Louisville, Ky 40292 Timing: Fiscal Year 2003; Project Start 10-JUL-1998; Project End 31-MAY-2007 Summary: (provided by applicant): The long-term objective of this application is to elucidate the roles of pulmonary afferents in cardiopulmonary diseases. Hyperpnea, tachypnea and dyspnea are common symptoms and signs of cardiopulmonary patients. Those patients often hyperventilate, which is detrimental to their existing disease. There are several types of nerve endings in the lung, which provide the respiratory center with
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information about mechanical and chemical changes. However, what roles these nerve endings play are still not fully understood. Recently, a vagally mediated 'excitatory lung reflex' is described. Initiation of the reflex may be a key step for the hyperpnea, tachypnea as well as dyspnea during cardiopulmonary diseases. Our preliminary data indicate that the receptor endings for the reflex are located in the small airways. The specific aims of this project are to identify the structure, mechanical and chemical properties of the responsible endings and to identify their afferent pathways. Phrenic nerve activity and intraluminal pressure in the trachea will be recorded for assessing respiration. The activity in the sensory endings will be recorded to quantify the afferent response. Using neurological and pharmacological methodology to stimulate or block nerve traffic, the reflex effects will be assessed, the reflex pathway will be established and the mechanisms for activation of the receptors will be explored. These physiological results will be confirmed by morphological studies with the techniques such as, neural tracing and histochemistry. The information gained will improve our understanding of neural control of breathing, leading to better clinical management of pulmonary problems. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SALMETEROL & FLUTICASONE PROPIONATE VS PLACEBO IN SUBJECTS W/ COPD Principal Investigator & Institution: Lodato, Robert F.; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 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: SCLERODERMA LUNG STUDY Principal Investigator & Institution: Elashoff, Robert M.; Professor; Biomathematics; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 10-AUG-1999; Project End 30-JUN-2004 Summary: In Systemic Sclerosis (SSc), interstitial pulmonary fibrosis is frequent (80%) and is now the leading cause of death. The mortality rate of patients with a forced vital capacity (FVC) 2.0% eosinophils in BAL fluid. Secondarily, we will assess the impact of CYC on quality of life (SF36), functional activity (SSc Health Assessment Questionnaire), dyspnea (Mahler Transition Dyspnea Index) and diffusing capacity for carbon monoxide (DLCO) in these patients. Patients will be recruited for study during the first 3 years (from 6 mos. to 2 yrs, 9 mos) of the 5-year project period. Randomized participants will be treated with study drug for 1 year and followed at 3-month intervals for 2 years. Overall study coordination and data collection, management and analysis will be centralized at UCLA. Proven methods for analyzing time-oriented data employed by the investigators in previous controlled studies of scleroderma will be used to evaluate whether oral CYC (1-2 mg/kg/day) is better than placebo a) in improving or preventing worsening of FVC (the primary outcome variable) and b) in improving or preventing worsening of quality of life, functional ability, breathlessness and DLCO (secondary outcome variables). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TECHNIQUE FOR DETERMINATION OF CARDIAC OUTPUT DURING HEAVY EXERCISE Principal Investigator & Institution: Johnson, Bruce E.; Director; Mayo Clinic Coll of Medicine, Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: The following protocol seeks to validate a non-invasive open circuit method for determination of cardiac output (pulmonary blood flow) at rest and during heavy exercise using simple gas exchange based measures. There are relatively few noninvasive techniques that give valid estimates of cardiac output at rest and during heavy whole body exercise. The acetylene rebreathing technique has been used extensively over the last 10-15 years and has been validated with thermodilution and Fick estimates of cardiac output in exercising humans and dogs. In this technique, the highly soluble gas, acetylene, is taken up in the lungs in direct proportion to the blood passing through the pulmonary circulation. A drawback to the rebreathing technique is the fact carbon dioxide builds up and oxygen decreases in both the rebreathing bag and lungs. The build up of CO2 causes increased dyspnea, particularly in patients with poor lung function and limited exercise tolerance. The transient changes in the VC02/V02 relationship make it difficult to control for changes in the lung-rebreathing bag volume which can lead to errors in the estimate of cardiac output. In addition, rebreathing may lead to alterations in breathing pattern, which also may cause changes in the cardiac output. Recently, an open circuit acetylene technique that offers several advantages over the rebreathing technique has been developed but not validated in humans. The present study proposes to validate the open circuit technique more fully in exercising humans against the already established technique, and the standard techniques to measure cardiac output using thermodilution and Fick. The specific aims of this study are to compare an open circuit acetylene uptake technique for determination of cardiac output with the traditional acetylene rebreathing technique; and to compare an open circuit acetylene technique for determination of cardiac output at rest and during exercise to the standard thermodilution and Fick measurements of cardiac output. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: TREATMENTS FOR DYSPNEA--EDUCATION, EXPOSURE, AND TRAINING Principal Investigator & Institution: Carrieri-Kohlma, Virginia; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 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: UPPER BODY STRENGTH TRAINING IN COPD Principal Investigator & Institution: Larson, Janet L.; Professor and Department Head; Medical-Surgical Nursing; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 30-JUN-2007 Summary: (provided by applicant): People with moderate to severe chronic obstructive pulmonary disease (COPD) experience intense symptoms of dyspnea when they use their arms and shoulders. To control the dyspnea people avoid the use of their upper extremities and ultimately experience a significant loss of upper body (UB) strength and
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a decrease in functional performance, reflected by a decrease in the level of activities performed on a daily basis. The purpose of this research is to examine the effects of UB strength training with a self-efficacy intervention to enhance adherence. This is an experimental study with random assignment of subjects to one experimental and two control groups: (a) UB strength training with self-efficacy intervention (experimental), (b) UB strength training with health education (control 1) and (c) armchair fitness exercises with health education (control 2). The interventions are four months in duration with three booster sessions scheduled during a 12 month follow up period. Each subject will be studied for a total of 16 months. The primary specific aims are to compare the short (4 months) and long term (12 months after termination of structured training) effects of the above interventions in terms of the following dependent variables: UB strength (one-repetition maximum), dyspnea during physical activities (Chronic Respiratory Disease Questionnaire) and functional performance (Functional Performance Inventory). Secondary aims are to examine the effects in terms of inspiratory muscle strength, exercise-related self-efficacy, and adherence to UB strength training. Additionally dual energy x-ray absorptiometry will be used to document changes in UB muscle mass (fat free soft tissue). Dual accelerometers (arm and waist) will be used to verify self-report of exercise adherence at home during the 12 months follow-up. The sample will be 120 people with moderate to severe COPD who experience dyspnea with UB activities, 40 per group. Researchers performing strength tests will be blinded to group assignment. This research is innovative in that it examines the effects of a comprehensive upper body strength training with weight lifting (8 exercises) and combines it with a theory-based self-efficacy intervention to promote adherence to training. This is important because people with COPD experience exacerbations that adversely affect adherence. Previous research in this area does not address the effect of multiple weight lifting exercises and long-term adherence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EMPHYSEMA
VENTING
FOR
REDUCTION
OF
HYPERINFLATION
IN
Principal Investigator & Institution: Cooper, Joel D.; Surgery; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2006 Summary: Description (provided by applicant) Emphysema affects approximately 2 million individuals in the US and is the fourth leading cause of death. Once medical therapy has been maximized, further therapeutic strategies are limited, apart from lung transplantation, and lung volume reduction surgery, both of which are applicable to only a small subsegment of end-stage patients. The crippling effects of end-stage emphysema, including severe dyspnea, relate not only to loss of lung substance but also to the dynamic hyperinflation of the lungs associated with loss of elastic recoil and a marked increase in the size of the lungs. The concomitant enlargement of the thorax, and flattening of the diaphragm, render the inspiratory muscles inefficient, increase the work of breathing, and contribute significantly to the feeling of breathlessness. The patient is trapped in a state of hyperinflation and no amount of forced effort can empty the lungs since the same force exerted to empty the lungs, is transmitted to the small airways which collapse and obstruct the outflow of gas. There is clear evidence that the normal collateral ventilation present in human lungs is markedly increased in emphysema due to extensive breakdown of alveolar walls. In fact, it has been demonstrated that airflow from one region of the lung to another in the emphysematous patient can exceed air flow through the nonnal air passages. We hypothesize that the
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extensive collateral ventilation existing in emphysematous lungs, can be utilized to decrease the hyperinflation and air trapping which is responsible for a significant portion of the dyspnea in such patients. We propose to create new passageways from the lung substance to large airways in order to bypass the small, obstructed airways. This will allow the lungs to deflate more completely on exhalation, relieving breathlessness and increasing the patients' tolerance for exertion. To accomplish this we propose: 1) to create a dog model of severe emphysema; 2) to develop a simple, safe, and effective endoscopic technique for creation of broncho-pulmonary conduits, using methods applicable for humans; 3) to evaluate the radiologic, physiologic, and functional consequences of alleviating dynamic hyperinflation with this method. 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 “dyspnea” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for dyspnea in the PubMed Central database: •
Alterations in the Mechanical Properties of the Lung during Dyspnea in Chronic Obstructive Pulmonary Disease. by Suero JT, Woolf CR.; 1970 Apr; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=322530
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Exertional dyspnea as initial manifestation of Takayasu's arteritis -- A case report and literature review. by Neidhart B, Kosek R, Bachmann LM, Stey C.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=64544
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Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer. by Bredin M, Corner J, Krishnasamy M, Plant H, Bailey C, A'Hern R.; 1999 Apr 3; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27809
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STUDIES IN CONGESTIVE HEART FAILURE XIII. The Relation of Dyspnea of Exertion to the Oxygen Saturation and Acid-Base Condition of the Blood. by Cullen GE, Harrison TR, Calhoun JA, Wilkins WE, Tims MM.; 1931 Oct; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=435784
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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STUDIES OF BREATHING, PULMONARY VENTILATION AND SUBJECTIVE AWARENESS OF SHORTNESS OF BREATH (DYSPNEA) IN NEUROCIRCULATORY ASTHENIA, EFFORT SYNDROME, ANXIETY NEUROSIS. by Cohen ME, White PD.; 1947 May; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=439184
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THE EFFECT OF SOME PATHOLOGICAL CONDITIONS UPON DYSPNEA DURING EXERCISE I. Artificial Stenosis. by Hewlett AW, Lewis JK, Franklin A.; 1925 Jun; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=434565
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 dyspnea, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “dyspnea” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for dyspnea (hyperlinks lead to article summaries): •
A 47-year-old woman with progressive dyspnea and cough. Author(s): Roy SR, Nelson HS. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2002 April; 88(4): 364-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11991553
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A 49-year-old male with intractable dyspnea, wheeze, and cough. Author(s): Bates CA, Rosenwasser LJ. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2003 July; 91(1): 20-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12877444
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 59-year-old liver-transplanted woman with fever, dyspnea and pulmonary infiltrates. Author(s): Del Bono L, Filipponi F, Marchetti G, Ferranti S, Menichetti F, Mosca F. Source: Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2003 October; 9(10): 1057-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14616753
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A 7-year-old girl with dyspnea and rash. Author(s): Zingg W, Kellenberger C, Frey B, Grimm F, Berger C. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 2003 July 1; 37(1): 73-4, 129-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12854512
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A dyspnea evaluation protocol for respiratory therapists: a feasibility study. Author(s): Karampela I, Hansen-Flachen J, Smith S, Reily D, Fuchs BD. Source: Respiratory Care. 2002 October; 47(10): 1158-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12354334
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A factor analysis of dyspnea indexes and lung function parameters in patients with chronic obstructive pulmonary disease. Author(s): Kostianev SS, Hodzhev VA, Todorov IT, Hristova AS, Mandulova PV, Iluchev DH. Source: Folia Med (Plovdiv). 2001; 43(3): 27-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11930829
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A randomized controlled trial of supplemental oxygen versus air in cancer patients with dyspnea. Author(s): Bruera E, Sweeney C, Willey J, Palmer JL, Strasser F, Morice RC, Pisters K. Source: Palliative Medicine. 2003 December; 17(8): 659-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14694916
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A twenty-two year old woman with hemoptysis and increasing dyspnea of two years' duration. Author(s): Aach R, Kissane J. Source: The American Journal of Medicine. 1967 April; 42(4): 609-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6023005
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Acute dyspnea during dental extraction. Author(s): Yoshimoto A, Mitamura Y, Nakamura H, Fujimura M. Source: Respiration; International Review of Thoracic Diseases. 2002; 69(4): 369-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12169756
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Acute dyspnea in the office. Author(s): Zoorob RJ, Campbell JS. Source: American Family Physician. 2003 November 1; 68(9): 1803-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14620600
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Acute effects of hyperoxia on dyspnea in hypoxemia patients with chronic airway obstruction at rest. Author(s): Alvisi V, Mirkovic T, Nesme P, Guerin C, Milic-Emili J. Source: Chest. 2003 April; 123(4): 1038-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12684291
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Aerobic exercise: effects on parameters related to fatigue, dyspnea, weight and body composition in HIV-infected adults. Author(s): Smith BA, Neidig JL, Nickel JT, Mitchell GL, Para MF, Fass RJ. Source: Aids (London, England). 2001 April 13; 15(6): 693-701. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11371683
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Alterations in the mechanical properties of the lung during dyspnea in chronic obstructive pulmonary disease. Author(s): Suero JT, Woolf CR. Source: The Journal of Clinical Investigation. 1970 April; 49(4): 747-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5443175
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An approach to dyspnea in advanced disease. Author(s): Gallagher R. Source: Can Fam Physician. 2003 December; 49: 1611-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14708926
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An unusual cause of dyspnea in a 77-year-old man. Author(s): Daniil ZD, Malagari K, Zakynthinos EG, Kapotsis GE, Roussos C, Papiris SA. Source: Chest. 2004 February; 125(2): 770-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14769763
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An unusual cause of dyspnea in the adult: Bochdalek's hernia. Author(s): Agozzino F, Picca M, Pelosi G. Source: Ann Ital Med Int. 2003 July-September; 18(3): 168-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14621429
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An unusual cause of dyspnea. Author(s): Jamali AH, Ahmed RM, Stein H. Source: Cardiology in Review. 2004 January-February; 12(1): 10-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14667257
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Arm exercise capacity and dyspnea ratings in subjects with chronic obstructive pulmonary disease. Author(s): McKeough ZJ, Alison JA, Bye PT. Source: Journal of Cardiopulmonary Rehabilitation. 2003 May-June; 23(3): 218-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782907
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Bacterial tracheitis among children hospitalized for severe obstructive dyspnea. Author(s): Dudin AA, Thalji A, Rambaud-Cousson A. Source: The Pediatric Infectious Disease Journal. 1990 April; 9(4): 293-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2336317
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Bilateral carotid body resection for the relief of dyspnea in severe chronic obstructive pulmonary disease. Physiologic and clinical observations in three patients. Author(s): Stulbarg MS, Winn WR, Kellett LE. Source: Chest. 1989 May; 95(5): 1123-8. Erratum In: Chest 1989 September; 96(3): 706. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2495905
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Bilateral hilar enlargement and dyspnea in a young black man. Author(s): Hnatiuk OW, Dillard TA, Schaefer PS, McManigle J. Source: Chest. 1992 April; 101(4): 1128-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1555431
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Bilateral thoracoscopic staple lung volume reduction surgery: Does improvement in dyspnea correlate with improvement in pulmonary function? Author(s): Teramoto S. Source: Chest. 1998 June; 113(6): 1730-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9631826
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Bone marrow necrosis with dyspnea in a patient with malignant lymphoma and plasma levels of thrombomodulin, tumor necrosis factor-alpha, and D-dimer. Author(s): Seki Y, Koike T, Yano M, Aoki S, Hiratsuka M, Fuse I, Aizawa Y. Source: American Journal of Hematology. 2002 July; 70(3): 250-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12111773
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Brain natriuretic peptide blood levels in the differential diagnosis of dyspnea. Author(s): Cabanes L, Richaud-Thiriez B, Fulla Y, Heloire F, Vuillemard C, Weber S, Dusser D. Source: Chest. 2001 December; 120(6): 2047-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11742939
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Brain natriuretic peptide: a marker for dyspnea? Author(s): Soares LG. Source: Journal of Pain and Symptom Management. 2002 November; 24(5): 457-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12547045
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Breathlessness. Strategies aimed at identifying and treating the cause of dyspnea. Author(s): Seamens CM, Wrenn K. Source: Postgraduate Medicine. 1995 October; 98(4): 215-6, 219-22, 225-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7567721
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Bronchiolitis obliterans organizing pneumonia. Cause of dyspnea and bilateral lung infiltrates in an adult Chinese patient. Author(s): Yam LY, Wong R. Source: Chinese Medical Journal. 1993 March; 106(3): 228-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8325150
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Bronchoprovocation test by forced oscillation technique: airway hyperresponsiveness in chronic cough and psychogenic dyspnea subjects. Author(s): Hsiue TR, Hsieh AL, Chang HY, Chen CR, Chen CW. Source: J Formos Med Assoc. 1993 March; 92(3): 231-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8102275
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B-type natriuretic peptide in the evaluation of acute dyspnea. Author(s): Martinez-Selles M. Source: The New England Journal of Medicine. 2004 June 3; 350(23): 2416-7; Author Reply 2416-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15175447
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B-type natriuretic peptide predicts future cardiac events in patients presenting to the emergency department with dyspnea. Author(s): Harrison A, Morrison LK, Krishnaswamy P, Kazanegra R, Clopton P, Dao Q, Hlavin P, Maisel AS. Source: Annals of Emergency Medicine. 2002 February; 39(2): 131-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11823766
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Cardiac and pulmonary dyspnea. Clinical differentiation. Author(s): Dines DE, Parkin TW. Source: Minn Med. 1967 August; 50(8): 1181-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6058587
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Cardiac or pulmonary dyspnea in patients admitted to the emergency department. Author(s): Malas O, Caglayan B, Fidan A, Ocal Z, Ozdogan S, Torun E. Source: Respiratory Medicine. 2003 December; 97(12): 1277-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14682407
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Cardiovascular imaging in-a-month. Chest roentogenogram mimicking double aortic arch in a 30-year-old female with effort dyspnea and dysphagia. Author(s): Ohgi S, Ito H, Isogami K, Kanno T. Source: J Cardiol. 2004 March; 43(3): 147-50. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15067803
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 12-2003. An 82-year-old man with dyspnea and pulmonary abnormalities. Author(s): Malhotra A, Muse VV, Mark EJ. Source: The New England Journal of Medicine. 2003 April 17; 348(16): 1574-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12700378
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 13-2002. A 43-year-old man with renal carcinoma and worsening dyspnea. Author(s): Markowitz DH, Mark EJ. Source: The New England Journal of Medicine. 2002 April 25; 346(17): 1309-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11973368
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 40-2002. A 56-year-old man with rapidly worsening dyspnea. Author(s): Gong MN, Mark EJ. Source: The New England Journal of Medicine. 2002 December 26; 347(26): 2149-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12501228
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Chest pain, dyspnea, and cyanosis with heart murmurs and history of streptococcal bacteremia. Author(s): Bruno MS, Ober WB. Source: N Y State J Med. 1969 May 1; 69(9): 1187-95. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5254289
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Chronic infiltrates of lung associated with dyspnea. Author(s): Weiner MA. Source: Jama : the Journal of the American Medical Association. 1968 August 19; 205(8): 581-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5695002
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Chronic obstructive pulmonary disease and dyspnea: a Pandora's box of comorbid symptoms? Author(s): Cox JM, Dickerson ED, Petty TL. Source: Am J Hosp Palliat Care. 2003 May-June; 20(3): 179-81. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12785038
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Clinical case of the month. Chest pain, diaphoresis, and dyspnea in a hypertensive 53year-old man. Author(s): Awtrey R, Gupta S, Kelley GP, Glancy DL, Harrison L, Lopez FA. Source: J La State Med Soc. 2002 March-April; 154(2): 60-5. Erratum In: J La State Med Soc 2002 May-June; 154(3): 156. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12014455
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Clinical validation of bronchial hyperresponsiveness, allergy tests and lung function in the diagnosis of asthma in persons with dyspnea. Author(s): Popovic-Grle S, Mehulic M, Pavicic F, Babic I, Beg-Zec Z. Source: Coll Antropol. 2002 December; 26 Suppl: 119-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12674843
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Clinico-pathologic conference. Fever, dyspnea, chest and abdominal pains. Author(s): Dalmacio-Cruz AE. Source: Acta Med Philipp. 1966 April-June; 2(4): 211-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5914292
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Clinicopathologic conference. Progressive dyspnea, enlarged cardiac silhouette and right pleural effusion. Author(s): Bruno MS, Ober WB. Source: N Y State J Med. 1969 April 15; 69(8): 1062-74. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4238990
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Comparative value of Doppler echocardiography and B-type natriuretic peptide assay in the etiologic diagnosis of acute dyspnea. Author(s): Logeart D, Saudubray C, Beyne P, Thabut G, Ennezat PV, Chavelas C, Zanker C, Bouvier E, Solal AC. Source: Journal of the American College of Cardiology. 2002 November 20; 40(10): 1794800. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12446063
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Comparison of continuous and discrete measurements of dyspnea during exercise in patients with COPD and normal subjects. Author(s): Fierro-Carrion G, Mahler DA, Ward J, Baird JC. Source: Chest. 2004 January; 125(1): 77-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14718424
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Comparison of the peak exercise response measured by the ramp and 1-min step cycle exercise protocols in patients with exertional dyspnea. Author(s): Revill SM, Beck KE, Morgan MD. Source: Chest. 2002 April; 121(4): 1099-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11948038
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Concordance of field and emergency department assessment in the prehospital management of patients with dyspnea. Author(s): Pozner CN, Levine M, Shapiro N, Hanrahan JP. Source: Prehosp Emerg Care. 2003 October-December; 7(4): 440-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14582094
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Controlled breathing and dyspnea in patients with chronic obstructive pulmonary disease (COPD). Author(s): Gosselink R. Source: Journal of Rehabilitation Research and Development. 2003 September-October; 40(5 Suppl 2): 25-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15074451
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Cracking a dyspnea mystery. Drug-induced pulmonary fibrosis. Author(s): Hiranniramol S, Braman S, O'Brien A. Source: Postgraduate Medicine. 2001 August; 110(2): 93-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11787418
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Critical outcomes in pulmonary rehabilitation: assessment and evaluation of dyspnea and fatigue. Author(s): Meek PM, Lareau SC. Source: Journal of Rehabilitation Research and Development. 2003 September-October; 40(5 Suppl 2): 13-24. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15074450
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Determinants of dyspnea in patients with different grades of stable asthma. Author(s): Martinez-Moragon E, Perpina M, Belloch A, de Diego A, Martinez-Frances M. Source: The Journal of Asthma : Official Journal of the Association for the Care of Asthma. 2003 June; 40(4): 375-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12870833
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Diagnostic and prognostic usefulness of natriuretic peptides in emergency department patients with dyspnea. Author(s): Collins SP, Ronan-Bentle S, Storrow AB. Source: Annals of Emergency Medicine. 2003 April; 41(4): 532-45. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12658254
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Diagnostic utility of B-type natriuretic peptide in patients with acute dyspnea or pleural effusions. Author(s): Zemans RL, Chatterjee K, Matthay MA. Source: The American Journal of Medicine. 2004 March 15; 116(6): 424-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15006593
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Diagnostic value of B-Type natriuretic peptide and chest radiographic findings in patients with acute dyspnea. Author(s): Knudsen CW, Omland T, Clopton P, Westheim A, Abraham WT, Storrow AB, McCord J, Nowak RM, Aumont MC, Duc P, Hollander JE, Wu AH, McCullough PA, Maisel AS. Source: The American Journal of Medicine. 2004 March 15; 116(6): 363-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15006584
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Dyspnea and bronchospasm from inappropriate postexercise hyperventilation. Author(s): Ferguson A, Addington WW, Gaensler EA. Source: Annals of Internal Medicine. 1969 December; 71(6): 1063-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5361406
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Dyspnea and cough in an elderly man. Author(s): Donnelly WJ. Source: Postgraduate Medicine. 1968 June; 43(6): 183-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5657027
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Dyspnea as an end point in clinical trials of therapies for acute decompensated heart failure. Author(s): Teerlink JR. Source: American Heart Journal. 2003 February; 145(2 Suppl): S26-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12594449
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Dyspnea due to giant goiter. Author(s): Alper F, Kantarci M, Kurkcuoglu IC, Balik AA. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2003 August; 24(2): 302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12895627
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Dyspnea in a teen-age girl. Author(s): Wilcox WA. Source: Minn Med. 1969 May; 52(5): 771-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5785057
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Dyspnea on exertion, fatigue, and pallor in a 50-year-old active duty soldier. Author(s): Verma PS, Gallagher CM. Source: Military Medicine. 2003 July; 168(7): 587-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12901473
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Dyspnea relief. Author(s): Mahler DA. Source: Monaldi Arch Chest Dis. 2003 October-December; 59(4): 331-4. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15148848
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Dyspnea scales as a measure of health-related quality of life in patients with idiopathic pulmonary fibrosis. Author(s): Baddini Martinez JA, Martinez TY, Lovetro Galhardo FP, de Castro Pereira CA. Source: Medical Science Monitor : International Medical Journal of Experimental and Clinical Research. 2002 June; 8(6): Cr405-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12070430
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Dyspnea, chest pain, and cough: the lurking culprit. Nitrofurantoin-induced pulmonary toxicity. Author(s): Liesching T, O'Brien A. Source: Postgraduate Medicine. 2002 July; 112(1): 19-20, 24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12146091
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Dyspnea, cyanosis, and pulmonary infiltrates in a young skier. Author(s): Accad MF, Fred HL. Source: Hosp Pract (Off Ed). 1997 December 15; 32(12): 93-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12828361
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Dyspnea, fever, and anasarca in a 39-year-old woman; a clinicopathologic conference. Author(s): Smith C. Source: Med Ann Dist Columbia. 1971 February; 40(2): 106-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5278228
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Dyspnea, respiratory function and sputum profile in asthmatic patients during exacerbations. Author(s): Rosi E, Lanini B, Ronchi MC, Romagnoli I, Stendardi L, Bianchi R, Zonefrati R, Duranti R, Scano G. Source: Respiratory Medicine. 2002 September; 96(9): 745-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12243322
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Dyspnea: psychologic and physiologic observations. Author(s): Dudley DL, Martin CJ, Holmes TH. Source: Journal of Psychosomatic Research. 1968 March; 11(4): 325-39. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5650593
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Dyspnea: recognizing and managing an invisible problem. Author(s): Wickham R. Source: Oncology Nursing Forum. 2002 July; 29(6): 925-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12096289
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Dyspnea: the continuing challenge of palliative management. Author(s): LeGrand SB. Source: Current Opinion in Oncology. 2002 July; 14(4): 394-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12130922
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Dyspnea-fasciculation syndrome: early respiratory failure in ALS with minimal motor signs. Author(s): Scelsa SN, Yakubov B, Salzman SH. Source: Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders : Official Publication of the World Federation of Neurology, Research Group on Motor Neuron Diseases. 2002 December; 3(4): 239-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12710515
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Echocardiographic predictors of hemodynamic response and significance of dyspnea development in patients with mitral stenosis during dobutamine stress echocardiography. Author(s): Belgi A, Yalcinkaya S, Umuttan D, Golbasi I, Kabukcu M, Sancaktar O, Tuzuner FE. Source: J Heart Valve Dis. 2003 July; 12(4): 482-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12918851
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Effect of chest wall vibration on dyspnea during exercise in chronic obstructive pulmonary disease. Author(s): Fujie T, Tojo N, Inase N, Nara N, Homma I, Yoshizawa Y. Source: Respiratory Physiology & Neurobiology. 2002 June; 130(3): 305-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12093627
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Effect of complex sanatorium treatment on some dyspnea indices in patients with chronic obstructive pulmonary disease. Author(s): Sandeva R, Kostianev S, Gardev G, Christova A, Illuchev D. Source: Folia Med (Plovdiv). 1999; 41(2): 57-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10534915
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Effect of nebulized furosemide in terminally ill cancer patients with dyspnea. Author(s): Kohara H, Ueoka H, Aoe K, Maeda T, Takeyama H, Saito R, Shima Y, Uchitomi Y. Source: Journal of Pain and Symptom Management. 2003 October; 26(4): 962-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14575057
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Effect of nebulized morphine in cancer patients with dyspnea: a pilot study. Author(s): Tanaka K, Shima Y, Kakinuma R, Kubota K, Ohe Y, Hojo F, Matsumoto T, Ohmatsu H, Goto K, Nagai K, Nishiwaki Y. Source: Japanese Journal of Clinical Oncology. 1999 December; 29(12): 600-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10721941
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Effects of inhaled furosemide on exertional dyspnea in chronic obstructive pulmonary disease. Author(s): Ong KC, Kor AC, Chong WF, Earnest A, Wang YT. Source: American Journal of Respiratory and Critical Care Medicine. 2004 May 1; 169(9): 1028-33. Epub 2004 February 20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14977622
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Effects of ondansetron on respiratory pattern and sensation of experimentally induced dyspnea. Author(s): Martinez JA, Rocha FS, Sobrani E, Galhardo FP, Terra Filho J. Source: Sao Paulo Medical Journal = Revista Paulista De Medicina. 2002 September 2; 120(5): 141-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12436150
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Effects of pulmonary rehabilitation on dyspnea, quality of life, and healthcare costs in California. Author(s): California Pulmonary Rehabilitation Collaborative Group. Source: Journal of Cardiopulmonary Rehabilitation. 2004 January-February; 24(1): 52-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14758104
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Erythroderma in a patient with arthralgias, uveitis, and dyspnea. Author(s): Wirth FA, Gould WM, Kauffman CL. Source: Archives of Dermatology. 1999 November; 135(11): 1411, 1414. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10566847
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Evaluation of dyspnea during physical and speech activities in patients with pulmonary diseases. Author(s): Lee L, Friesen M, Lambert IR, Loudon RG. Source: Chest. 1998 March; 113(3): 625-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9515835
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Evaluation of dyspnea in the elderly. Author(s): Mahler DA, Fierro-Carrion G, Baird JC. Source: Clinics in Geriatric Medicine. 2003 February; 19(1): 19-33, V. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12735113
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Evaluation of exertional dyspnea in the active duty patient: the diagnostic approach and the utility of clinical testing. Author(s): Morris MJ, Grbach VX, Deal LE, Boyd SY, Morgan JA, Johnson JE. Source: Military Medicine. 2002 April; 167(4): 281-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11977877
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Exercise echocardiographic findings and outcome of patients referred for evaluation of dyspnea. Author(s): Bergeron S, Ommen SR, Bailey KR, Oh JK, McCully RB, Pellikka PA. Source: Journal of the American College of Cardiology. 2004 June 16; 43(12): 2242-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15193687
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Exercise hemodynamic findings in patients with exertional dyspnea. Author(s): James KB, Maurer J, Wolski K, Lutton SR, Haas G, Schilz R, Rubin D, Young JB. Source: Texas Heart Institute Journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital. 2000; 27(2): 100-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10928494
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Exercise training improves exertional dyspnea in patients with COPD: evidence of the role of mechanical factors. Author(s): Gigliotti F, Coli C, Bianchi R, Romagnoli I, Lanini B, Binazzi B, Scano G. Source: Chest. 2003 June; 123(6): 1794-802. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12796152
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Exercise training improves outcomes of a dyspnea self-management program. Author(s): Stulbarg MS, Carrieri-Kohlman V, Demir-Deviren S, Nguyen HQ, Adams L, Tsang AH, Duda J, Gold WM, Paul S. Source: Journal of Cardiopulmonary Rehabilitation. 2002 March-April; 22(2): 109-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11984209
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Exertional dyspnea in congestive heart failure. Living longer and doing more? Author(s): Sue DY. Source: Chest. 2000 July; 118(1): 5-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10893348
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Exertional dyspnea in heart failure: a symptom unrelated to pulmonary function at rest or during exercise. Duke University Clinical Cardiology Studies (DUCCS) Exercise Group. Author(s): Russell SD, McNeer FR, Higginbotham MB. Source: American Heart Journal. 1998 March; 135(3): 398-405. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9506324
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Experimental pain augments experimental dyspnea, but not vice versa in human volunteers. Author(s): Nishino T, Shimoyama N, Ide T, Isono S. Source: Anesthesiology. 1999 December; 91(6): 1633-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10598604
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Factor analysis of changes in dyspnea and lung function parameters after bronchodilation in chronic obstructive pulmonary disease. Author(s): Taube C, Lehnigk B, Paasch K, Kirsten DK, Jorres RA, Magnussen H. Source: American Journal of Respiratory and Critical Care Medicine. 2000 July; 162(1): 216-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10903244
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Factor analysis of laboratory and clinical measurements of dyspnea in patients with chronic obstructive pulmonary disease. Author(s): Nguyen HQ, Altinger J, Carrieri-Kohlman V, Gormley JM, Stulbarg MS. Source: Journal of Pain and Symptom Management. 2003 February; 25(2): 118-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12590027
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Factor analysis of quality of life, dyspnea, and physiologic variables in patients with chronic obstructive pulmonary disease before and after rehabilitation. Author(s): Fuchs-Climent D, Le Gallais D, Varray A, Desplan J, Cadopi M, Prefaut CG. Source: American Journal of Physical Medicine & Rehabilitation / Association of Academic Physiatrists. 2001 February; 80(2): 113-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11212011
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Factors correlated with dyspnea in advanced lung cancer patients: organic causes and what else? Author(s): Tanaka K, Akechi T, Okuyama T, Nishiwaki Y, Uchitomi Y. Source: Journal of Pain and Symptom Management. 2002 June; 23(6): 490-500. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12067773
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False atrial dissociation (the Deitz-Marques phenomenon) and its dependence on dyspnea. Author(s): Nakamoto K, Tanikado O. Source: Japanese Circulation Journal. 1975 December; 39(12): 1329-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1219148
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Fatal dyspnea in a patient with renal failure. Author(s): DePalo LR. Source: The Mount Sinai Journal of Medicine, New York. 2002 May; 69(3): 113-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12035070
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February 2001: A 74 year old man with a history over 3 months of increasing dyspnea and malaise. Author(s): Baldwin L, Poller D, Ellison D. Source: Brain Pathology (Zurich, Switzerland). 2001 July; 11(3): 389-90; 393. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11414480
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Fentanyl for dyspnea relief. Author(s): Glass E. Source: Oncology Nursing Forum. 1998 September; 25(8): 1310. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9766281
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Fever with dyspnea and swollen bilateral subclavicular area in a drug addict. Author(s): Magadle R, Weiner P, Sotzkover A, Mizrahi-Reuveni M, Yanay NB. Source: Isr Med Assoc J. 2001 July; 3(7): 546. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11791431
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Fever, dyspnea, and slurred speech following lower extremity trauma. Author(s): McCarthy JD, Fleischmann J, George WL. Source: Reviews of Infectious Diseases. 1991 January-February; 13(1): 172-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2017619
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Forty-seven year old woman with dyspnea and multiple nodules in the lung fields. Author(s): Barlow JF, Mutch MG. Source: S D J Med. 1973 January; 26(1): 13-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4509750
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Functional dyspnea. Author(s): Dines DE. Source: J Lancet. 1966 October; 86(10): 493-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5915809
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Further specification and evaluation of a new clinical index for dyspnea. Author(s): Stoller JK, Ferranti R, Feinstein AR. Source: Am Rev Respir Dis. 1986 December; 134(6): 1129-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3789515
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Giant cell myocarditis: a fatal cause of dyspnea in pregnancy. Author(s): van Haelst PL, van Rossem M, Valentijn RM, Beijer GJ. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2001 December 10; 100(1): 105-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11728670
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Graded comprehensive cardiopulmonary exercise testing in the evaluation of dyspnea unexplained by routine evaluation. Author(s): Martinez FJ, Stanopoulos I, Acero R, Becker FS, Pickering R, Beamis JF. Source: Chest. 1994 January; 105(1): 168-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8275727
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Hamartoma of the larynx: an unusual cause of dyspnea. Author(s): Makitie AA, Lehtonen H, Back L, Aaltonen LM, Leivo I. Source: The Annals of Otology, Rhinology, and Laryngology. 2003 October; 112(10): 8413. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14587973
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Health status, dyspnea, lung function and exercise capacity in patients with chronic obstructive pulmonary disease. Author(s): Stavem K, Boe J, Erikssen J. Source: The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 1999 October; 3(10): 920-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10524591
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Heart or lung disease: determining the primary cause for dyspnea on exertion. Author(s): Mohnssen SR, Weisman IM, Zeballos RJ, Hall A, Wasserman K, Tavel ME. Source: Chest. 1998 June; 113(6): 1705-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9631817
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Hemoptysis and dyspnea in a 67-year-old man with a normal chest radiograph. Author(s): Velez Jo ET, Morehead RS. Source: Chest. 1999 September; 116(3): 803-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10492290
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Hepatocellular carcinoma having progressive dyspnea as clinical presentation. Author(s): Shuangshoti S. Source: J Med Assoc Thai. 1996 November; 79(11): 744-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8997015
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Hepatoma, paroxysmal dyspnea and diaphragmatic hump. Author(s): Leow CK, Lau WY. Source: Canadian Journal of Surgery. Journal Canadien De Chirurgie. 1997 February; 40(1): 12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9030076
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Hit the dyspnea target! Author(s): Mahler DA. Source: Journal of Cardiopulmonary Rehabilitation. 2003 May-June; 23(3): 226-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782908
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Home care rehabilitation and perception of dyspnea in chronic obstructive pulmonary disease (COPD) patients. Author(s): Strijbos JH, Koeter GH, Meinesz AF. Source: Chest. 1990 March; 97(3 Suppl): 109S-110S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2306995
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How does negative affectivity contribute to medically unexplained dyspnea? Author(s): Van de Woestijne KP. Source: Chinese Medical Journal. 2004 January; 117(1): 3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14733763
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How effective are supplementary doses of opioids for dyspnea in terminally ill cancer patients? A randomized continuous sequential clinical trial. Author(s): Allard P, Lamontagne C, Bernard P, Tremblay C. Source: Journal of Pain and Symptom Management. 1999 April; 17(4): 256-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10203878
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Huge intraoral aneurysm presenting with dysphagia and dyspnea successfully treated with STA-MCA anastomosis and ICA ligation: case report. Author(s): Hori T, Terao H, Eguchi T, Matsutani M. Source: Journal of Neurosurgery. 1981 October; 55(4): 625-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7277010
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Hyperventilation and effort dyspnea in porto-pulmonary bilharziasis. Author(s): Zaky HA, El-Heneidy AR, El-Maksoud AA. Source: Dis Chest. 1968 February; 53(2): 162-71. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5635734
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Identifying risk factors for imminent death in cancer patients with acute dyspnea. Author(s): Escalante CP, Martin CG, Elting LS, Price KJ, Manzullo EF, Weiser MA, Harle TS, Cantor SB, Rubenstein EB. Source: Journal of Pain and Symptom Management. 2000 November; 20(5): 318-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11068153
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Impact of dyspnea and physiologic function on general health status in patients with chronic obstructive pulmonary disease. Author(s): Mahler DA, Faryniarz K, Tomlinson D, Colice GL, Robins AG, Olmstead EM, O'Connor GT. Source: Chest. 1992 August; 102(2): 395-401. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1643921
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Impact of dyspnea, pain, and fatigue on daily life activities in ambulatory patients with advanced lung cancer. Author(s): Tanaka K, Akechi T, Okuyama T, Nishiwaki Y, Uchitomi Y. Source: Journal of Pain and Symptom Management. 2002 May; 23(5): 417-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12007759
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Impaired perception of dyspnea in patients with severe asthma. Relation to sputum eosinophils. Author(s): Veen JC, Smits HH, Ravensberg AJ, Hiemstra PS, Sterk PJ, Bel EH. Source: American Journal of Respiratory and Critical Care Medicine. 1998 October; 158(4): 1134-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9769272
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Increased perception of dyspnea by inhalation of short acting beta2 agonist in patients with asthma of varying severity. Author(s): Jang AS, Choi IS. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 2000 January; 84(1): 79-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10674569
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Influence of body weight on the severity of dyspnea in chronic obstructive pulmonary disease. Author(s): Sahebjami H, Sathianpitayakul E. Source: American Journal of Respiratory and Critical Care Medicine. 2000 March; 161(3 Pt 1): 886-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10712338
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Interpretive algorithms for the symptom-limited exercise test: assessing dyspnea in Persian Gulf war veterans. Author(s): Medinger AE, Chan TW, Arabian A, Rohatgi PK. Source: Chest. 1998 March; 113(3): 612-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9515833
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Left atrial function preserves pulmonary circulatory pressure during pacingtachycardia and contributes to exercise capacity in patients with idiopathic dilated cardiomyopathy in sinus rhythm, whose exercise is limited by dyspnea. Author(s): Sasaki T, Kubo T, Miyamoto T, Komamura K, Honda K, Masuyama T, Miyatake K. Source: Circulation Journal : Official Journal of the Japanese Circulation Society. 2002 October; 66(10): 937-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12381089
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Limitation of physical activity, dyspnea and chest pain prior to and during two years after coronary artery bypass grafting in relation to a history of hypertension. Author(s): Herlitz J, Caidahl K, Albertsson P, Karlsson T, Hartford M, Haglid M, Lurje L, Karlson BW, Sjoland H. Source: Blood Pressure. 1997 November; 6(6): 349-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9495660
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Lung volume, diffusing capacity, chest roentgenogram and dyspnea index in interstitial lung disease. Author(s): Yang SC, Wu HD, Yang SP. Source: J Formos Med Assoc. 1991 March; 90(3): 244-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1677399
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Lung water, hemodynamics and dyspnea before and after valvuloplasty in mitral stenosis. Author(s): Wellnhofer E, Cramer C, Dreysse S, Fleck E. Source: International Journal of Cardiology. 2000 September 15; 75(2-3): 217-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11077137
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Lung-volume reduction improves dyspnea, dynamic hyperinflation, and respiratory muscle function. Author(s): Martinez FJ, de Oca MM, Whyte RI, Stetz J, Gay SE, Celli BR. Source: American Journal of Respiratory and Critical Care Medicine. 1997 June; 155(6): 1984-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9196106
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Management of dyspnea at the end of life. Author(s): Frankel KM. Source: Journal of the American College of Surgeons. 2002 September; 195(3): 436; Author Reply 437. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12229956
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Management of dyspnea at the end of life: relief for patients and surgeons. Author(s): Mosenthal AC, Lee KF. Source: Journal of the American College of Surgeons. 2002 March; 194(3): 377-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11893139
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Management of dyspnea in advanced cancer patients. Author(s): Ripamonti C. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 1999 July; 7(4): 233-43. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10423049
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Massive congenital coronary arteriovenous malformation presenting with exertional dyspnea and desaturation in an adult: a case report and review of the literature. Author(s): Burns KE, Ferguson KA, Spouge A, Brown JE. Source: The Canadian Journal of Cardiology. 2001 January; 17(1): 85-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11173319
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Massive pleural effusion with dyspnea in a 17-year-old boy as the first sign of ewing sarcoma. Author(s): Wolf G, Aigner RM, Schwarz T. Source: Journal of Pediatric Hematology/Oncology : Official Journal of the American Society of Pediatric Hematology/Oncology. 2002 June-July; 24(5): 420. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12142797
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Meal-induced oxygen desaturation and dyspnea in chronic obstructive pulmonary disease. Author(s): Wolkove N, Fu LY, Purohit A, Colacone A, Kreisman H. Source: Can Respir J. 1998 September-October; 5(5): 361-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9832603
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Measurement of dyspnea in patients treated with mechanical ventilation. Author(s): Powers J, Bennett SJ. Source: American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses. 1999 July; 8(4): 254-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10392226
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Measurement of dyspnea: word labeled visual analog scale vs. verbal ordinal scale. Author(s): Lansing RW, Moosavi SH, Banzett RB. Source: Respiratory Physiology & Neurobiology. 2003 March 3; 134(2): 77-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12609476
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Measurement of short-term changes in dyspnea and disease-specific quality of life following an acute COPD exacerbation. Author(s): Aaron SD, Vandemheen KL, Clinch JJ, Ahuja J, Brison RJ, Dickinson G, Hebert PC. Source: Chest. 2002 March; 121(3): 688-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11888946
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Mechanism of transient dyspnea induced by pegylated-liposomal doxorubicin (Doxil). Author(s): Skubitz KM, Skubitz AP. Source: Anti-Cancer Drugs. 1998 January; 9(1): 45-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9491791
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Nasal dyspnea: the place of rhinomanometry in its objective assessment. Author(s): Schumacher MJ. Source: American Journal of Rhinology. 2004 January-February; 18(1): 41-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15035570
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Nausea, dyspnea, and heart block in an 86-year-old patient with congestive heart failure. Author(s): Propp DA, Hogan T, Mattimore J. Source: Annals of Emergency Medicine. 1988 March; 17(3): 261-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3345020
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Nearly fatal episodes of hypotension, flushing, and dyspnea in a 47-year-old woman. Author(s): Doan T, Greenberger PA. Source: Ann Allergy. 1993 June; 70(6): 439-44. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8507037
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Nebulized fentanyl citrate improves patients' perception of breathing, respiratory rate, and oxygen saturation in dyspnea. Author(s): Coyne PJ, Viswanathan R, Smith TJ. Source: Journal of Pain and Symptom Management. 2002 February; 23(2): 157-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11844637
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Nebulized furosemide as a novel treatment for dyspnea in terminal cancer patients. Author(s): Shimoyama N, Shimoyama M. Source: Journal of Pain and Symptom Management. 2002 January; 23(1): 73-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11779672
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Nebulized hydromorphone for dyspnea in hospice care of advanced cancer. Author(s): Sarhill N, Walsh D, Khawam E, Tropiano P, Stahley MK. Source: Am J Hosp Palliat Care. 2000 November-December; 17(6): 389-91. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11886040
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Nebulized morphine as a treatment for dyspnea in a child with cystic fibrosis. Author(s): Cohen SP, Dawson TC. Source: Pediatrics. 2002 September; 110(3): E38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12205288
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Nebulized morphine for paroxysmal cough and dyspnea in a nursing home resident with metastatic cancer. Author(s): Stein WM, Min YK. Source: Am J Hosp Palliat Care. 1997 March-April; 14(2): 52-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9295402
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Nebulized morphine for the relief of dyspnea. Author(s): Mabe SR, Connelly JF. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 1995 January 15; 52(2): 146-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12879541
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Nebulized opioids in the treatment of dyspnea. Author(s): Quelch PC, Faulkner DE, Yun JW. Source: Journal of Palliative Care. 1997 Autumn; 13(3): 48-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9354041
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Nephrotic syndrome, shoulder pain, and dyspnea in a persistent cougher. Author(s): Marsh CB, Mazzaferri EL. Source: Hosp Pract (Off Ed). 1994 October 15; 29(10): 70-6, 79, 83 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7929678
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Neural substrates for the perception of acutely induced dyspnea. Author(s): Peiffer C, Poline JB, Thivard L, Aubier M, Samson Y. Source: American Journal of Respiratory and Critical Care Medicine. 2001 March; 163(4): 951-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11282772
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New onset dyspnea with reversible airway obstruction in a 70-year-old man. Author(s): Hermanoff MH, Nelson HS. Source: Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology. 1995 December; 75(6 Pt 1): 475-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8603275
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New use of simple equipment to treat dyspnea in infants. Author(s): Chusid E. Source: Pediatrics. 1968 July; 42(1): 215. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5657693
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Nocturnal dyspnea and atrial fibrillation predict Cheyne-Stokes respirations in patients with congestive heart failure. Author(s): Blackshear JL, Kaplan J, Thompson RC, Safford RE, Atkinson EJ. Source: Archives of Internal Medicine. 1995 June 26; 155(12): 1297-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7778961
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Nocturnal dyspnea in a young adult male patient: a typical case of an unrecognized traumatic rupture of the diaphragm. Author(s): Basso SM, Caratozzolo E, Massani M, Antoniutti M, di Pinto FC, Callegari P, Bonariol L, Bassi N. Source: The Journal of Trauma. 2004 March; 56(3): 720. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15128153
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Nonproductive cough, dyspnea, malaise, and night sweats in a 47-year-old woman. Author(s): Adlakha A, Kang E, Adlakha K, Ryu JH. Source: Chest. 1996 May; 109(5): 1385-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8625694
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Nonpulmonary causes of dyspnea. Author(s): Sivraprasad R, Payne CB Jr. Source: Radiologic Clinics of North America. 1984 September; 22(3): 463-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6382416
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Obese young woman with exertional dyspnea. Author(s): Shaknovich A, Gerling B, Kubo SH, Cody RJ. Source: Hosp Pract (Off Ed). 1986 September 30; 21(9A): 88-91, 94-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3093511
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Obesity is a risk factor for dyspnea but not for airflow obstruction. Author(s): Sin DD, Jones RL, Man SF. Source: Archives of Internal Medicine. 2002 July 8; 162(13): 1477-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12090884
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Obstructive sleep dyspnea. Diagnosis and treatment. Author(s): Togawa K, Konno A, Miyazaki S, Yamakawa K, Okawa M. Source: Acta Otolaryngol Suppl. 1988; 458: 167-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3245426
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Of paroxysmal nocturnal dyspnea. Author(s): Burch GE. Source: American Heart Journal. 1979 December; 98(6): 812. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=573963
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Of walking and dyspnea of congestive heart failure. Author(s): Burch GE. Source: American Heart Journal. 1980 October; 100(4): 588-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7415950
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Operationalizing dyspnea: focus on measurement. Author(s): McCord M, Cronin-Stubbs D. Source: Heart & Lung : the Journal of Critical Care. 1992 March; 21(2): 167-79. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1544811
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Opioids, respiratory function, and dyspnea. Author(s): LeGrand SB, Khawam EA, Walsh D, Rivera NI. Source: Am J Hosp Palliat Care. 2003 January-February; 20(1): 57-61. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12568438
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Optimal management strategies for HIV-infected patients who present with cough or dyspnea: a cost-effective analysis. Author(s): Freedberg KA, Tosteson AN, Cotton DJ, Goldman L. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 1992 May-June; 7(3): 261-72. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1351940
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Ovarian hyperstimulation syndrome: acute onset dyspnea in a young woman. Author(s): Garrett CW, Gaeta TJ. Source: The American Journal of Emergency Medicine. 2002 January; 20(1): 63-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11781924
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Oxygen may improve dyspnea and endurance in patients with chronic obstructive pulmonary disease and only mild hypoxemia. Author(s): Dean NC, Brown JK, Himelman RB, Doherty JJ, Gold WM, Stulbarg MS. Source: Am Rev Respir Dis. 1992 October; 146(4): 941-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1416422
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Paroxysmal postural dyspnea related to a left atrial ball thrombus. Author(s): Grandmougin D, Letourneau T, Favre JP, Barral X. Source: The Annals of Thoracic Surgery. 2002 November; 74(5): 1691-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12440634
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Paroxysmal postural dyspnea related to multiple large organized thrombi in the left atrium. Author(s): Davutoglu V, Soydinc S, Akdemir I, Turkmen S. Source: Clin Cardiol. 2004 February; 27(2): 105. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14979633
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Partial epilepsy presenting as episodic dyspnea: a specific network involved in limbic seizure propagation. Case report. Author(s): Cohen-Gadol AA, DiLuna ML, Spencer DD. Source: Journal of Neurosurgery. 2004 March; 100(3): 565-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15035297
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Pathologic quiz case: a 17-year-old adolescent girl with a short history of dyspnea. Endobronchial, anaplastic large cell lymphoma, T-cell phenotype. Author(s): Bhalla R, McClure S. Source: Archives of Pathology & Laboratory Medicine. 2003 December; 127(12): E430-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14632556
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Pathologic quiz case: a 38-year-old woman with chronic renal disease and dyspnea. Author(s): Quinn AM, McClatchey KD. Source: Archives of Pathology & Laboratory Medicine. 2003 April; 127(4): 499-500. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12683886
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Pathologic quiz case: a 40-year-old woman with exertional dyspnea. Author(s): Mahmood MN, Stone CH. Source: Archives of Pathology & Laboratory Medicine. 2003 April; 127(4): E239-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12683915
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Pathologic quiz case: a 6-year-old girl with progressive dyspnea. Pulmonary venoocclusive disease. Author(s): Yang DT, Zhou H, Jaffe RB. Source: Archives of Pathology & Laboratory Medicine. 2003 September; 127(9): E393-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12951993
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Pathophysiology of dyspnea. Author(s): Scano G, Ambrosino N. Source: Lung. 2002; 180(3): 131-48. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12177728
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Pathophysiology of dyspnea. Author(s): Manning HL, Mahler DA. Source: Monaldi Arch Chest Dis. 2001 August; 56(4): 325-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11770215
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Perception of dyspnea during exercise-induced bronchoconstriction. Author(s): Melani AS, Ciarleglio G, Pirrelli M, Sestini P. Source: Respiratory Medicine. 2003 March; 97(3): 221-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12645828
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Perception of dyspnea in patients with neuromuscular disease. Author(s): Lanini B, Misuri G, Gigliotti F, Iandelli I, Pizzi A, Romagnoli I, Scano G. Source: Chest. 2001 August; 120(2): 402-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11502636
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Physical activity as a mediator between dyspnea and fatigue in patients with chronic obstructive pulmonary disease. Author(s): Woo K. Source: The Canadian Journal of Nursing Research = Revue Canadienne De Recherche En Sciences Infirmieres. 2000 December; 32(3): 85-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11928136
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Physiologic causes of dyspnea. Author(s): Snider GL. Source: Adv Cardiopulm Dis. 1969; 4: 145-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5762788
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Prevalence and screening of dyspnea interfering with daily life activities in ambulatory patients with advanced lung cancer. Author(s): Tanaka K, Akechi T, Okuyama T, Nishiwaki Y, Uchitomi Y. Source: Journal of Pain and Symptom Management. 2002 June; 23(6): 484-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12067772
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Pro-brain natriuretic peptide as marker of cardiovascular or pulmonary causes of dyspnea in patients with terminal parenchymal lung disease. Author(s): Goetze JP, Videbaek R, Boesgaard S, Aldershvile J, Rehfeld JF, Carlsen J. Source: The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation. 2004 January; 23(1): 80-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14734131
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Progressive dyspnea in a 49-year-old woman with long-standing epilepsy. Author(s): Halabi S, Convery R, Curtis JM. Source: Chest. 2002 July; 122(1): 352-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12114381
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Psychometric characteristics of dyspnea descriptor ratings in emergency department patients with exacerbated chronic obstructive pulmonary disease. Author(s): Parshall MB. Source: Research in Nursing & Health. 2002 October; 25(5): 331-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12221688
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Pulmonary function in patients with heart disease. Separation of dyspnea due to lung disease from that due to heart disease. Author(s): Kettel LJ, Moran F, Cugell DW. Source: The Medical Clinics of North America. 1966 January; 50(1): 141-57. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5324675
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Pulmonary lesion, hemoptysis, anemia, and progressive dyspnea. Author(s): Bruno MS, Ober WB. Source: N Y State J Med. 1969 October 15; 69(20): 2669-77. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5259560
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Pulmonary muscle strength, pulmonary function tests, and dyspnea in women with major depression. Author(s): Calikoglu M, Sahin G, Yazici AE, Yazici K, Ozisik S. Source: Journal of Women's Health (2002). 2004 January-February; 13(1): 93-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15006282
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Qualitative aspects of exertional dyspnea in patients with interstitial lung disease. Author(s): O'Donnell DE, Chau LK, Webb KA. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1998 June; 84(6): 2000-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9609795
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Quality of dyspnea in bronchoconstriction differs from external resistive loads. Author(s): Moy ML, Woodrow Weiss J, Sparrow D, Israel E, Schwartzstein RM. Source: American Journal of Respiratory and Critical Care Medicine. 2000 August; 162(2 Pt 1): 451-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10934069
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Quantification of dyspnea confirmed by voice pitch analysis. Author(s): Mohler JG. Source: Bull Eur Physiopathol Respir. 1982 November-December; 18(6): 837-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6927538
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Quantitative assessment of dyspnea during exercise before and after bullectomy for giant bulla. Author(s): Teramoto S, Fukuchi Y, Nagase T, Matsuse T, Shindo G, Orimo H. Source: Chest. 1992 November; 102(5): 1362-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1424852
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Questioning the use of heart rate and dyspnea in the prescription of exercise in subjects with chronic obstructive pulmonary disease. Author(s): Brolin SE, Cecins NM, Jenkins SC. Source: Journal of Cardiopulmonary Rehabilitation. 2003 May-June; 23(3): 228-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12782909
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Quiz page. A 49-year-old man presented with 1 month history of bilateral lower extremity swelling, dyspnea-on-exertion, and several month of foamy, tea-colored urine. Author(s): Weber ML, Connaire J. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2003 April; 41(4): Xli. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12666086
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Rapidly progressing dyspnea associated with a mass in the right side of the heart. Author(s): Tavel ME, Goldhaber SZ, Moser KM. Source: Chest. 1995 March; 107(3): 866-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7874967
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Re: a pilot study exploring mood state and dyspnea in mechanically ventilated patients. Author(s): Alkhuja S. Source: Heart & Lung : the Journal of Critical Care. 2001 March-April; 30(2): 166. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11248722
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Re: Dyspnea in the advanced cancer patient. Author(s): Edgecombe J, Wilcock A, Carr D, Clarke D, Corcoran R, Tattersfield AE. Source: Journal of Pain and Symptom Management. 1999 November; 18(5): 313-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10584452
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Re: nebulized furosemide for dyspnea in terminal cancer patients. Author(s): Stone P, Rix, Kurowska A, Tookman. Source: Journal of Pain and Symptom Management. 2002 September; 24(3): 274-5; Author Reply 275-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12458098
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Recurrent sinusitis, arthralgias, and progressive dyspnea in a 26-year-old woman. Author(s): Arcasoy SM, Kreit JW. Source: Chest. 1999 June; 115(6): 1731-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10378574
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Regulation of breathing and perception of dyspnea in healthy pregnant women. Author(s): Garcia-Rio F, Pino JM, Gomez L, Alvarez-Sala R, Villasante C, Villamor J. Source: Chest. 1996 August; 110(2): 446-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8697850
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Relationship between chronic dyspnea and expiratory flow limitation in patients with chronic obstructive pulmonary disease. Author(s): Eltayara L, Becklake MR, Volta CA, Milic-Emili J. Source: American Journal of Respiratory and Critical Care Medicine. 1996 December; 154(6 Pt 1): 1726-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8970362
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Relationship between dyspnea in daily life and psycho-physiologic state in patients with chronic obstructive pulmonary disease during long-term domiciliary oxygen therapy. Author(s): Mishima M, Oku Y, Muro S, Hirai T, Chin K, Ohi M, Nakagawa M, Fujita M, Sato K, Shimada K, Yamaoka S, Oda Y, Asai N, Sagawa Y, Kuno K. Source: Intern Med. 1996 June; 35(6): 453-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8835595
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Reliability and validity of dyspnea sensory quality descriptors in heart failure patients treated in an emergency department. Author(s): Parshall MB, Welsh JD, Brockopp DY, Heiser RM, Schooler MP, Cassidy KB. Source: Heart & Lung : the Journal of Critical Care. 2001 January-February; 30(1): 57-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11174368
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Remission of angina pectoris and dyspnea by fundoplication in gastro-oesophageal reflux disease. Author(s): Tibbling L, Gibellino F. Source: Annals of Medicine. 1992 December; 24(6): 457-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1485938
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Re-opened foramen ovale--a rare cause of postoperative dyspnea following pneumonectomy. Author(s): Mall JW, Vogel B, Grohmann A, Muller JM. Source: The Thoracic and Cardiovascular Surgeon. 2000 October; 48(5): 308-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11100768
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Reproducibility of Borg scale measurements of dyspnea during exercise in patients with COPD. Author(s): Mador MJ, Rodis A, Magalang UJ. Source: Chest. 1995 June; 107(6): 1590-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7781352
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Reproducibility of visual analog scale measurements of dyspnea in patients with chronic obstructive pulmonary disease. Author(s): Mador MJ, Kufel TJ. Source: Am Rev Respir Dis. 1992 July; 146(1): 82-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1626820
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Respiratory bronchiolitis associated with severe dyspnea, exertional hypoxemia, and clubbing. Author(s): Sadikot RT, Johnson J, Loyd JE, Christman JW. Source: Chest. 2000 January; 117(1): 282-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10631233
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Respiratory distress in woman who began complaining of dyspnea and cough 5 months ago. Author(s): Schwarz MI. Source: Chest. 2003 December; 124(6): 2388-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14665526
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Respiratory muscle function and dyspnea in patients with chronic congestive heart failure. Author(s): Mancini DM, Henson D, LaManca J, Levine S. Source: Circulation. 1992 September; 86(3): 909-18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1516204
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Respiratory muscle performance and the Perception of dyspnea in Parkinson's disease. Author(s): Weiner P, Inzelberg R, Davidovich A, Nisipeanu P, Magadle R, Berar-Yanay N, Carasso RL. Source: The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques. 2002 February; 29(1): 68-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11858539
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Respiratory muscle strength, lung function, and dyspnea in patients with sarcoidosis. Author(s): Baydur A, Alsalek M, Louie SG, Sharma OP. Source: Chest. 2001 July; 120(1): 102-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11451823
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Retropharyngeal lipoma causing severe dysphagia and dyspnea. Author(s): Yoshihara T, Kawano K, Mita N. Source: The Journal of Otolaryngology. 1998 December; 27(6): 363-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9857324
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Seasonal dyspnea. Author(s): Ramirez-Icaza C, Winer-Muram HT, Meyer CA, Jennings SG. Source: Chest. 2002 June; 121(6): 2040-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12065375
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Self-efficacy in managing dyspnea in COPD. Author(s): Siela D. Source: Perspect Respir Nurs. 1998 February; 9(1): 9, 12. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10808912
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Severe dyspnea due to jellyfish envenomation. Author(s): Armoni M, Ohali M, Hay E. Source: Pediatric Emergency Care. 2003 April; 19(2): 84-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12698031
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Severe exertional dyspnea in a patient with localized emphysema. Author(s): Giustino G, Webb KA, Sutherland KB, O'Donnell DE. Source: Can Respir J. 1999 November-December; 6(6): 535-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10623791
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Shock and dyspnea after cardiopulmonary resuscitation: a case of iatrogenic gastric rupture. Author(s): Piardi T, D'Adda F, Palmieri F, Vettoretto N, Lanzi S, Pouche A. Source: Chir Ital. 2000 September-October; 52(5): 593-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11190556
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Significance of right ventricular visualization on stress sestamibi in a patient with dyspnea after atrial septal defect repair. Author(s): Wu WC, Tilkemeier PL. Source: Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology. 2002 March-April; 9(2): 236-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11986570
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Sore throat, dysphagia, stiffness in back of neck, and dyspnea following tricyclic antidepressant overdose. Author(s): Irwin RS. Source: Chest. 2003 October; 124(4): 1533-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14555590
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Stability of dyspnea ratings after exercise training in patients with COPD. Author(s): Mahler DA, Ward J, Mejia-Alfaro R. Source: Medicine and Science in Sports and Exercise. 2003 July; 35(7): 1083-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12840626
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Sustained improvements in dyspnea and pulmonary function 3 to 5 years after lung volume reduction surgery. Author(s): Appleton S, Adams R, Porter S, Peacock M, Ruffin R. Source: Chest. 2003 June; 123(6): 1838-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12796158
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Symptomatic improvement in dyspnea following tracheobronchial metallic stenting for malignant airway obstruction. Author(s): Tanigawa N, Sawada S, Okuda Y, Kobayashi M, Mishima K. Source: Acta Radiologica (Stockholm, Sweden : 1987). 2000 September; 41(5): 425-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11016759
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Systemic arterial embolism in patients with mitral stenosis and minimal dyspnea. Author(s): McHenry MM. Source: The American Journal of Cardiology. 1966 August; 18(2): 169-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5913010
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The acute effects of noninvasive ventilatory support during exercise on exercise endurance and dyspnea in patients with chronic obstructive pulmonary disease: a systematic review. Author(s): van 't Hul A, Kwakkel G, Gosselink R. Source: Journal of Cardiopulmonary Rehabilitation. 2002 July-August; 22(4): 290-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12202851
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The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. Author(s): Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, Pinto Plata V, Cabral HJ. Source: The New England Journal of Medicine. 2004 March 4; 350(10): 1005-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14999112
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The perception of dyspnea after bronchoconstriction and bronchodilation in patients with asthma. Author(s): Weiner P, Beckerman M, Berar-Yanay N, Magadle R. Source: Respiratory Medicine. 2003 October; 97(10): 1120-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14561019
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The role of B-type natriuretic peptide in the diagnosis of congestive heart failure in patients presenting to an emergency department with dyspnea. Author(s): Villacorta H, Duarte A, Duarte NM, Carrano A, Mesquita ET, Dohmann HJ, Ferreira FE. Source: Arquivos Brasileiros De Cardiologia. 2002 December; 79(6): 569-72, 564-8. English, Portuguese. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12532240
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The role of nebulized opioids in managing terminal dyspnea: implications for the clinical nurse specialist. Author(s): Doorley J, Hobbs M, Delaney E, Murphy J. Source: Clinical Nurse Specialist Cns. 2003 January; 17(1): 19-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12544116
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The use of B-type natriuretic peptide (BNP) to distinguish heart failure from lung disease in patients presenting with dyspnea to the emergency department. Author(s): Pesola GR. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 2003 March; 10(3): 275-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12615595
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The use of nebulized fentanyl for the management of dyspnea. Author(s): Coyne PJ. Source: Clinical Journal of Oncology Nursing. 2003 May-June; 7(3): 334-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12793342
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Treatment of dyspnea in cancer patients. Author(s): Thomas JR, Von Gunten CF. Source: Oncology (Huntingt). 2002 June; 16(6): 745-50; Discussion 750, 755, 758-60. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12088297
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Tricuspid valve papillary fibroelastoma: an unusual cause of intermittent dyspnea. Author(s): Georghiou GP, Erez E, Vidne BA, Aravot D. Source: European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery. 2003 March; 23(3): 429-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12614822
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Unexplained dyspnea. Author(s): Gillespie DJ, Staats BA. Source: Mayo Clinic Proceedings. 1994 July; 69(7): 657-63. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8015330
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University of Cincinnati Dyspnea Questionnaire for Evaluation of Dyspnoea during physical and speech activities in patients with chronic obstructive pulmonary disease: a validation analysis. Author(s): Hodgev V, Kostianev S, Marinov B. Source: Clinical Physiology and Functional Imaging. 2003 September; 23(5): 269-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12950324
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Unusual cause of dyspnea after pneumonectomy. Author(s): Riedel BJ, Vaporciyan AA. Source: Journal of Cardiothoracic and Vascular Anesthesia. 2003 February; 17(1): 131-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12635076
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Unusual disease of pulmonary arteries with dyspnea. Structure-function relationships. Author(s): Nadel JA, Gold WM, Jennings DB, Wright RR, Fudenberg HH. Source: The American Journal of Medicine. 1966 September; 41(3): 440-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4161849
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Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. Author(s): Mueller C, Scholer A, Laule-Kilian K, Martina B, Schindler C, Buser P, Pfisterer M, Perruchoud AP. Source: The New England Journal of Medicine. 2004 February 12; 350(7): 647-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14960741
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Usefulness of B-type natriuretic peptide in hypertensive patients with exertional dyspnea and normal left ventricular ejection fraction and correlation with new echocardiographic indexes of systolic and diastolic function. Author(s): Mottram PM, Leano R, Marwick TH. Source: The American Journal of Cardiology. 2003 December 15; 92(12): 1434-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14675580
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Usefulness of the modified 0-10 Borg scale in assessing the degree of dyspnea in patients with COPD and asthma. Author(s): Kendrick KR, Baxi SC, Smith RM. Source: Journal of Emergency Nursing: Jen : Official Publication of the Emergency Department Nurses Association. 2000 June; 26(3): 216-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10839848
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Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea. Author(s): Morrison LK, Harrison A, Krishnaswamy P, Kazanegra R, Clopton P, Maisel A. Source: Journal of the American College of Cardiology. 2002 January 16; 39(2): 202-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11788208
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Utility of impedance cardiography to determine cardiac vs. noncardiac cause of dyspnea in the emergency department. Author(s): Springfield CL, Sebat F, Johnson D, Lengle S, Sebat C. Source: Congestive Heart Failure (Greenwich, Conn.). 2004 March-April; 10(2 Suppl 2): 14-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15073480
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Validation of a new dyspnea measure: the UCSD Shortness of Breath Questionnaire. University of California, San Diego. Author(s): Eakin EG, Resnikoff PM, Prewitt LM, Ries AL, Kaplan RM. Source: Chest. 1998 March; 113(3): 619-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9515834
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Validation of a vertical visual analogue scale as a measure of clinical dyspnea. Author(s): Gift AG. Source: Rehabilitation Nursing : the Official Journal of the Association of Rehabilitation Nurses. 1989 November-December; 14(6): 323-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2813949
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Validity of the numeric rating scale as a measure of dyspnea. Author(s): Gift AG, Narsavage G. Source: American Journal of Critical Care : an Official Publication, American Association of Critical-Care Nurses. 1998 May; 7(3): 200-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9579246
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Ventilatory drive at rest and perception of exertional dyspnea in severe COPD. Author(s): Marin JM, Montes de Oca M, Rassulo J, Celli BR. Source: Chest. 1999 May; 115(5): 1293-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10334142
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Visualization of neural activity associated with dyspnea. Author(s): Harper RM. Source: American Journal of Respiratory and Critical Care Medicine. 2001 March; 163(4): 805-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11282740
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Vocal cord dysfunction in patients with exertional dyspnea. Author(s): Morris MJ, Deal LE, Bean DR, Grbach VX, Morgan JA. Source: Chest. 1999 December; 116(6): 1676-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10593794
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Weakness and dyspnea in a man with hemolytic anemia. Author(s): Freeman NJ, Milchev V, Carvalho A. Source: Hosp Pract (Off Ed). 1995 February 15; 30(2): 31-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7852464
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Weakness, dyspnea in an obese leukemia patient. Author(s): Young EJ. Source: Hosp Pract (Off Ed). 1984 June; 19(6): 106E, 106H. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6427239
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What is the cause of dyspnea in asthma and emphysema? Author(s): Govindaraj M. Source: Ann Allergy. 1987 July; 59(1): 63-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3605800
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Wheezing, hypoxia, and dyspnea in a 62-year-old woman. Author(s): Hatch RT, Parker JM, Engler RJ. Source: Ann Allergy. 1993 May; 70(5): 363-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8498725
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When is the dyspnea worth it? Understanding functional performance in people with alpha-1 antitrypsin deficiency. Author(s): Knebel A, Leidy NK, Sherman S. Source: Image--The Journal of Nursing Scholarship. 1998; 30(4): 339-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9866294
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Woman with dry cough and dyspnea on exertion has clubbing, conjunctival injection, and diffuse crackles. Author(s): Harding SM. Source: Chest. 2003 March; 123(3): 935-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12628897
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CHAPTER 2. NUTRITION AND DYSPNEA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and dyspnea.
Finding Nutrition Studies on Dyspnea 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 “dyspnea” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “dyspnea” (or a synonym): •
61-year-old man with dyspnea and bilateral foot drop. Author(s): Mayo Graduate School of Medicine, Mayo Clinic, Rochester, Minn 55905, USA. Source: Cranmer, Lee D Warrington, Kenneth J Ytterberg, Steven R Mayo-Clin-Proc. 2002 April; 77(4): 363-6 0025-6196
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Characterization of aeroallergen-induced dyspnea in unrestrained guinea pigs by bias-flow-ventilated whole body plethysmography. Author(s): Wallace Laboratories, Division of Carter-Wallace Inc., Cranbury, NJ 08512. Source: Chand, N Nolan, K Pillar, J Zomask, M Diamantis, W Sofia, R D Agents-Actions. 1992 November; 37(3-4): 184-7 0065-4299
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Effects of chronic administration of codeine and promethazine on breathlessness and exercise tolerance in patients with chronic airflow obstruction. Author(s): Department of Medicine, Minneapolis Veterans, Administration Medical Center. Source: Rice, K L Kronenberg, R S Hedemark, L L Niewoehner, D E Br-J-Dis-Chest. 1987 July; 81(3): 287-92 0007-0971
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Syndrome of acute dyspnea related to combined mitomycin plus vinca alkaloid chemotherapy. Author(s): Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. Source: Rivera, M P Kris, M G Gralla, R J White, D A Am-J-Clin-Oncol. 1995 June; 18(3): 245-50 0277-3732
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Treatment of acute wheezing and dyspnea attacks in children under 2 years old: inhalation of fenoterol plus ipratropium bromide versus fenoterol. Author(s): Department of Pediatrics, Escola Paulista de Medicina, Sao Paulo, Brazil. Source: Naspitz, C K Sole, D J-Asthma. 1992; 29(4): 253-8 0277-0903
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Treatment of cough and dyspnea due to acute bronchitis by plaster for cough and dyspnea--a report of 735 cases. Author(s): Zhongxiang Municipal Hospital of Traditional Chinese Medicine, Zhongxiang City 431900, Hubei Province. Source: Chen, Z Zhou, W Gao, J Sun, J J-Tradit-Chin-Med. 2002 March; 22(1): 5-8 02546272
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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WebMDHealth: 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 dyspnea; 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: •
Minerals Magnesium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html
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CHAPTER 3. ALTERNATIVE MEDICINE AND DYSPNEA Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to dyspnea. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to dyspnea 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 “dyspnea” (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 dyspnea: •
A focus group for caregivers of hospice patients with severe dyspnea. Author(s): Moody LE, Webb M, Cheung R, Lowell J. Source: Am J Hosp Palliat Care. 2004 March-April; 21(2): 121-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15055512
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Acute dyspnea as perceived by patients with chronic obstructive pulmonary disease. Author(s): Heinzer MM, Bish C, Detwiler R. Source: Clinical Nursing Research. 2003 February; 12(1): 85-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12583501
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Behavioral interventions for lung cancer-related breathlessness. Author(s): Gallo-Silver L, Pollack B.
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Source: Cancer Practice. 2000 November-December; 8(6): 268-73. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11898143 •
Breathlessness clinics within specialist palliative care settings can improve the quality of life and functional capacity of patients with lung cancer. Author(s): Hately J, Laurence V, Scott A, Baker R, Thomas P. Source: Palliative Medicine. 2003 July; 17(5): 410-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12882259
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Cancer nursing practice development: understanding breathlessness. Author(s): Krishnasamy M, Corner J, Bredin M, Plant H, Bailey C. Source: Journal of Clinical Nursing. 2001 January; 10(1): 103-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11820227
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Chest pain and breathlessness after acupuncture--again. Author(s): Jones KS. Source: The Medical Journal of Australia. 1998 September 21; 169(6): 344. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9785544
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Chest pain and breathlessness after acupuncture--again. Author(s): Fulde GW. Source: The Medical Journal of Australia. 1998 July 6; 169(1): 64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9695712
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Chronic dyspnea. Controlling a perplexing symptom. Author(s): Ambrose MS. Source: Nursing. 1998 May; 28(5): 41-6; Quiz 46-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9616592
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Comparison of clinical dyspnea ratings and psychophysical measurements of respiratory sensation in obstructive airway disease. Author(s): Mahler DA, Rosiello RA, Harver A, Lentine T, McGovern JF, Daubenspeck JA. Source: Am Rev Respir Dis. 1987 June; 135(6): 1229-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3592398
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Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life. A systematic review. Author(s): Pan CX, Morrison RS, Ness J, Fugh-Berman A, Leipzig RM. Source: Journal of Pain and Symptom Management. 2000 November; 20(5): 374-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11068159
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Dyspnea assessment and management in hospice patients with pulmonary disorders. Author(s): Webb M, Moody LE, Mason LA. Source: Am J Hosp Palliat Care. 2000 July-August; 17(4): 259-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11883802
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Dyspnea following vinblastine or vindesine administration in patients receiving mitomycin plus vinca alkaloid combination therapy. Author(s): Kris MG, Pablo D, Gralla RJ, Burke MT, Prestifilippo J, Lewin D. Source: Cancer Treat Rep. 1984 July-August; 68(7-8): 1029-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6744336
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Dyspnea in advanced cancer. Author(s): Maxwell MB. Source: The American Journal of Nursing. 1985 June; 85(6): 672-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3847255
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Dyspnea in advanced cancer. Putting the patient in control. Author(s): Cunningham CA. Source: The American Journal of Nursing. 1985 June; 85(6): 676-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3847256
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Dyspnea in the patient with chronic obstructive pulmonary disease. Etiology and management. Author(s): Sweer L, Zwillich CW. Source: Clinics in Chest Medicine. 1990 September; 11(3): 417-45. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1976053
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Dyspnea in the weaning patient: assessment and intervention. Author(s): Carrieri-Kohlman V. Source: Aacn Clin Issues Crit Care Nurs. 1991 August; 2(3): 462-73. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1873121
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Dyspnea ratings for prescription of cross-modal exercise in patients with COPD. Author(s): Horowitz MB, Mahler DA. Source: Chest. 1998 January; 113(1): 60-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9440569
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Dyspnea self-management in African Americans with chronic lung disease. Author(s): Nield M. Source: Heart & Lung : the Journal of Critical Care. 2000 January-February; 29(1): 50-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10636957
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Dyspnea treatment. Author(s): Manning HL. Source: Respiratory Care. 2000 November; 45(11): 1342-50; Discussion 1350-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11063522
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Effect of progressive relaxation on dyspnea and state anxiety in patients with chronic obstructive pulmonary disease. Author(s): Renfroe KL. Source: Heart & Lung : the Journal of Critical Care. 1988 July; 17(4): 408-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3292465
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Evaluating the effects of music on dyspnea during exercise in individuals with chronic obstructive pulmonary disease: a pilot study. Author(s): Brooks D, Sidani S, Graydon J, McBride S, Hall L, Weinacht K. Source: Rehabilitation Nursing : the Official Journal of the Association of Rehabilitation Nurses. 2003 November-December; 28(6): 192-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14649167
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Evaluation of dyspnea in the elderly patient. Author(s): Silvestri GA, Mahler DA. Source: Clinics in Chest Medicine. 1993 September; 14(3): 393-404. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8222558
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How you and your patient can manage dyspnea. Author(s): Rifas EM. Source: Nursing. 1980 June; 10(6): 34-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6991985
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Influence of gender and inspiratory muscle training on the perception of dyspnea in patients with asthma. Author(s): Weiner P, Magadle R, Massarwa F, Beckerman M, Berar-Yanay N. Source: Chest. 2002 July; 122(1): 197-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12114358
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Inspiratory muscle training in patients with COPD: effect on dyspnea, exercise performance, and quality of life. Author(s): Sanchez Riera H, Montemayor Rubio T, Ortega Ruiz F, Cejudo Ramos P, Del Castillo Otero D, Elias Hernandez T, Castillo Gomez J. Source: Chest. 2001 September; 120(3): 748-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11555505
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Medically unexplained dyspnea: psychophysiological characteristics and role of breathing therapy.
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Author(s): Han JN, Zhu YJ, Li SW, Luo DM, Hu Z, Van Diest I, De Peuter S, Van de Woestijne KP, Van den Bergh O. Source: Chinese Medical Journal. 2004 January; 117(1): 6-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14733765 •
Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer. Author(s): Bredin M, Corner J, Krishnasamy M, Plant H, Bailey C, A'Hern R. Source: Bmj (Clinical Research Ed.). 1999 April 3; 318(7188): 901-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10102851
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Non-pharmacological treatment of breathlessness. Author(s): Cox C. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2002 February 27; 16(24): 33-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11917513
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Psychophysics--an approach to the study of respiratory sensation and the assessment of dyspnea. Author(s): Altose MD. Source: Am Rev Respir Dis. 1987 June; 135(6): 1227-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3592397
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Psychophysiologic aspects of dyspnea in chronic obstructive pulmonary disease: a pilot study. Author(s): Gift AG, Cahill CA. Source: Heart & Lung : the Journal of Critical Care. 1990 May; 19(3): 252-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2341263
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Pulmonary function in panic disorder: evidence against the dyspnea-fear theory. Author(s): Spinhoven P, Onstein EJ, Sterk PJ. Source: Behaviour Research and Therapy. 1995 May; 33(4): 457-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7755534
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Relaxation to reduce dyspnea and anxiety in COPD patients. Author(s): Gift AG, Moore T, Soeken K. Source: Nursing Research. 1992 July-August; 41(4): 242-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1408866
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Relieving dyspnea with an inexpensive and simple method in patients with severe chronic airflow limitation. Author(s): Falk P, Eriksen AM, Kolliker K, Andersen JB.
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Source: Eur J Respir Dis. 1985 March; 66(3): 181-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3979485 •
Research into practice: the reality of implementing a non-pharmacological breathlessness intervention into clinical practice. Author(s): Johnson M, Moore S. Source: European Journal of Oncology Nursing : the Official Journal of European Oncology Nursing Society. 2003 March; 7(1): 33-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12849573
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Respiratory muscle endurance training in chronic obstructive pulmonary disease: impact on exercise capacity, dyspnea, and quality of life. Author(s): Scherer TA, Spengler CM, Owassapian D, Imhof E, Boutellier U. Source: American Journal of Respiratory and Critical Care Medicine. 2000 November; 162(5): 1709-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11069801
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Selective low-level leg muscle training alleviates dyspnea in patients with heart failure. Author(s): Beniaminovitz A, Lang CC, LaManca J, Mancini DM. Source: Journal of the American College of Cardiology. 2002 November 6; 40(9): 1602-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12427412
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Self-hypnosis for management of chronic dyspnea in pediatric patients. Author(s): Anbar RD. Source: Pediatrics. 2001 February; 107(2): E21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11158495
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Specific respiratory warm-up improves rowing performance and exertional dyspnea. Author(s): Volianitis S, McConnell AK, Koutedakis Y, Jones DA. Source: Medicine and Science in Sports and Exercise. 2001 July; 33(7): 1189-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11445767
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Sudden dyspnea occurring 24 hours after mitomycin plus etoposide combination therapy. Author(s): Rowinsky EK, Harwood KV, Ettinger DS. Source: Cancer Treat Rep. 1987 January; 71(1): 103-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3791264
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Targeted inspiratory muscle training improves respiratory muscle function and reduces dyspnea in patients with chronic obstructive pulmonary disease. Author(s): Harver A, Mahler DA, Daubenspeck JA.
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Source: Annals of Internal Medicine. 1989 July 15; 111(2): 117-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2742247 •
The effect of an educational support program on dyspnea and the emotional status of COPD clients. Author(s): Hunter SM, Hall SS. Source: Rehabilitation Nursing : the Official Journal of the Association of Rehabilitation Nurses. 1989 July-August; 14(4): 200-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2748985
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The effect of specific inspiratory muscle training on the sensation of dyspnea and exercise tolerance in patients with congestive heart failure. Author(s): Weiner P, Waizman J, Magadle R, Berar-Yanay N, Pelled B. Source: Clin Cardiol. 1999 November; 22(11): 727-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10554688
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The management of breathlessness in palliative care. Author(s): Andrewes T. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2002 October 16-22; 17(5): 43-52; Quiz 54-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12430497
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The relationship among inspiratory muscle strength, the perception of dyspnea and inhaled beta2-agonist use in patients with asthma. Author(s): Weiner P, Magadle R, Beckerman M, Berar-Yanay N. Source: Can Respir J. 2002 September-October; 9(5): 307-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12410322
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The therapeutic use of music for dyspnea and anxiety in patients with COPD who live at home. Author(s): McBride S, Graydon J, Sidani S, Hall L. Source: Journal of Holistic Nursing : Official Journal of the American Holistic Nurses' Association. 1999 September; 17(3): 229-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10690067
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Therapies for dyspnea relief. Author(s): Gift AG. Source: Holistic Nursing Practice. 1993 January; 7(2): 57-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8429070
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Tolerance of chronic dyspnea using a hypnoeducational approach: a case report. Author(s): Acosta-Austan F.
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Source: Am J Clin Hypn. 1991 April; 33(4): 272-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2024620 •
Treating dyspnea in a patient with advanced chronic obstructive pulmonary disease. Author(s): Runo JR, Ely EW. Source: The Western Journal of Medicine. 2001 September; 175(3): 197-201. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11527853
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Treatment of cough and dyspnea due to acute bronchitis by plaster for cough and dyspnea--a report of 735 cases. Author(s): Chen Z, Zhou W, Gao J, Sun J. Source: J Tradit Chin Med. 2002 March; 22(1): 5-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11977523
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Use of self-efficacy and dyspnea perceptions to predict functional performance in people with COPD. Author(s): Siela D. Source: Rehabilitation Nursing : the Official Journal of the Association of Rehabilitation Nurses. 2003 November-December; 28(6): 197-204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14649168
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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WebMDHealth: 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/
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The following is a specific Web list relating to dyspnea; 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 Allergies and Sensitivities Source: Healthnotes, Inc.; www.healthnotes.com Anaphylaxis Source: Integrative Medicine Communications; www.drkoop.com Anemia Source: Integrative Medicine Communications; www.drkoop.com Anxiety Source: Healthnotes, Inc.; www.healthnotes.com Anxiety Source: Integrative Medicine Communications; www.drkoop.com Asthma Source: Healthnotes, Inc.; www.healthnotes.com Asthma Source: Integrative Medicine Communications; www.drkoop.com Bone Marrow Disorders Source: Integrative Medicine Communications; www.drkoop.com Bronchitis Source: Integrative Medicine Communications; www.drkoop.com Cardiomyopathy Source: Healthnotes, Inc.; www.healthnotes.com Chronic Myelogenous Leukemia Source: Integrative Medicine Communications; www.drkoop.com Chronic Obstructive Pulmonary Disease Source: Healthnotes, Inc.; www.healthnotes.com Chronic Obstructive Pulmonary Disease Source: Integrative Medicine Communications; www.drkoop.com
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Colorectal Cancer Source: Integrative Medicine Communications; www.drkoop.com Congestive Heart Failure Source: Healthnotes, Inc.; www.healthnotes.com Congestive Heart Failure Source: Integrative Medicine Communications; www.drkoop.com Congestive Heart Failure Source: Prima Communications, Inc.www.personalhealthzone.com Edema Source: Integrative Medicine Communications; www.drkoop.com Emphysema Source: Integrative Medicine Communications; www.drkoop.com Endocarditis Source: Integrative Medicine Communications; www.drkoop.com Epilepsy Source: Integrative Medicine Communications; www.drkoop.com Epstein-Barr Virus Source: Integrative Medicine Communications; www.drkoop.com Flu Source: Integrative Medicine Communications; www.drkoop.com Food Poisoning Source: Integrative Medicine Communications; www.drkoop.com Heart Attack Source: Healthnotes, Inc.; www.healthnotes.com Heart Attack Source: Integrative Medicine Communications; www.drkoop.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com Histoplasmosis Source: Integrative Medicine Communications; www.drkoop.com HIV and AIDS Source: Integrative Medicine Communications; www.drkoop.com Hyperkalemia Source: Integrative Medicine Communications; www.drkoop.com
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Hypertension Source: Integrative Medicine Communications; www.drkoop.com Influenza Source: Integrative Medicine Communications; www.drkoop.com Insect Bites and Stings Source: Integrative Medicine Communications; www.drkoop.com Insomnia Source: Integrative Medicine Communications; www.drkoop.com Leukemia Source: Integrative Medicine Communications; www.drkoop.com Lung Cancer Source: Healthnotes, Inc.; www.healthnotes.com Lung Cancer Source: Integrative Medicine Communications; www.drkoop.com Lyme Disease Source: Integrative Medicine Communications; www.drkoop.com Mitral Valve Prolapse Source: Healthnotes, Inc.; www.healthnotes.com Mononucleosis Source: Integrative Medicine Communications; www.drkoop.com Myelofibrosis Source: Integrative Medicine Communications; www.drkoop.com Myeloproliferative Disorders Source: Integrative Medicine Communications; www.drkoop.com Myocardial Infarction Source: Integrative Medicine Communications; www.drkoop.com Pericarditis Source: Integrative Medicine Communications; www.drkoop.com Peritonitis Source: Integrative Medicine Communications; www.drkoop.com Pharyngitis Source: Integrative Medicine Communications; www.drkoop.com Polycythemia Vera Source: Integrative Medicine Communications; www.drkoop.com
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Post Traumatic Stress Disorder Source: Integrative Medicine Communications; www.drkoop.com PTSD Source: Integrative Medicine Communications; www.drkoop.com Pulmonary Edema Source: Integrative Medicine Communications; www.drkoop.com Pulmonary Hypertension Source: Integrative Medicine Communications; www.drkoop.com Sarcoidosis Source: Integrative Medicine Communications; www.drkoop.com Scleroderma Source: Integrative Medicine Communications; www.drkoop.com Seizure Disorders Source: Integrative Medicine Communications; www.drkoop.com Sickle Cell Anemia Source: Healthnotes, Inc.; www.healthnotes.com Sleep Apnea Source: Integrative Medicine Communications; www.drkoop.com Sleeplessness Source: Integrative Medicine Communications; www.drkoop.com Sore Throat Source: Integrative Medicine Communications; www.drkoop.com Stress Source: Integrative Medicine Communications; www.drkoop.com Thrombocytosis Source: Integrative Medicine Communications; www.drkoop.com Tuberculosis Source: Integrative Medicine Communications; www.drkoop.com Water Retention Source: Integrative Medicine Communications; www.drkoop.com •
Alternative Therapy Macrobiotics Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,714,00.html
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Meditation Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,717,00.html Rosen Method Alternative names: Rosen Method bodywork Rosen Method psychospiritual bodywork Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/r.html Tai Chi Source: Integrative Medicine Communications; www.drkoop.com •
Chinese Medicine Baiqian Alternative names: Willowleaf Swallowwort Rhizome; Rhizome Cynanchi Stauntonii Source: Chinese Materia Medica Baolong Wan Alternative names: Baolong Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Bawei Qingxin Chenxiang San Alternative names: Bawei Qingxin Chenxiang Powder Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Cishi Alternative names: Magnetite; Magnetitum Source: Chinese Materia Medica Daii Alternative names: Japanese Thistle Herb; Herba Cirsii Japonici Source: Chinese Materia Medica Dangshen Alternative names: Medicinal Changium Root; Mingdangshen; Radix Changii Source: Chinese Materia Medica Fuzi Alternative names: Beivedere Fruit; Difuzi; Fructus Kochiae Source: Chinese Materia Medica Gancao Alternative names: Liquorice Root; Radix Glycyrrhizae Source: Chinese Materia Medica
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Ganjiang Alternative names: ingiber (Dried Ginger); Rhizoma Zingiberi Source: Chinese Materia Medica Gansui Alternative names: Gansui Root; Radix Kansui Source: Chinese Materia Medica Gejie Alternative names: Tokay Gecko; Gecko Source: Chinese Materia Medica Guangzao Alternative names: Axillary Chocrospondias Fruit; Fructus Choerospondiatis Source: Chinese Materia Medica Haima Alternative names: Sea-horse; Hippocampus Source: Chinese Materia Medica Heshi Alternative names: Wild Carrot Fruit; Nanheshi; Fructus Carotae Source: Chinese Materia Medica Houpo Alternative names: Officinal Magnolia Bark; Cortex Magnoliae Officinalis Source: Chinese Materia Medica Hupo Baolong Wan Alternative names: Hupo Baolong Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Jiezi Alternative names: Mustard Seed; Semen Sinapis Source: Chinese Materia Medica Jinfeicao Alternative names: Inula Herb; Herba Inulae Source: Chinese Materia Medica Jingdaii Alternative names: Peking Euphorbia Root; Radix Euphorbiae Pekinensis Source: Chinese Materia Medica Jinmengshi Alternative names: Mica-schist; Lapis Micas Aureus Source: Chinese Materia Medica
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Jisheng Shenqi Wan Alternative names: Jisheng Shenqi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Kuandonghua Alternative names: Common Coltsfoot Flower; Flos Farfarae Source: Chinese Materia Medica Laifuzi Alternative names: Radish Seed; Semen Raphani Source: Chinese Materia Medica Mengshi Guntan Wan Alternative names: Mengshi Guntan Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Pipaye Alternative names: Loquat Leaf; Folium Eriobotryae Source: Chinese Materia Medica Qianhu Alternative names: Hogfennel Root; Radix Peucedani Source: Chinese Materia Medica Qianniuzi Alternative names: Pharbitis Seed; Semen Pharbitidis Source: Chinese Materia Medica Qingmengshi Alternative names: Chlorite Schist; Lapis Chloriti Source: Chinese Materia Medica Qiwei Duqi Wan Alternative names: Qiwei Duqi Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Qiwei Guangzao Wan Alternative names: Qiwei Guangzao Pills Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Qiwei Putao San Alternative names: Qiwei Putao Powder Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Renshen Alternative names: inseng Leaf; Renshenye (Ren Shen Ye); Folium Ginsen Source: Chinese Materia Medica
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Rougui Alternative names: Cassia Bark; Cortex Cinnamomi Source: Chinese Materia Medica Shanyao Alternative names: Common Yam Rhizome; Rhizoma Dioscoreae Source: Chinese Materia Medica Shegan Alternative names: Blackberrylily Rhizome; Rhizoma Belamcandae Source: Chinese Materia Medica Shengmai Yin Alternative names: hengmai Yin Oral Liquid; Shengmai Yin (Sheng Mai Yin Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shenling Baizhu San Alternative names: henling Baizhu Powder; Shenling Baizhu San (Shen Ling Bai Zhu San Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shiquan Dabu Wan Alternative names: hiquan Dabu Pills; Shiquan Dabu Wan (Shi Qu An Da Bu Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Shiwuwei Chenxiang Wan Alternative names: hiwuwei Chenxiang Pills; Shiwuwei Chenxiang Wan (Shi Wu Wei Chen Xiang Wan Source: Pharmacopoeia Commission of the Ministry of Health, People's Republic of China Tinglizi Alternative names: Pepperweed Seed; Semen Lepidii Source: Chinese Materia Medica Wuweizi Alternative names: Chinese Magnoliavine Fruit; Fructus Schisandrae Source: Chinese Materia Medica Wuyao Alternative names: Combined Spicebush Root; Radix Linderae Source: Chinese Materia Medica Xiangjiapi Alternative names: Chinese Silkvine Root-bark; Cortex Periplocae Source: Chinese Materia Medica
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Xiebai Alternative names: ongstamen Onion Bulb; Xiebai (Xie Bai); Bulbus Aiiii Macrostem Source: Chinese Materia Medica Xixin Alternative names: Manchurian Wildginger; Herba Asari Source: Chinese Materia Medica Xuanfuhua Alternative names: Inula Flower; Flos Inulae Source: Chinese Materia Medica Yuxingcao Alternative names: Heartleaf Houttuynia Herb; Herba Houttuyniae Source: Chinese Materia Medica Zhuyazao Alternative names: Chinese Honeylocust Abnormal Fruit; Fructus Gleditsiae Abnormalis Source: Chinese Materia Medica Zisuzi Alternative names: Perilia Fruit; Fructus Perillae Source: Chinese Materia Medica •
Herbs and Supplements Adenosine Monophosphate (amp) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10106,00.html Aminoglycosides Source: Integrative Medicine Communications; www.drkoop.com Aristolochia Alternative names: Snakeroot, Guaco; Aristolochia sp Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Arnica Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,753,00.html Astragalus Alternative names: Astragalus membranaceus, Astragalus membranaceus var. mongholicus, Huang-qi, Milk-Vetch Root Source: Integrative Medicine Communications; www.drkoop.com Astragalus Membranaceus Source: Integrative Medicine Communications; www.drkoop.com
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Astragalus Mongholicus Alternative names: Astragalus membranaceus, Astragalus membranaceus var. mongholicus, Huang-qi, Milk-Vetch Root Source: Integrative Medicine Communications; www.drkoop.com Astragalus Sp Alternative names: Vetch, Rattlepod, Locoweed; Astragalus sp. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Bile Acid Sequestrants Source: Integrative Medicine Communications; www.drkoop.com Cactus Grandiflorus Source: The Canadian Internet Directory for Holistic Help, WellNet, Health and Wellness Network; www.wellnet.ca Coenzyme Q Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,768,00.html Coenzyme Q10 (CoQ10) Source: Prima Communications, Inc.www.personalhealthzone.com Crataegus Alternative names: Hawthorn; Crataegus oxyacantha L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Ephedra Source: Healthnotes, Inc.; www.healthnotes.com Epinephrine Source: Healthnotes, Inc.; www.healthnotes.com Glycyrrhiza Alternative names: Licorice; Glycyrrhiza glabra L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Hawthorn Alternative names: Crataegus laevigata, Crataegus oxyacantha, Crataegus monogyna Source: Healthnotes, Inc.; www.healthnotes.com Histamine H2 Antagonists Source: Integrative Medicine Communications; www.drkoop.com Huang-Qi Source: Integrative Medicine Communications; www.drkoop.com Ivy Leaf Alternative names: Hedera helix Source: Healthnotes, Inc.; www.healthnotes.com
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Kava Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,798,00.html Licorice Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,801,00.html Lobelia Alternative names: Lobelia inflata Source: Healthnotes, Inc.; www.healthnotes.com Milk-Vetch Root Source: Integrative Medicine Communications; www.drkoop.com Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Source: Integrative Medicine Communications; www.drkoop.com Salicylates Source: Integrative Medicine Communications; www.drkoop.com Sanguinaria Alternative names: Bloodroot; Sanguinaria canadensis L. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Taurine 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
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON DYSPNEA Overview In this chapter, we will give you a bibliography on recent dissertations relating to dyspnea. 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 “dyspnea” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on dyspnea, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Dyspnea 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 dyspnea. 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: •
Internet-based support for dyspnea self-management in patients with COPD by Nguyen, Huong Que, PhD from University of California, San Francisco, 2003, 181 pages http://wwwlib.umi.com/dissertations/fullcit/3088642
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Mechanisms of dyspnea during lung hyperinflation in chronic obstructive pulmonary disease by Palumbo, Gisella, MSc from Queen's University at Kingston (Canada), 2003, 91 pages http://wwwlib.umi.com/dissertations/fullcit/MQ74919
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. PATENTS ON DYSPNEA Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “dyspnea” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on dyspnea, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Dyspnea By performing a patent search focusing on dyspnea, 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
8Adapted
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 dyspnea: •
Abnormal dyspnea perception detection system and method Inventor(s): Hillsman; Deane (Sacramento, CA) Assignee(s): Sierra Biotechnology Company, LC (McLean, VA) Patent Number: 5,582,182 Date filed: October 3, 1994 Abstract: Apparatus and methods to test respiratory patients for altered dyspnea awareness. The device imposes a defined inspiratory resistive load under controlled breathing conditions and records the patient's subjective sensation of dyspnea over time by incrementally increasing the inspiratory resistive load. In a preferred embodiment, the patient breathes in a controlled manner with visual biofeedback prompting, having predetermined respiratory rate, inspiration to expiration time ratio and inspiration and expiration respiratory waveforms. Excerpt(s): This invention relates to improved methods and apparatus to detect patients with an abnormally altered perception of dyspnea. Of particular concern are asthma patients at risk for fatal asthmatic attacks. An unexpected rising incidence of fatal asthmatic attacks in recent years has been of concern to the medical profession. The sensitivity of the testing procedure is enhanced by the test being performed under controlled conditions by having the patient breathe in a precisely defined manner by visual biofeedback means, with the subject following a predetermined breathing pattern on a computer CRT or similar means. Hillsman incorporates by reference his U.S. Pat. No. 3,991,304 which describes a sophisticated method to prompt patients to desired breathing patterns by visual biofeedback means. Prior art has indicated patients who have survived a near fatal asthma attack have decreased dyspnea awareness to increased inspiratory resistance (See: LOWERED CHEMOSENSITIVITY AND PERCEPTION OF DYSPNEA IN PATIENTS WITH NEAR--FATAL ASTHMA-Kikuchi, Y. et all, Respiratory and Critical Care Medicine, Supplement, Volume 149, Number 4, April 1994). The cited investigators demonstrated decreased dyspnea awareness in near fatal asthma patients by imposing graded inspiratory respiratory resistance from zero to minus 30 cm. water/liter/second gauge pressure. But no attempt was made by these investigators to further control the experimental conditions by defining the testing tidal volume to the patient's available lung volume as reflected in the patient's vital capacity, or the testing inspiratory resistance load to the patient's available maximum inspiratory pressure capability. Further, no attempt was made to otherwise precisely control the patient's breathing pattern or the precise timing of the breathing stages under the testing conditions, or to otherwise detect whether or not the subjects were performing as required under the testing conditions. Therefore, absent comprehensive controlled breathing conditions the testing achieved was relatively crude and therefore less sensitive to defining and detecting dyspnea awareness as measured by the commonly used Borg scale of dyspnea, and likewise there was no assurance as to patient performance and therefore data reliability. Web site: http://www.delphion.com/details?pn=US05582182__
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•
Pulmonary surfactant Inventor(s): Durr; Manfred (Am blouen Stein 1o, 5024 Pulheim-Dansweiler, DE), Harhausen; Ekkehard (Kaulchensweg 32, 5000 Koln 91, DE), Rontgen-Odenthal; Renate (Wasserackerstr. 16, 7800 Freiburg-Littenweiler, DE) Assignee(s): none reported Patent Number: 4,828,844 Date filed: August 4, 1983 Abstract: A pulmonary surfactant for the treatment of dyspnea syndromes, containing dipalmitoyl phosphatidyl choline (DPPC) and dipalmitoyl phosphatidyl glycerol (DPPG) in a ratio of from 9:1 to 8:2 and a sugar, in the form of a redispersable powder, which is obtained by dissolving the phospholipids in glacial acetic acid, adding the sugar, and finally freeze-drying of the mixture. The lyophilisate is redispersed in a suitable buffer solution for application. Excerpt(s): The object of the invention is a new pulmonary surfactant consisting of a mixture of dipalmitoyl phosphatidylcholine, dipalmitoyl phosphatidyl glycerol and a sugar in the form of a lyophilisate, and utilization of the surfactant after redispersion in a buffer solution, for the treatment of dyspnea syndromes. More newborns die yearly of dyspnea syndomes than of any other disease. The cause is an excessive surface tension in the alveoli, which prevents the lungs from independently breathing. This in turn is caused by a deficiency in surfactant factors. This substance normally forms shortly before birth. The surface active substances needed for breathing are phospholipids which are formed in the alveolar cells of type II in the process of phospholipid metabolism. There will be an inadequate quantity of the substances if the child is born prematurely or is a Ceasarian delivery, is born before labor pains have begun, or if the mother is a diabetic. In central Europe the rate of dyspnea syndrome in newborns is between 15 and 20%. To prevent and treat the syndrome, attempts have been made to stimulate phospholipid synthesis with glycocorticoides and bromohexine metabolites. The therapy with glycocorticoids involves a high risk and is therefore applied with much hesitation. Therapy with bromohexine metabolites has been abandoned for various reasons. Web site: http://www.delphion.com/details?pn=US04828844__
•
X-salizer an exerciser for the lungs Inventor(s): Rogacki; Zenon Anthony (North Hollywood, CA) Assignee(s): Rogacki; Zenon A. (North Hollywood, CA) Patent Number: 6,651,654 Date filed: May 17, 2002 Abstract: A mode of providing halotherapy to the lower respiratory tract that includes the step of operating a plastic apparatus and inhaling. The plastic apparatus contains sodium chloride (common table salt) User operates the plastic apparatus to release a dosage of salt-filtered air for inhalation when the apparatus is aimed into the user's mouth by way of corrugated plastic tubing and a plastic breathing regulator located next to a plastic mouthpiece. The user then inhales the dosage of salt-filtered air to target the lower respiratory tract (lungs). This dosage of salt-filtered air supplies a
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concentration adequate to produce potent halotherapy and with continual use, on a daily basis, eliminates dyspnea due to chronic respiratory ailments. Excerpt(s): The present invention enumerates to a technique of inhaling salt air (halotherapy) to a person's lower respiratory tract to provide symptomatic treatment for major ailments to a person's lungs such as bronchial and allergic asthma. More expressly, the present invention is designed to provide a method of exercising and strengthening the lungs of a person with major respiratory ailments. The usage of inhaling salt air (halotherapy) has been practiced for centuries in eastern Europe in such places as Wieliczka Kapahia, the oldest operating salt mine in Europe. The mine has been in operation for over 800 years and has more than 120 miles of passageways and chambers on nine levels to a depth of more than 1,000 feet. It is used as a sanatorium for people who have bronchial and allergic asthma. Patients live on the surface and are lowered into the mine each day for six hours where they breathe soothing salt air. Wieliczka is eight miles southeast of Krakow, Poland. In recent times halotherapy has been noted as a powerful drug-free treatment for patients with chronic respiratory ailments. When a salt mine or cave is not available special rooms are created to simulate the atmosphere of the interior of the salt mines. Nevertheless, monetary restraints limit most patients from availing themselves of the healing salt air of the mines or created rooms. This creates a need for a portable apparatus that provides halotherapy treatment to respiratory patients wherever they might be. Web site: http://www.delphion.com/details?pn=US06651654__
Patent Applications on Dyspnea As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to dyspnea: •
"X-Salizer" An exerciser for the lungs Inventor(s): Rogacki, Zenon Anthony; (North Hollywood, CA) Correspondence: Zenon A. Rogacki; 6755 Rhodes AVE.; APT. 208 Mailbox 76; North Hollywood; CA; 91606; US Patent Application Number: 20020162560 Date filed: May 17, 2002 Abstract: A mode of providing halotherapy to the lower respiratory tract that includes the step of operating a plastic apparatus and inhaling. The plastic apparatus contains sodium chloride (common table salt) User operates the plastic apparatus to release a dosage of salt-filtered air for inhalation when the apparatus is aimed into the user's mouth by way of corrugated plastic tubing and a plastic breathing regulator located next to a plastic mouthpiece. The user then inhales the dosage of salt-filtered air to target the lower respiratory tract (lungs). This dosage of salt-filtered air supplies a concentration adequate to produce potent halotherapy and with continual use, on a daily basis, eliminates dyspnea due to chronic respiratory ailments.
9
This has been a common practice outside the United States prior to December 2000.
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Excerpt(s): The present invention enumerates to a technique of inhaling salt air (halotherapy) to a person's lower respiratory tract to provide symptomatic treatment for major ailments to a person's lungs such as bronchial and allergic asthma. More expressly, the present invention is designed to provide a method of exercising and strengthening the lungs of a person with major respiratory ailments. The usage of inhaling salt air (halotherapy) has been practiced for centuries in eastern Europe in such places as Wieliczka Kapahia, the oldest operating salt mine in Europe. The mine has been in operation for over 800 years and has more than 120 miles of passageways and chambers on nine levels to a depth of more than 1,000 feet. It is used as a sanatorium for people who have bronchial and allergic asthma. Patients live on the surface and are lowered into the mine each day for six hours where they breathe soothing salt air. Wieliczka is eight miles southeast of Krakow, Poland. In recent times halotherapy has been noted as a powerful drug-free treatment for patients with chronic respiratory ailments. When a salt mine or cave is not available special rooms are created to simulate the atmosphere of the interior of the salt mines. Nevertheless, monetary restraints limit most patients from availing themselves of the healing salt air of the mines or created rooms. This creates a need for a portable apparatus that provides halotherapy treatment to respiratory patients wherever they might be. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Dyspnea monitor, and telemedicine system and method Inventor(s): Sarel, Oded; (Even Yehuda, IL) Correspondence: G.E. Ehrlich (1995) LTD.; C/o Anthony Castorina; Suite 207; 2001 Jefferson Davis Highway; Arlington; VA; 22202; US Patent Application Number: 20040068197 Date filed: October 3, 2002 Abstract: Breathing interval measurement apparatus for measuring breathing of a subject, the apparatus comprising: a breathing interval beginning determinator, a breathing interval end determinator, and a timer associated with said breathing interval beginning determinator and said breathing interval end determinator to measure an interval between activation of said determinators, and a processor operable with said timer to assign levels of importance to said measured time interval. Excerpt(s): The present invention relates to a telemedicine system and method and a dyspnea monitor device and method for use therewith. A number of respiratory problems are preceded by detectable reductions in the ability to inhale or hold one's breath. Thus, it is possible to determine from a simple breathing test whether a patient is likely to suffer from such problems in the short term. Such a simple test is described in the literature in which the patient is placed in a rest position, asked to take a deep breath and then to count continuously until he has to take a breath again. An unusually short interval between breaths is indicative of congestion of the lungs or breathing passages. The patient is generally not in the presence of a doctor at the times the test can yield the most helpful information, and indeed, the test is most useful as part of regular and frequent monitoring. 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 dyspnea, 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 “dyspnea” (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 dyspnea. You can also use this procedure to view pending patent applications concerning dyspnea. 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 6. BOOKS ON DYSPNEA Overview This chapter provides bibliographic book references relating to dyspnea. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on dyspnea 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 “dyspnea” (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 dyspnea: •
Clinical Features of the Acquired Immune Deficiency Syndrome Source: AIDS. Contact: American Association of Blood Banks, 8101 Glenbrook Rd, Bethesda, MD, 20814-2749, (301) 907-6977, http://www.aabb.org. Summary: Clinical features of AIDS are described, including epidemiologic features, beginning with those noted in the first published reports in the summer of 1981. The etiologic agent, or retroviruses discovered to be common in populations detected with AIDS are covered, as are the immunologic abnormalities of both T and B lymphocytes, and, more notably the defects in cell-mediated immunity caused by alterations in Tlymphocyte subjects. The broad spectrum of disease caused by infection with the AIDS virus is considered, including asymptomatic infection, acute viral syndrome, the ARC complex, and, finally AIDS. Conduct of physical examinations of AIDS patients and laboratory studies of their blood are considered. A review of the specific disorders
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associated with AIDS, such as fever, dyspnea, lymphadenopathy, diarrhea, perirectal pain, dysphagia, cutaneous lesions, and central nervous system symptoms and visual disturbances is presented. Prognosis and treatment are discussed; 33 references are included.
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 “dyspnea” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “dyspnea” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “dyspnea” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
RXDX Dyspnea Instit License by Hoffer; ISBN: 0683400290; http://www.amazon.com/exec/obidos/ASIN/0683400290/icongroupinterna
The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “dyspnea” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:10 •
Chronic cough or shortness of breath: differential diagnosis: a practical guide for physicians. Author: Aupetit, J. F; Year: 1962
Chapters on Dyspnea In order to find chapters that specifically relate to dyspnea, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and dyspnea using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “dyspnea” (or synonyms)
10
In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.
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into the “For these words:” box. The following is a typical result when searching for book chapters on dyspnea: •
Lungs and Pleura Source: in Daugirdas, J.T. and Ing, T.S., eds. Handbook of Dialysis. 2nd ed. Boston, MA: Little, Brown and Company. 1994. p. 598-603. Contact: Available from Lippincott-Raven Publishers. 12107 Insurance Way, Hagerstown, MD 21740. (800) 777-2295. Fax (301) 824-7390. E-mail:
[email protected]. Website: http://www.lrpub.com. PRICE: $37.95. ISBN: 0316173835. Summary: This chapter on complications affecting the lungs and pleura is from a handbook that outlines all aspects of dialysis therapy, emphasizing the management of dialysis patients. Topics include pulmonary edema, pleural effusion, infection, dyspnea during dialysis, respiratory failure due to hyperkalemia, hypophosphatemia, or glucose load, dosages of pulmonary drugs in dialysis patients, and sleep apnea syndrome in dialysis patients. The author presents information in outline form, for easy reference. 17 references.
•
Small Bowel Source: in Gelb, A.M., ed. Clinical Gastroenterology in the Elderly. New York, NY: Marcel Dekker, Inc. 1996. p. 73-83. Contact: Available from Marcel Dekker, Inc. Cimarron Road, P.O. Box 5005, Monticello, NY 12701-5185. (800) 228-1160 or (914) 796-1919. Fax (914) 796-1772. E-mail:
[email protected]. Website: www.dekker.com. PRICE: $135.00 plus shipping and handling. ISBN: 0824793986. Summary: This chapter on the small bowel is from a textbook that offers an up to date reference source on geriatric gastroenterology. The author notes that, aside from vascular and motility disorders (which are discussed in separate chapters), there are no small bowel conditions unique to older people. Therefore, the author addresses small intestinal dysfunction in this population from the viewpoint of patient complaints. Some symptoms focus immediately on the gastrointestinal tract as a potential etiology. These include bloating, nausea, emesis, alterations in the pattern of defecation and in stool volume and consistency, fecal incontinence, and abdominal pain. Other signs and symptoms of small bowel origin are more subtle, such as weight loss, dyspnea on exertion, edema, ecchymoses, cheilosis, glossitis, bone pain, arthritis, arthralgias, fatigue, and muscular weakness. Finally, abnormalities found on blood testing, such as microcytic and megaloblastic anemias, and hypocalcemia may also be caused by disorders affecting the small intestine. Topics include absorption, malabsorption syndrome, bacterial overgrowth and its effects, tests and treatment for bacterial overgrowth, celiac sprue, and NSAIDs and the small bowel. 29 references.
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CHAPTER 7. PERIODICALS AND NEWS ON DYSPNEA Overview In this chapter, we suggest a number of news sources and present various periodicals that cover dyspnea.
News Services and Press Releases One of the simplest ways of tracking press releases on dyspnea 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 “dyspnea” (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 dyspnea. 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 “dyspnea” (or synonyms). The following was recently listed in this archive for dyspnea: •
Inhaled furosemide reduces dyspnea in COPD Source: Reuters Industry Breifing Date: May 07, 2004
•
Chest wall hyperinflation contributes significantly to dyspnea in asthma Source: Reuters Medical News Date: January 02, 2004
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•
Low-level leg exercise improves dyspnea in patients with severe CHF Source: Reuters Medical News Date: November 05, 2002
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Reduced sensitivity to dyspnea may predispose to severe asthma attacks Source: Reuters Medical News Date: February 19, 2002
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Nebulized furosemide relieves dyspnea in patients with terminal cancer Source: Reuters Industry Breifing Date: February 18, 2002
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Steroid injection does not cut dyspnea in acute asthma Source: Reuters Medical News Date: January 09, 2001
•
Bronchoconstriction and respiratory effort prompt differing dyspnea perception Source: Reuters Medical News Date: September 12, 2000 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 “dyspnea” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or
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you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “dyspnea” (or synonyms). If you know the name of a company that is relevant to dyspnea, 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 “dyspnea” (or synonyms).
Academic Periodicals covering Dyspnea Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to dyspnea. In addition to these sources, you can search for articles covering dyspnea that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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CHAPTER 8. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.
U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for dyspnea. 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 dyspnea. 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 dyspnea: Bronchodilators, Adrenergic •
Oral/Injection - U.S. Brands: Adrenalin; Alupent; Ana-Guard; Brethine; Bricanyl; EpiPen Auto-Injector; EpiPen Jr. Auto-Injector; Isuprel; Proventil; Proventil Repetabs; Ventolin; Volmax http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202096.html
Bronchodilators, Theophylline •
Systemic - U.S. Brands: Aerolate Sr; Asmalix; Choledyl; Choledyl SA; Elixophyllin; Lanophyllin; Phyllocontin; Quibron-T Dividose; Quibron-T/SR Dividose; Respbid; Slo-Bid Gyrocaps; Slo-Phyllin; Theo-24; Theobid Duracaps; Theochron; Theo-Dur; Theolair; Theolair-SR; Theo-Time; Theovent Long-Acting; Theo-X; T-Phyl; Truphylline; Truxophyllin; Uni-Dur; Uniphyl http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/201945.html
Dornase Alfa •
Inhalation - U.S. Brands: Pulmozyme http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202710.html
Enfuvirtide •
Systemic - U.S. Brands: Fuzeon http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500467.html
Ipratropium •
Inhalation - U.S. Brands: Atrovent http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202304.html
Ipratropium and Albuterol •
Inhalation-Local - U.S. Brands: Combivent; DuoNeb http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203487.html
Iron Supplements •
Systemic - U.S. Brands: DexFerrum; Femiron; Feosol Caplets; Feosol Tablets; Feostat; Feostat Drops; Feratab; Fer-gen-sol; Fergon; Fer-In-Sol Drops; Fer-In-Sol Syrup; Fer-Iron Drops; Fero-Gradumet; Ferospace; Ferralet; Ferralet Slow Release; Ferralyn Lanacaps; Ferra-TD; Ferretts; Ferrlecit; Fumasorb; Fumerin; Hemocyte; Hytinic; InFeD; Ircon; Mol-Iron; Nephro-Fer; Niferex; Niferex-150; Nu-Iron; Nu-Iron 150; Simron; Slow Fe; Span-FF; Venofer http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202305.html
Isoxsuprine •
Systemic - U.S. Brands: Vasodilan http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202310.html
Levalbuterol •
Inhalation-Local - U.S. Brands: Xopenex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/203784.html
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Oxtriphylline and Guaifenesin •
Systemic - U.S. Brands: Brondelate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202430.html
Theophylline and Guaifenesin •
Systemic - U.S. Brands: Bronchial; Broncomar GG; Ed-Bron G; Elixophyllin-GG; Equibron G; Glyceryl-T; Quibron; Quibron-300; Slo-Phyllin GG; Theocon; Theolate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202557.html
Theophylline, Ephedrine, and Hydroxyzine •
Systemic - U.S. Brands: Marax; Marax-DF http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202555.html
Thiamine (Vitamin B 1) •
Vitamin B 1 - U.S. Brands: Biamine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202560.html
Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.
Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.
PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee.
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If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.
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APPENDICES
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute11: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
11
These publications are typically written by one or more of the various NIH Institutes.
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•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
•
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.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
12
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.
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•
Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “dyspnea” (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 22406 93 873 184 1708 25264
HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “dyspnea” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
14
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
15
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
19 Adapted 20
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on dyspnea 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 dyspnea. 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 dyspnea. 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 “dyspnea”:
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Asthma http://www.nlm.nih.gov/medlineplus/asthma.html Asthma in Children http://www.nlm.nih.gov/medlineplus/asthmainchildren.html Breathing Problems http://www.nlm.nih.gov/medlineplus/breathingproblems.html Children's Health http://www.nlm.nih.gov/medlineplus/childrenshealth.html Death and Dying http://www.nlm.nih.gov/medlineplus/deathanddying.html Diphtheria http://www.nlm.nih.gov/medlineplus/diphtheria.html Heart Failure http://www.nlm.nih.gov/medlineplus/heartfailure.html Infant and Toddler Health http://www.nlm.nih.gov/medlineplus/infantandtoddlerhealth.html Lung Cancer http://www.nlm.nih.gov/medlineplus/lungcancer.html Premature Babies http://www.nlm.nih.gov/medlineplus/prematurebabies.html Pulmonary Fibrosis http://www.nlm.nih.gov/medlineplus/pulmonaryfibrosis.html Respiratory Diseases http://www.nlm.nih.gov/medlineplus/respiratorydiseases.html Sleep Apnea http://www.nlm.nih.gov/medlineplus/sleepapnea.html Sleep Disorders http://www.nlm.nih.gov/medlineplus/sleepdisorders.html
Within the health topic page dedicated to dyspnea, the following was listed: •
Diagnosis/Symptoms Blood Gas Tests Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/blood_gases/test.html Shortness of Breath Source: American Academy of Family Physicians http://familydoctor.org/521.xml Shortness of Breath in a Child or Infant Source: American Academy of Family Physicians http://familydoctor.org/522.xml
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Spirometry Source: National Lung Health Education Program http://www.nlhep.org/spirom1.html •
Children Helping Your Child Breathe Easier Source: American Association for Respiratory Care http://www.aarc.org/patient_education/tips/kids.html
•
From the National Institutes of Health Living with Dyspnea -- 4 Ways to Breathe Easier Source: National Institutes of Health, Clinical Center http://www.cc.nih.gov/ccc/patient_education/pepubs/dyspnea.pdf
•
Organizations American Lung Association http://www.lungusa.org/ National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/
•
Pictures/Diagrams How the Body Works: The Respiratory System Source: Nemours Foundation http://www.kidshealth.org/kid/closet/how_the_body_works_interim.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 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 dyspnea. 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.
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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMDHealth: 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 dyspnea. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with dyspnea. 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 dyspnea. 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 “dyspnea” (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
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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 “dyspnea”. 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 “dyspnea” (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 “dyspnea” (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.22
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
22
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)23: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
23
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
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
•
Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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DYSPNEA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abscess: A localized, circumscribed collection of pus. [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] Action Potentials: The electric response of a nerve or muscle to its stimulation. [NIH] Acupuncture Points: Designated locations along nerves or organ meridians for inserting acupuncture needles. [NIH] Acute leukemia: A rapidly progressing cancer of the blood-forming tissue (bone marrow). [NIH]
Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adenine: A purine base and a fundamental unit of adenine nucleotides. [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] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [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
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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] 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] Air Embolism: Occurs when the lungs over expand to the point that air bubbles are forced through the air sacs of the lungs into the circulatory system. [NIH] Air Sacs: Thin-walled sacs or spaces which function as a part of the respiratory system in birds, fishes, insects, and mammals. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Airway Obstruction: Any hindrance to the passage of air into and out of the lungs. [NIH] Airway Resistance: Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow. [NIH] Albuterol: A racemic mixture with a 1:1 ratio of the r-isomer, levalbuterol, and s-albuterol. It is a short-acting beta 2-adrenergic agonist with its main clinical use in asthma. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Alveolitis: Inflammation of an alveolus. Called also odontobothritis. [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 (-
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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] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaemia: A reduction below normal in the number of erythrocytes per cu. mm., in the quantity of haemoglobin, or in the volume of packed red cells per 100 ml. of blood which occurs when the equilibrium between blood loss (through bleeding or destruction) and blood production is disturbed. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]
Anaplastic: A term used to describe cancer cells that divide rapidly and bear little or no resemblance to normal cells. [NIH] Anaplastic large cell lymphoma: A rare agressive form of lymphoma (cancer that begins in cells of the lymphatic system) that is usually of T-cell origin. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another
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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] Antiallergic: Counteracting allergy or allergic conditions. [EU] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antiproliferative: Counteracting a process of proliferation. [EU] 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] Aorta: The main trunk of the systemic arteries. [NIH] Apnea: A transient absence of spontaneous respiration. [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] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU]
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Arteries: The vessels carrying blood away from the heart. [NIH] Arteriosus: Circle composed of anastomosing arteries derived from two long posterior ciliary and seven anterior ciliary arteries, located in the ciliary body about the root of the iris. [NIH]
Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrial Function: The hemodynamic and electrophysiological action of the atria. [NIH] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrioventricular Node: A small nodular mass of specialized muscle fibers located in the interatrial septum near the opening of the coronary sinus. It gives rise to the atrioventricular bundle of the conduction system of the heart. [NIH] 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] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Auscultation: Act of listening for sounds within the body. [NIH] Autosuggestion: Suggestion coming from the subject himself. [NIH] Bacillus: A genus of Bacillaceae that are spore-forming, rod-shaped cells. Most species are saprophytic soil forms with only a few species being pathogenic. [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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Bacteriuria: The presence of bacteria in the urine with or without consequent urinary tract infection. Since bacteriuria is a clinical entity, the term does not preclude the use of urine/microbiology for technical discussions on the isolation and segregation of bacteria in the urine. [NIH] 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
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donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its subdivisions is the basal (basement) lamina. [NIH] 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] 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] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biphasic: Having two phases; having both a sporophytic and a gametophytic phase in the life cycle. [EU] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [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
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mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachytherapy: A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] 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] Bronchioles: The tiny branches of air tubes in the lungs. [NIH] Bronchiolitis: Inflammation of the bronchioles. [NIH] Bronchiolitis Obliterans: Inflammation of the bronchioles with obstruction by fibrous granulation tissue or bronchial exudate. It may follow inhalation of irritating gases or foreign bodies and it complicates pneumonia. [NIH] Bronchiolitis Obliterans Organizing Pneumonia: Inflammation of the bronchioles. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bronchoalveolar Lavage: Washing out of the lungs with saline or mucolytic agents for diagnostic or therapeutic purposes. It is very useful in the diagnosis of diffuse pulmonary infiltrates in immunosuppressed patients. [NIH] Bronchoconstriction: Diminution of the caliber of a bronchus physiologically or as a result of pharmacological intervention. [NIH] Bronchodilator: A drug that relaxes the smooth muscles in the constricted airway. [NIH] Bronchopulmonary: Pertaining to the lungs and their air passages; both bronchial and pulmonary. [EU] Bronchospasm: Spasmodic contraction of the smooth muscle of the bronchi, as occurs in asthma. [EU] Bronchus: A large air passage that leads from the trachea (windpipe) to the lung. [NIH] Budesonide: A glucocorticoid used in the management of asthma, the treatment of various skin disorders, and allergic rhinitis. [NIH] Bupivacaine: A widely used local anesthetic agent. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [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
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functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [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] Carbon Monoxide Poisoning: Toxic asphyxiation due to the displacement of oxygen from oxyhemoglobin by carbon monoxide. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for heart arrest resulting from electric shock, drowning, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation and closed-chest cardiac massage. [NIH] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [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] 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] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in
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obstructions. [NIH] 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 Adhesion: Adherence of cells to surfaces or to other 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 Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Size: The physical dimensions of a cell. It refers mainly to changes in dimensions correlated with physiological or pathological changes in cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [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] 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] Cervical Plexus: A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory 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] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that
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contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] 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] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] 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] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] 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] Clubbing: A proliferative change in the soft tissues about the terminal phalanges of the fingers or toes, with no constant osseous changes. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties
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and mild sedative effects. It also acts centrally to suppress cough. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [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] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as 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
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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] Concomitant: Accompanying; accessory; joined with another. [EU] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Congestive heart failure: Weakness of the heart muscle that leads to a buildup of fluid in body tissues. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Conus: A large, circular, white patch around the optic disk due to the exposing of the sclera as a result of degenerative change or congenital abnormality in the choroid and retina. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or
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groups of muscles, in a complex action or series of actions. [NIH] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion. [NIH] Coronary Circulation: The circulation of blood through the coronary vessels of the heart. [NIH]
Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Critical Illness: A disease or state in which death is possible or imminent. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyanosis: A bluish or purplish discoloration of the skin and mucous membranes due to an increase in the amount of deoxygenated hemoglobin in the blood or a structural defect in the hemoglobin molecule. [NIH] 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] Cytokine: Small but highly potent protein that modulates the activity of many cell types, 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] Cytoskeleton: The network of filaments, tubules, and interconnecting filamentous bridges which give shape, structure, and organization to the cytoplasm. [NIH] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [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] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]
Decompression: Decompression external to the body, most often the slow lessening of external pressure on the whole body (especially in caisson workers, deep sea divers, and persons who ascend to great heights) to prevent decompression sickness. It includes also sudden accidental decompression, but not surgical (local) decompression or decompression applied through body openings. [NIH] Decompression Sickness: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral
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circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. [NIH] Defecation: The normal process of elimination of fecal material from the rectum. [NIH] Defense Mechanisms: Unconscious process used by an individual or a group of individuals in order to cope with impulses, feelings or ideas which are not acceptable at their conscious level; various types include reaction formation, projection and self reversal. [NIH] 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] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [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] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diagnostic Services: Organized services for the purpose of providing diagnosis to promote and maintain health. [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] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] 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] Dilated cardiomyopathy: Heart muscle disease that leads to enlargement of the heart's chambers, robbing the heart of its pumping ability. [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] Diphtheria: A localized infection of mucous membranes or skin caused by toxigenic strains of Corynebacterium diphtheriae. It is characterized by the presence of a pseudomembrane at the site of infection. Diphtheria toxin, produced by C. diphtheriae, can cause myocarditis, polyneuritis, and other systemic toxic effects. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention
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of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] 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] Dissociative Disorders: Sudden temporary alterations in the normally integrative functions of consciousness. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Dobutamine: A beta-2 agonist catecholamine that has cardiac stimulant action without evoking vasoconstriction or tachycardia. It is proposed as a cardiotonic after myocardial infarction or open heart surgery. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysphagia: Difficulty in swallowing. [EU] Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service
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produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Ejection fraction: A measure of ventricular contractility, equal to normally 65 8 per cent; lower values indicate ventricular dysfunction. [EU] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electric shock: A dangerous patho-physiological effect resulting from an electric current passing through the body of a human or animal. [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] Embolectomy: Surgical removal of an obstructing clot or foreign material which has been transported from a distant vessel by the bloodstream. Removal of a clot at its original site is called thrombectomy. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]
Emollient: Softening or soothing; called also malactic. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [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] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [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] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH]
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Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental 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] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]
Ergometer: An instrument for measuring the force of muscular contraction. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] 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] Esophageal Stricture: A narrowing of the esophagus often caused by acid flowing back from the stomach. This condition may require surgery. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagoscopy: Endoscopic examination, therapy, or surgery of the esophagus. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH]
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Evacuation: An emptying, as of the bowels. [EU] 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] Exercise Test: Controlled physical activity, more strenuous than at rest, which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used. The intensity of exercise is often graded, using criteria such as rate of work done, oxygen consumption, and heart rate. Physiological data obtained from an exercise test may be used for diagnosis, prognosis, and evaluation of disease severity, and to evaluate therapy. Data may also be used in prescribing exercise by determining a person's exercise capacity. [NIH] Exercise Tolerance: The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an exercise test. [NIH]
Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] External-beam radiation: Radiation therapy that uses a machine to aim high-energy rays at the cancer. Also called external radiation. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraction: The process or act of pulling or drawing out. [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] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciculation: A small local contraction of muscles, visible through the skin, representing a spontaneous discharge of a number of fibres innervated by a single motor nerve filament. [EU]
Fat: Total lipids including phospholipids. [NIH] 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]
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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] Fenoterol: An adrenergic beta-2 agonist that is used as a bronchodilator and tocolytic. [NIH] Fentanyl: A narcotic opioid drug that is used in the treatment of pain. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibronectin: An adhesive glycoprotein. One form circulates in plasma, acting as an opsonin; another is a cell-surface protein which mediates cellular adhesive interactions. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flatus: Gas passed through the rectum. [NIH] Flow Cytometry: Technique using an instrument system for making, processing, and displaying one or more measurements on individual cells obtained from a cell suspension. Cells are usually stained with one or more fluorescent dyes specific to cell components of interest, e.g., DNA, and fluorescence of each cell is measured as it rapidly transverses the excitation beam (laser or mercury arc lamp). Fluorescence provides a quantitative measure of various biochemical and biophysical properties of the cell, as well as a basis for cell sorting. Other measurable optical parameters include light absorption and light scattering, the latter being applicable to the measurement of cell size, shape, density, granularity, and stain uptake. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescent Dyes: Dyes that emit light when exposed to light. The wave length of the emitted light is usually longer than that of the incident light. Fluorochromes are substances that cause fluorescence in other substances, i.e., dyes used to mark or label other compounds with fluorescent tags. They are used as markers in biochemistry and immunology. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Foramen: A natural hole of perforation, especially one in a bone. [NIH] Forced Expiratory Volume: Measure of the maximum amount of air during a forced vital capacity determination that can be expelled in a given number of seconds. It is usually given as FEV followed by a subscript indicating the number of seconds over which the measurement is made, although it is sometimes given as a percentage of forced vital capacity. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH]
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Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Furosemide: A sulfamyl saluretic and diuretic. It has a fast onset and short duration of action and is used in edema and chronic renal insufficiency. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] 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] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Generator: Any system incorporating a fixed parent radionuclide from which is produced a daughter radionuclide which is to be removed by elution or by any other method and used in a radiopharmaceutical. [NIH] Genetic Markers: A phenotypically recognizable genetic trait which can be used to identify a genetic locus, a linkage group, or a recombination event. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glossitis: Inflammation of the tongue. [NIH]
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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] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]
Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Goiter: Enlargement of the thyroid gland. [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] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulation Tissue: A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid cells, macrophages, and plasma cells. [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] Haematemesis: The vomiting of blood. [EU] 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 Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart Arrest: Sudden and usually momentary cessation of the heart beat. This sudden cessation may, but not usually, lead to death, sudden, cardiac. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heart Murmurs: Abnormal heart sounds heard during auscultation caused by alterations in the flow of blood into a chamber, through a valve, or by a valve opening or closing
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abnormally. They are classified by the time of occurrence during the cardiac cycle, the duration, and the intensity of the sound on a scale of I to V. [NIH] Heart Sounds: The sounds heard over the cardiac region produced by the functioning of the heart. There are four distinct sounds: the first occurs at the beginning of systole and is heard as a "lubb" sound; the second is produced by the closing of the aortic and pulmonary valves and is heard as a "dupp" sound; the third is produced by vibrations of the ventricular walls when suddenly distended by the rush of blood from the atria; and the fourth is produced by atrial contraction and ventricular filling but is rarely audible in the normal heart. The physiological concept of heart sounds is differentiated from the pathological heart murmurs. [NIH]
Heartbeat: One complete contraction of the heart. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues. [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] Hemoglobin M: A group of abnormal hemoglobins in which amino acid substitutions take place in either the alpha or beta chains but near the heme iron. This results in facilitated oxidation of the hemoglobin to yield excess methemoglobin which leads to cyanosis. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemoptysis: Bronchial hemorrhage manifested with spitting of blood. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]
Heterodimers: Zippered pair of nonidentical proteins. [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]
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Hiatal Hernia: A small opening in the diaphragm that allows the upper part of the stomach to move up into the chest. Causes heartburn from stomach acid flowing back up through the opening. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Hoarseness: An unnaturally deep or rough quality of voice. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hospice: Institution dedicated to caring for the terminally ill. [NIH] Hospital Mortality: A vital statistic measuring or recording the rate of death from any cause in hospitalized populations. [NIH] Hydra: A genus of freshwater cnidarians, of interest because of their complex organization and because their adult organization corresponds roughly to the gastrula of higher animals. [NIH]
Hydrocortisone: The main glucocorticoid secreted by the adrenal cortex. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] 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] Hydromorphone: An opioid analgesic made from morphine and used mainly as an analgesic. It has a shorter duration of action than morphine. [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] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hyperoxia: An abnormal increase in the amount of oxygen in the tissues and organs. [NIH] Hyperpnea: Increased ventilation in proportion to increased metabolism. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH]
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Hyperstimulation: Excessive stimulation. [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperventilate: To breathe abnormally fast and deep; results in the intake of excessive amounts of oxygen into the lung and reduced carbon dioxide levels in the blood. [NIH] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypotension: Abnormally low blood pressure. [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] Hypoxic: Having too little oxygen. [NIH] Iatrogenic: Resulting from the activity of physicians. Originally applied to disorders induced in the patient by autosuggestion based on the physician's examination, manner, or discussion, the term is now applied to any adverse condition in a patient occurring as the result of treatment by a physician or surgeon, especially to infections acquired by the patient during the course of treatment. [EU] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]
effects
of
foreign
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] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] 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] 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
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clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] 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] 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] Inoculum: The spores or tissues of a pathogen that serve to initiate disease in a plant. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Integrins: A family of transmembrane glycoproteins consisting of noncovalent heterodimers. They interact with a wide variety of ligands including extracellular matrix glycoproteins, complement, and other cells, while their intracellular domains interact with the cytoskeleton. The integrins consist of at least three identified families: the cytoadhesin receptors, the leukocyte adhesion receptors, and the very-late-antigen receptors. Each family contains a common beta-subunit combined with one or more distinct alpha-subunits. These receptors participate in cell-matrix and cell-cell adhesion in many physiologically important processes, including embryological development, hemostasis, thrombosis, wound healing, immune and nonimmune defense mechanisms, and oncogenic transformation. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH]
Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] 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] Intestinal: Having to do with the intestines. [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] Intracellular: Inside a cell. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]
Involuntary: Reaction occurring without intention or volition. [NIH] 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] Ipratropium: A muscarinic antagonist structurally related to atropine but often considered safer and more effective for inhalation use. It is used for various bronchial disorders, in rhinitis, and as an antiarrhythmic. [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 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] Jellyfish: Free swimming marine cnidarians. Most of the large jellyfish are in the class Scyphozoa; the small jellyfish are in the class Hydrozoa (hydra). [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] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid
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bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Latent period: A seemingly inactive period, as that between exposure of tissue to an injurious agent and the manifestation of response, or that between the instant of stimulation and the beginning of response. [EU] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]
Leukemia: Cancer of blood-forming tissue. [NIH] Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Life cycle: The successive stages through which an organism passes from fertilized ovum or spore to the fertilized ovum or spore of the next generation. [NIH] Life Expectancy: A figure representing the number of years, based on known statistics, to which any person of a given age may reasonably expect to live. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] 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] Lipoma: A benign tumor composed of fat cells. [NIH] Liposomal: A drug preparation that contains the active drug in very tiny fat particles. This fat-encapsulated drug is absorbed better, and its distribution to the tumor site is improved. [NIH]
Liposomes: Artificial, single or multilaminar vesicles (made from lecithins or other lipids) that are used for the delivery of a variety of biological molecules or molecular complexes to cells, for example, drug delivery and gene transfer. They are also used to study membranes and membrane proteins. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] 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] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a
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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]
Lung Transplantation: The transference of either one or both of the lungs from one human or animal to another. [NIH] Lung volume: The amount of air the lungs hold. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]
Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph 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] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Lyophilisate: The product of lyophilization ( the creation of a stable preparation of a biological substance, such as blood plasma or serum, by rapid freezing and dehydration of the frozen product under high vacuum). [EU] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] 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] Malformation: A morphologic developmental process. [EU]
defect
resulting
from
an
intrinsically
abnormal
Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mammary: Pertaining to the mamma, or breast. [EU] Mechanical ventilation: Use of a machine called a ventilator or respirator to improve the exchange of air between the lungs and the atmosphere. [NIH] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve
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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] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Glycoproteins: Glycoproteins found on the membrane or surface of cells. [NIH] Membrane Lipids: Lipids, predominantly phospholipids, cholesterol and small amounts of glycolipids found in membranes including cellular and intracellular membranes. These lipids may be arranged in bilayers in the membranes with integral proteins between the layers and peripheral proteins attached to the outside. Membrane lipids are required for active transport, several enzymatic activities and membrane formation. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mercury: A silver metallic element that exists as a liquid at room temperature. It has the atomic symbol Hg (from hydrargyrum, liquid silver), atomic number 80, and atomic weight 200.59. Mercury is used in many industrial applications and its salts have been employed therapeutically as purgatives, antisyphilitics, disinfectants, and astringents. It can be absorbed through the skin and mucous membranes which leads to mercury poisoning. Because of its toxicity, the clinical use of mercury and mercurials is diminishing. [NIH] Metaplasia: A condition in which there is a change of one adult cell type to another similar adult cell type. [NIH] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Metastatic cancer: Cancer that has spread from the place in which it started to other parts of the body. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH]
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Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mitomycin: An antineoplastic antibiotic produced by Streptomyces caespitosus. It acts as a bi- or trifunctional alkylating agent causing cross-linking of DNA and inhibition of DNA synthesis. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] 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] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]
Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU]
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Mucolytic: Destroying or dissolving mucin; an agent that so acts : a mucopolysaccharide or glycoprotein, the chief constituent of mucus. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multicenter Studies: Controlled studies which are planned and carried out by several cooperating institutions to assess certain variables and outcomes in specific patient populations, for example, a multicenter study of congenital anomalies in children. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]
Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelosuppression: A condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets. Myelosuppression is a side effect of some cancer treatments. [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] Myocarditis: Inflammation of the myocardium; inflammation of the muscular walls of the heart. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [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] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors
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which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neural Pathways: Neural tracts connecting one part of the nervous system with another. [NIH]
Neuroeffector Junction: The synapse between a neuron (presynaptic) and an effector cell other than another neuron (postsynaptic). Neuroeffector junctions include synapses onto muscles and onto secretory cells. [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] Neuromuscular: Pertaining to muscles and nerves. [EU] 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] Neurophysiology: The scientific discipline concerned with the physiology of the nervous system. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]
Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] 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
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volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Medicine: A specialty field of radiology concerned with diagnostic, therapeutic, and investigative use of radioactive compounds in a pharmaceutical form. [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] Oncogenic: Chemical, viral, radioactive or other agent that causes cancer; carcinogenic. [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] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] 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] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Oximetry: The determination of oxygen-hemoglobin saturation of blood either by withdrawing a sample and passing it through a classical photoelectric oximeter or by electrodes attached to some translucent part of the body like finger, earlobe, or skin fold. It includes non-invasive oxygen monitoring by pulse oximetry. [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pallor: A clinical manifestation consisting of an unnatural paleness of the skin. [NIH] 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] 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
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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] Papilla: A small nipple-shaped elevation. [NIH] Papillary: Pertaining to or resembling papilla, or nipple. [EU] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]
Parenchyma: The essential elements of an organ; used in anatomical nomenclature as a general term to designate the functional elements of an organ, as distinguished from its framework, or stroma. [EU] Paresthesias: Abnormal touch sensations, such as burning or prickling, that occur without an outside stimulus. [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] 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] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH]
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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] Pernicious: Tending to a fatal issue. [EU] Perspiration: Sweating; the functional secretion of sweat. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phrenic Nerve: The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm. [NIH]
Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Plethysmography: Recording of change in the size of a part as modified by the circulation in it. [NIH] Pleura: The thin serous membrane enveloping the lungs and lining the thoracic cavity. [NIH] Pleural: A circumscribed area of hyaline whorled fibrous tissue which appears on the surface of the parietal pleura, on the fibrous part of the diaphragm or on the pleura in the
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interlobar fissures. [NIH] Pleural cavity: A space enclosed by the pleura (thin tissue covering the lungs and lining the interior wall of the chest cavity). It is bound by thin membranes. [NIH] Pleural Effusion: Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. [NIH] Pneumonectomy: An operation to remove an entire lung. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polyneuritis: Inflammation of several peripheral nerves at the same time. [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] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Postural: Pertaining to posture or position. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium Channels: Cell membrane glycoproteins selective for potassium ions. [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] 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] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH]
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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] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promethazine: A phenothiazine derivative with histamine H1-blocking, antimuscarinic, and sedative properties. It is used as an antiallergic, in pruritus, for motion sickness and sedation, and also in animals. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [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] Protease Inhibitors: Compounds which inhibit or antagonize biosynthesis or actions of proteases (endopeptidases). [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] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]
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Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]
Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Circulation: The circulation of blood through 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 Fibrosis: Chronic inflammation and progressive fibrosis of the pulmonary alveolar walls, with steadily progressive dyspnea, resulting finally in death from oxygen lack or right heart failure. [NIH] Pulmonary hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Pulmonary Stretch Receptors: Stretch receptors found in the bronchi and bronchioles. Pulmonary stretch receptors are sensors for a reflex which stops inspiration. In humans, the reflex is protective and is probably not activated during normal respiration. [NIH] Pulmonary Ventilation: The total volume of gas per minute inspired or expired measured in liters per minute. [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] Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Pyrimidines: A family of 6-membered heterocyclic compounds occurring in nature in a wide variety of forms. They include several nucleic acid constituents (cytosine, thymine, and uracil) and form the basic structure of the barbiturates. [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] 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] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [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]
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Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunotherapy: Radiotherapy where cytotoxic radionuclides are linked to antibodies in order to deliver toxins directly to tumor targets. Therapy with targeted radiation rather than antibody-targeted toxins (immunotoxins) has the advantage that adjacent tumor cells, which lack the appropriate antigenic determinants, can be destroyed by radiation cross-fire. Radioimmunotherapy is sometimes called targeted radiotherapy, but this latter term can also refer to radionuclides linked to non-immune molecules (radiotherapy). [NIH] Radiolabeled: Any compound that has been joined with a radioactive substance. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Radiolucent: Partly or wholly permeable to X-rays or other forms of radiation contrasted with radiopaque. [NIH] Radiopharmaceutical: Any medicinal product which, when ready for use, contains one or more radionuclides (radioactive isotopes) included for a medicinal purpose. [NIH] Radiotherapy: The use of ionizing radiation to treat malignant neoplasms and other benign conditions. The most common forms of ionizing radiation used as therapy are x-rays, gamma rays, and electrons. A special form of radiotherapy, targeted radiotherapy, links a cytotoxic radionuclide to a molecule that targets the tumor. When this molecule is an antibody or other immunologic molecule, the technique is called radioimmunotherapy. [NIH] 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] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] 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] 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]
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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] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [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] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH] Respiratory distress syndrome: A lung disease that occurs primarily in premature infants; the newborn must struggle for each breath and blueing of its skin reflects the baby's inability to get enough oxygen. [NIH] Respiratory failure: Inability of the lungs to conduct gas exchange. [NIH] Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Respiratory System: The tubular and cavernous organs and structures, by means of which pulmonary ventilation and gas exchange between ambient air and the blood are brought about. [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] Retrospective: Looking back at events that have already taken place. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Saline: A solution of salt and water. [NIH] Sanatorium: This category applies to all those institutions partially or wholly devoted to the diagnosis and treatment of tuberculosis. [NIH] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH] Saphenous Vein: The vein which drains the foot and leg. [NIH]
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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] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sediment: A precipitate, especially one that is formed spontaneously. [EU] 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] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Septal: An abscess occurring at the root of the tooth on the proximal surface. [NIH] Serine: A non-essential amino acid occurring in natural form as the L-isomer. It is synthesized from glycine or threonine. It is involved in the biosynthesis of purines, pyrimidines, and other amino acids. [NIH] 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] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
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Shoulder Pain: Unilateral or bilateral pain of the shoulder. It is often caused by physical activities such as work or sports participation, but may also be pathologic in origin. [NIH] Shunt: A surgically created diversion of fluid (e.g., blood or cerebrospinal fluid) from one area of the body to another area of the body. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skin test: A test for an immune response to a compound by placing it on or under the skin. [NIH]
Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] 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 intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Sneezing: Sudden, forceful, involuntary expulsion of air from the nose and mouth caused by irritation to the mucous membranes of the upper respiratory tract. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social 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] Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH]
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Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] 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] Spirometry: Measurement of volume of air inhaled or exhaled by the lung. [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] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Spores: The reproductive elements of lower organisms, such as protozoa, fungi, and cryptogamic plants. [NIH] Sprue: A non febrile tropical disease of uncertain origin. [NIH] Sputum: The material expelled from the respiratory passages by coughing or clearing the throat. [NIH] Squamous: Scaly, or platelike. [EU] Standard therapy: A currently accepted and widely used treatment for a certain type of cancer, based on the results of past research. [NIH] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Sterile: Unable to produce children. [NIH] Steroids: Drugs used to relieve swelling and inflammation. [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
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the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Streptococcal: Caused by infection due to any species of streptococcus. [NIH] Streptococcus: A genus of gram-positive, coccoid bacteria whose organisms occur in pairs or chains. No endospores are produced. Many species exist as commensals or parasites on man or animals with some being highly pathogenic. A few species are saprophytes and occur in the natural environment. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stridor: The loud, harsh, vibrating sound produced by partial obstruction of the larynx or trachea. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Stroke Volume: The amount of blood pumped out of the heart per beat not to be confused with cardiac output (volume/time). [NIH] Stroma: The middle, thickest layer of tissue in the cornea. [NIH] Stromal: Large, veil-like cell in the bone marrow. [NIH] Stromal Cells: Connective tissue cells of an organ found in the loose connective tissue. These are most often associated with the uterine mucosa and the ovary as well as the hematopoietic system and elsewhere. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [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]
Sudden cardiac death: Cardiac arrest caused by an irregular heartbeat. [NIH] Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Superoxide Dismutase: An oxidoreductase that catalyzes the reaction between superoxide anions and hydrogen to yield molecular oxygen and hydrogen peroxide. The enzyme protects the cell against dangerous levels of superoxide. EC 1.15.1.1. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supraventricular: Situated or occurring above the ventricles, especially in an atrium or atrioventricular node. [EU] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]
Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and
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followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods. [NIH] 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] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic 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] Systemic: Affecting the entire 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] Tachypnea: Rapid breathing. [NIH] Telecommunications: Transmission of information over distances via electronic means. [NIH]
Telemedicine: Delivery of health services via remote telecommunications. This includes interactive consultative and diagnostic services. [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] Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [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] Thermodilution: Measurement of blood flow based on induction at one point of the circulation of a known change in the intravascular heat content of flowing blood and detection of the resultant change in temperature at a point downstream. [NIH]
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Thoracic: Having to do with the chest. [NIH] Threonine: An essential amino acid occurring naturally in the L-form, which is the active form. It is found in eggs, milk, gelatin, and other proteins. [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] Thrombectomy: Surgical removal of an obstructing clot or foreign material from a blood vessel at the point of its formation. Removal of a clot arising from a distant site is called embolectomy. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [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] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Tidal Volume: The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tissue Donors: Individuals suppling living tissue, organs, cells, blood or blood components for transfer or transplantation to histocompatible recipients. [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] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] 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]
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Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Tracheitis: Inflammation of the trachea. [EU] Traction: The act of pulling. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] 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] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tuberculin: A sterile liquid containing the growth products of, or specific substances extracted from, the tubercle bacillus; used in various forms in the diagnosis of tuberculosis. [NIH]
Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Uncontrolled study: A clinical study that lacks a comparison (i.e., a control) group. [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] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the
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sediment microscopically. [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] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagal: Pertaining to the vagus nerve. [EU] 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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] 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] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Dysfunction: A condition in which the ventricles of the heart exhibit a decreased functionality. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. It is a mitotic inhibitor. [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] Vindesine: Vinblastine derivative with antineoplastic activity against acute leukemia, lung cancer, carcinoma of the breast, squamous cell carcinoma of the esophagus, head, and neck,
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and Hodgkin's and non-Hodgkin's lymphomas. Major side effects are myelosuppression and neurotoxicity. Vindesine is used extensively in chemotherapy protocols. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] 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] Vital Capacity: The volume of air that is exhaled by a maximal expiration following a maximal inspiration. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] War: Hostile conflict between organized groups of people. [NIH] Weight Lifting: A sport in which weights are lifted competitively or as an exercise. [NIH] Wheezing: Breathing with a rasp or whistling sound; a sign of airway constriction or obstruction. [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]
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] 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]
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INDEX A Abdomen, 4, 141, 146, 147, 149, 166, 167, 174, 183, 188 Abdominal, 38, 87, 109, 141, 154, 168, 173, 174 Abdominal Pain, 38, 109, 141, 168 Abscess, 141, 181 Acetylcholine, 141, 150, 172 Action Potentials, 9, 141 Acupuncture Points, 6, 141 Acute leukemia, 141, 188 Acute renal, 141, 162 Adenine, 141, 178 Adenosine, 7, 26, 51, 95, 141, 175, 185 Adrenal Cortex, 141, 163 Adrenergic, 116, 141, 142, 159 Adverse Effect, 141, 182 Aerobic, 34, 141, 158 Aerosol, 20, 141 Afferent, 9, 23, 28, 141 Affinity, 141, 142, 182 Agonist, 12, 26, 49, 51, 85, 142, 155, 159, 171 Air Embolism, 15, 142 Air Sacs, 142 Airway, 4, 7, 12, 15, 16, 23, 24, 26, 34, 36, 59, 69, 80, 142, 147, 182, 189 Airway Obstruction, 4, 34, 59, 69, 142 Airway Resistance, 7, 142 Albuterol, 16, 52, 116, 142 Algorithms, 51, 142, 146 Alkaline, 142, 147 Alkaloid, 76, 81, 142, 145, 170, 185 Alleles, 16, 142 Allergen, 16, 23, 142 Allergic Rhinitis, 142, 147 Alpha-1, 73, 142 Alternative medicine, 112, 142 Alveoli, 16, 103, 142, 188 Alveolitis, 7, 22, 142 Amino Acid Sequence, 142, 144, 158 Amino Acids, 142, 143, 174, 176, 177, 181 Ampulla, 143, 156 Anaemia, 143, 169 Anal, 143, 159, 171 Analgesic, 143, 150, 163, 170, 173 Analog, 57, 67, 143 Analytes, 128, 143
Anaplastic, 62, 143 Anaplastic large cell lymphoma, 62, 143 Anastomosis, 48, 143 Anatomical, 143, 145, 149, 174 Anemia, 64, 73, 87, 90, 143 Anesthesia, 71, 142, 143, 177 Aneurysm, 48, 143 Angina, 66, 143 Angina Pectoris, 66, 143 Animal model, 22, 143 Anions, 143, 166, 184 Anomalies, 143, 171 Anorexia, 3, 13, 143 Antagonism, 21, 143, 185 Antiallergic, 144, 177 Antiarrhythmic, 144, 166 Antibacterial, 144, 183 Antibiotic, 144, 153, 155, 170, 174, 183 Antibodies, 144, 179 Antibody, 12, 22, 142, 144, 151, 157, 163, 164, 166, 169, 170, 179, 189 Anticholinergic, 51, 53, 144 Antidepressant, 68, 144 Antigen, 23, 25, 142, 144, 151, 163, 164, 165, 169 Antineoplastic, 144, 155, 170, 176, 188 Antiproliferative, 21, 144 Anxiety, 5, 9, 19, 25, 82, 83, 85, 87, 144, 173 Anxiety Disorders, 144, 174 Anxiolytic, 144, 173 Aorta, 144, 153, 188 Apnea, 10, 17, 90, 128, 144 Apoptosis, 21, 144 Arginine, 144, 172 Arterial, 12, 69, 144, 145, 164, 177, 185 Arteries, 10, 71, 144, 145, 146, 153, 171, 178 Arteriosus, 145, 178 Arteriovenous, 56, 145 Arteritis, 31, 145 Artery, 143, 144, 145, 148, 153, 156, 174, 178 Assay, 38, 72, 145 Asymptomatic, 8, 16, 107, 145 Atmospheric Pressure, 145, 163 Atrial, 46, 52, 59, 61, 68, 145, 162 Atrial Fibrillation, 59, 145 Atrial Function, 52, 145 Atrioventricular, 145, 184
192
Dyspnea
Atrioventricular Node, 145, 184 Atrium, 61, 145, 184, 188 Atropine, 145, 166 Auscultation, 145, 161 Autosuggestion, 145, 164 B Bacillus, 145, 187 Bacteremia, 37, 145 Bacteria, 13, 144, 145, 156, 157, 159, 169, 170, 183, 184, 187, 188 Bacterium, 145, 162 Bacteriuria, 145, 187 Base, 31, 141, 145, 166, 185 Basement Membrane, 27, 146, 158, 166 Benign, 146, 167, 171, 179 Benign tumor, 146, 167 Bilateral, 35, 36, 46, 65, 76, 146, 182 Bile, 96, 146, 160, 167 Biochemical, 23, 142, 146, 159, 181 Biological response modifier, 146, 165 Biomarkers, 21, 146 Biosynthesis, 146, 177, 181 Biotechnology, 13, 31, 32, 102, 108, 112, 123, 146 Biphasic, 17, 146 Bladder, 146, 177, 187, 188 Bloating, 109, 146, 168 Blood Coagulation, 146, 148, 186 Blood pressure, 13, 24, 146, 149, 164, 170, 178, 182 Blood vessel, 146, 148, 150, 156, 157, 158, 162, 168, 174, 182, 184, 185, 186, 188 Body Composition, 34, 146 Body Fluids, 146, 147, 155, 182, 187 Bone Marrow, 22, 87, 141, 146, 168, 171, 182, 184 Bowel, 109, 143, 147, 154, 166, 184 Bowel Movement, 147, 154, 184 Brachytherapy, 147, 165, 166, 179, 189 Bradykinin, 147, 172 Bronchi, 147, 178, 185, 187 Bronchial, 13, 38, 104, 105, 117, 147, 162, 163, 166, 185 Bronchioles, 142, 147, 178 Bronchiolitis, 21, 36, 67, 147 Bronchiolitis Obliterans, 21, 147 Bronchiolitis Obliterans Organizing Pneumonia, 21, 147 Bronchitis, 76, 86, 87, 147, 150 Bronchoalveolar Lavage, 7, 147 Bronchoconstriction, 7, 62, 64, 69, 112, 147 Bronchodilator, 11, 147, 159
Bronchopulmonary, 7, 147 Bronchospasm, 23, 40, 51, 147 Bronchus, 147 Budesonide, 50, 147 Bupivacaine, 147, 167 Bypass, 31, 147 C Calcium, 17, 147, 151 Caloric intake, 3, 148 Carbohydrate, 148, 161, 176 Carbon Dioxide, 29, 148, 160, 164, 180 Carbon Monoxide Poisoning, 15, 148 Carcinogenic, 148, 165, 173 Carcinoma, 37, 48, 148, 188 Cardiac, 12, 25, 29, 36, 37, 38, 51, 72, 144, 145, 148, 155, 161, 162, 167, 171, 184 Cardiac Output, 29, 148, 184 Cardiomyopathy, 87, 148 Cardiopulmonary, 7, 27, 35, 43, 44, 47, 48, 64, 68, 69, 148 Cardiopulmonary Resuscitation, 68, 148 Cardiotonic, 148, 155 Cardiovascular, 37, 63, 66, 148, 158, 181 Carotid Body, 7, 9, 35, 148, 149 Case report, 31, 48, 56, 61, 85, 148, 150 Catecholamine, 148, 155 Catheter, 148, 166 Catheterization, 148, 166 Cause of Death, 11, 23, 28, 30, 149 Cell Adhesion, 149, 165 Cell Cycle, 149, 150, 157 Cell Death, 144, 149, 157, 171 Cell Division, 145, 149, 157, 169, 170, 175, 177 Cell membrane, 149, 160, 175, 176 Cell Respiration, 149, 180 Cell Size, 149, 159 Central Nervous System, 23, 108, 141, 149, 170, 181, 185 Cerebrospinal, 149, 182 Cerebrospinal fluid, 149, 182 Cervical, 26, 149, 175 Cervical Plexus, 149, 175 Cervix, 149 Character, 143, 149 Chemoreceptor, 7, 9, 149 Chemotherapy, 76, 149, 189 Chest Pain, 41, 52, 149 Chest wall, 42, 50, 111, 149 Chin, 66, 76, 86, 149, 169 Choline, 103, 150 Chromatin, 144, 150, 157, 168
193
Chromosomal, 10, 150 Chromosome, 10, 16, 150, 167 Chronic Disease, 13, 16, 150, 151 Chronic renal, 62, 150, 160 Circadian, 24, 150 Circadian Rhythm, 24, 150 Circulatory system, 142, 150 Cisplatin, 150, 173 Clamp, 17, 150 Clinical study, 150, 152, 187 Clinical trial, 5, 19, 40, 48, 123, 150, 152, 171, 177, 179 Cloning, 146, 150 Clubbing, 67, 73, 150 Codeine, 76, 150, 173 Cofactor, 151, 177, 186 Collagen, 25, 146, 151, 159, 163, 175, 177 Collagen disease, 151, 163 Collapse, 30, 151, 182 Combination Therapy, 81, 84, 151 Complement, 151, 165 Complementary and alternative medicine, 79, 80, 97, 151 Complementary medicine, 79, 151 Computational Biology, 123, 152 Computed tomography, 16, 152 Computerized axial tomography, 152 Computerized tomography, 152 Concomitant, 25, 30, 152 Congestion, 26, 105, 152 Congestive heart failure, 18, 20, 45, 57, 59, 60, 67, 70, 72, 85, 152 Connective Tissue, 147, 151, 152, 159, 161, 168, 181, 184 Consciousness, 143, 152, 155 Constipation, 3, 5, 152 Constriction, 152, 188, 189 Consultation, 19, 152 Contractility, 152, 156 Contraindications, ii, 152 Contralateral, 13, 152 Control group, 5, 8, 14, 21, 30, 152 Controlled clinical trial, 18, 152 Controlled study, 26, 152 Conus, 152, 178 Coordination, 23, 28, 152 Cornea, 153, 181, 184, 188 Coronary, 52, 56, 143, 145, 153, 171 Coronary Artery Bypass, 52, 153 Coronary Circulation, 143, 153 Cortical, 153, 158, 181 Corticosteroids, 12, 153, 161
Critical Illness, 20, 153 Curative, 6, 153, 185 Cutaneous, 108, 149, 153 Cyanosis, 37, 41, 153, 162 Cyclic, 153, 161, 172, 185 Cytokine, 12, 13, 153 Cytoplasm, 144, 149, 153, 157, 168 Cytoskeleton, 153, 165 Cytotoxic, 153, 173, 179 Cytotoxic chemotherapy, 153, 173 D Data Collection, 6, 23, 28, 153 Daunorubicin, 153, 155 Decompression, 4, 15, 153 Decompression Sickness, 15, 153 Defecation, 109, 154 Defense Mechanisms, 154, 165 Dehydration, 154, 168 Deletion, 144, 154 Dendrites, 154, 172 Depersonalization, 154, 174 Derealization, 154, 174 Diagnostic procedure, 101, 112, 154 Diagnostic Services, 154, 185 Diaphoresis, 38, 154 Diaphragm, 30, 59, 149, 154, 163, 175 Diarrhea, 108, 154, 168 Diastole, 154 Diastolic, 71, 154, 164 Digestion, 146, 147, 154, 166, 167, 183 Digestive system, 154, 160 Digestive tract, 154, 182 Dilated cardiomyopathy, 52, 154 Dilation, 4, 147, 154 Diphtheria, 128, 154 Direct, iii, 7, 11, 16, 17, 29, 115, 154, 179, 185 Discrete, 11, 38, 155 Disorientation, 154, 155 Dissociation, 9, 46, 141, 155 Dissociative Disorders, 155 Distal, 4, 153, 155, 176, 177 Diuresis, 26, 155, 185 Diuretic, 20, 26, 155, 160 Dizziness, 155, 174 Dobutamine, 42, 155 Doxorubicin, 57, 155 Drive, ii, vi, 72, 75, 155 Drug Interactions, 117, 155 Drug Tolerance, 155, 186 Duct, 143, 148, 155, 183 Duodenum, 146, 155, 156, 184
194
Dyspnea
Dysphagia, 3, 4, 37, 48, 67, 68, 108, 155 E Echocardiography, 38, 42, 155 Edema, 26, 88, 109, 155, 160 Efficacy, 9, 13, 14, 18, 21, 26, 30, 68, 86, 155 Effusion, 6, 156 Ejection fraction, 19, 71, 156 Elastic, 30, 156, 184 Elastin, 151, 156 Elective, 84, 156 Electric shock, 148, 156 Electrolyte, 156, 176, 182 Electrons, 146, 156, 166, 178, 179 Embolectomy, 53, 156, 186 Embolism, 69, 156 Embolus, 5, 156 Emergency Treatment, 4, 156 Emesis, 109, 156 Emollient, 156, 161 Emphysema, 30, 68, 73, 88, 150, 156 Encapsulated, 156, 167 Endemic, 19, 156, 183 Endogenous, 10, 25, 156 Endoscope, 156 Endoscopic, 31, 156, 157 Endothelial cell, 22, 156, 186 Endothelium, 157, 172 Endothelium-derived, 157, 172 Endotoxin, 157, 187 End-stage renal, 150, 157 Environmental Health, 10, 122, 124, 157 Enzymatic, 148, 151, 157, 163, 169 Enzyme, 157, 161, 177, 184, 186, 189 Eosinophils, 23, 28, 49, 157 Epidemic, 157, 183 Epithelial, 12, 15, 157, 166 Epithelium, 146, 157 Epitope, 22, 157 Ergometer, 11, 157 Erythrocytes, 143, 147, 157, 179 Escalation, 12, 157 Esophageal, 4, 157 Esophageal Stricture, 4, 157 Esophagitis, 4, 157 Esophagoscopy, 4, 157 Esophagus, 4, 154, 157, 160, 162, 167, 180, 184, 188 Etoposide, 84, 157 Evacuation, 4, 152, 158 Excitation, 149, 158, 159, 172 Excitatory, 9, 28, 158 Exercise Test, 47, 51, 158
Exercise Tolerance, 8, 15, 29, 76, 85, 158 Exhaustion, 144, 158 Exogenous, 156, 158 Exon, 11, 158 Expiration, 102, 158, 180, 189 Expiratory, 66, 158 External-beam radiation, 158, 166, 179, 189 Extracellular, 152, 158, 159, 165, 182 Extracellular Matrix, 152, 158, 159, 165 Extraction, 33, 158 Extremity, 46, 65, 158 Exudate, 147, 158, 173 F Family Planning, 123, 158 Fasciculation, 42, 158 Fat, 4, 30, 146, 147, 156, 158, 167, 182, 184 Fatigue, 8, 10, 34, 39, 41, 49, 63, 109, 158, 161 Febrile, 159, 183 Fecal Incontinence, 109, 159 Feces, 152, 159, 184 Fenoterol, 76, 159 Fentanyl, 46, 58, 70, 159 Fibroblasts, 27, 159 Fibronectin, 27, 159 Fibrosis, 8, 22, 27, 50, 58, 159, 178, 181 Flatus, 159, 160 Flow Cytometry, 13, 159 Fluorescence, 159 Fluorescent Dyes, 159 Flushing, 57, 159 Fold, 159, 173 Foramen, 66, 150, 159 Forced Expiratory Volume, 24, 159 Forearm, 146, 159 Free Radicals, 155, 159 Friction, 142, 160 Furosemide, 43, 50, 58, 65, 111, 112, 160 G Gallbladder, 141, 154, 160 Gamma Rays, 160, 179 Gap Junctions, 160, 185 Gas, 15, 16, 29, 30, 128, 148, 153, 159, 160, 163, 168, 172, 178, 180, 188 Gas exchange, 29, 160, 180, 188 Gastric, 4, 68, 160, 162, 163 Gastroenterology, 109, 160 Gastrointestinal, 109, 147, 160, 181, 184, 187 Gastrointestinal tract, 109, 160, 181, 187 Gene, 10, 15, 21, 108, 142, 146, 160, 167
195
Gene Expression, 22, 160 Generator, 15, 160 Genetic Markers, 15, 160 Genetics, 16, 160 Genotype, 160, 175 Geriatric, 44, 109, 160 Germ Cells, 160, 169, 173, 183 Gland, 141, 160, 168, 173, 174, 177, 181, 183, 186 Glomerular, 160, 180 Glossitis, 109, 160 Glucocorticoid, 147, 161, 163 Glucose, 109, 161, 162 Glycerol, 103, 161, 175 Glycerophospholipids, 161, 175 Glycine, 161, 172, 181 Glycoprotein, 159, 161, 166, 171, 186, 187 Goiter, 40, 161 Governing Board, 161, 176 Grade, 6, 161 Grafting, 52, 153, 161 Granulation Tissue, 147, 161 Guanylate Cyclase, 161, 172 H Haematemesis, 156, 161 Health Education, 30, 129, 161 Health Resources, iv, 5, 21, 161 Health Services, 161, 185 Health Status, 49, 161 Heart Arrest, 148, 161 Heart failure, 10, 40, 45, 51, 66, 70, 84, 161, 178 Heart Murmurs, 37, 161, 162 Heart Sounds, 161, 162 Heartbeat, 162, 184 Heartburn, 4, 162, 163 Hematology, 13, 35, 55, 56, 162 Hemodynamics, 54, 162 Hemoglobin, 143, 153, 157, 162, 173 Hemoglobin M, 153, 162 Hemolytic, 73, 162 Hemoptysis, 33, 47, 64, 162 Hemorrhage, 162, 184 Hemostasis, 162, 165, 181 Heredity, 160, 162 Hernia, 4, 34, 162 Heterodimers, 162, 165 Heterogeneity, 8, 142, 162 Hiatal Hernia, 4, 163 Histamine, 96, 163, 177 Hoarseness, 4, 163 Homologous, 142, 163, 185
Hormone, 150, 153, 163, 169, 186 Hospice, 5, 58, 79, 81, 163 Hospital Mortality, 20, 163 Hydra, 163, 166 Hydrocortisone, 50, 163 Hydrogen, 145, 148, 163, 170, 172, 184 Hydrogen Peroxide, 163, 184 Hydromorphone, 58, 163 Hydroxylysine, 151, 163 Hydroxyproline, 151, 163 Hyperbaric, 15, 163 Hyperbaric oxygen, 15, 163 Hyperoxia, 34, 163 Hyperpnea, 27, 163 Hypersensitivity, 142, 163 Hyperstimulation, 61, 164 Hypertension, 12, 52, 89, 90, 164 Hyperventilate, 27, 164 Hyperventilation, 25, 40, 49, 164 Hypotension, 57, 164 Hypoxemia, 12, 14, 34, 61, 67, 164 Hypoxia, 9, 16, 50, 73, 164 Hypoxic, 17, 164 I Iatrogenic, 68, 164 Idiopathic, 21, 41, 52, 164, 181 Immune response, 13, 144, 164, 182, 184, 189 Immune system, 164, 168, 188, 189 Immunity, 107, 164 Immunologic, 107, 164, 179 Implant radiation, 164, 165, 166, 179, 189 In situ, 22, 164 In vitro, 21, 24, 27, 164 In vivo, 13, 16, 27, 164 Incision, 164, 166 Induction, 164, 185 Infection, 13, 24, 33, 107, 109, 145, 146, 154, 164, 168, 174, 184, 189 Infusion, 12, 25, 165 Inhalation, 16, 20, 49, 76, 103, 104, 116, 141, 147, 165, 166, 176 Initiation, 12, 28, 165 Innervation, 23, 165 Inoculum, 13, 165 Inorganic, 150, 165, 171 Insight, 16, 22, 25, 165 Integrins, 27, 165 Intensive Care, 20, 165 Interferon, 21, 165 Interferon-alpha, 165 Intermittent, 51, 70, 165
196
Dyspnea
Internal Medicine, 7, 26, 27, 40, 59, 60, 61, 85, 160, 162, 165 Internal radiation, 165, 166, 179, 189 Interstitial, 11, 21, 23, 28, 54, 64, 147, 165, 166, 180, 189 Intestinal, 109, 165, 168 Intestine, 147, 166, 175 Intracellular, 17, 27, 164, 165, 166, 169, 172, 176 Intravascular, 166, 185 Intravenous, 7, 12, 20, 25, 50, 165, 166 Intrinsic, 16, 23, 142, 146, 166 Intubation, 56, 148, 166 Invasive, 10, 18, 27, 29, 164, 166, 173 Involuntary, 159, 166, 171, 179, 182 Ion Channels, 166, 185 Ionizing, 166, 179 Ions, 145, 155, 156, 163, 166, 170, 176 Ipratropium, 76, 116, 166 Irradiation, 22, 166, 189 J Jellyfish, 68, 166 K Kb, 122, 166 L Laminin, 146, 166 Large Intestine, 154, 166, 179, 182 Larynx, 47, 54, 166, 184, 187, 188 Latency, 7, 167 Latent, 22, 167 Latent period, 22, 167 Lesion, 12, 17, 64, 153, 167 Lethal, 13, 167 Leucocyte, 142, 167 Leukemia, 73, 87, 89, 155, 167 Lidocaine, 7, 167 Life cycle, 146, 167 Life Expectancy, 10, 167 Ligament, 167, 177 Ligands, 165, 167 Ligation, 48, 167 Limbic, 61, 167 Linkage, 10, 160, 167 Lipid, 150, 161, 167 Lipoma, 67, 167 Liposomal, 57, 167 Liposomes, 22, 167 Liver, 13, 33, 141, 146, 154, 159, 160, 167, 181 Localized, 68, 141, 154, 156, 164, 166, 167, 175, 181 Loop, 20, 162, 167
Lower Esophageal Sphincter, 4, 167 Lung Transplantation, 24, 30, 53, 63, 168 Lung volume, 30, 35, 54, 69, 102, 168 Lymph, 13, 26, 108, 149, 150, 156, 157, 168, 181 Lymph node, 13, 149, 168, 181 Lymphadenopathy, 108, 168 Lymphatic, 13, 26, 143, 157, 165, 168, 182, 183, 186 Lymphatic system, 143, 168, 182, 183, 186 Lymphocytes, 107, 144, 167, 168, 183, 186, 189 Lymphoid, 144, 153, 161, 167, 168 Lymphoma, 35, 143, 168 Lyophilisate, 103, 168 M Macrophage, 22, 168 Malabsorption, 109, 168 Malabsorption syndrome, 109, 168 Malaise, 46, 60, 168 Malformation, 56, 168 Malignant, 35, 69, 144, 168, 171, 179, 181 Mammary, 153, 168 Mechanical ventilation, 56, 168 Mediator, 63, 168, 181 MEDLINE, 123, 169 Medullary, 26, 169 Megaloblastic, 109, 169 Meiosis, 169, 185 Membrane, 27, 142, 149, 151, 166, 167, 169, 170, 171, 175, 180 Membrane Glycoproteins, 169 Membrane Lipids, 169, 175 Membrane Proteins, 167, 169 Memory, 143, 169 Meninges, 149, 169 Mental, iv, 5, 122, 124, 150, 155, 158, 169, 177, 178, 187 Mental Health, iv, 5, 122, 124, 169, 178 Mental Processes, 155, 169, 178 Mercury, 159, 169 Metaplasia, 25, 169 Metastasis, 169 Metastatic, 58, 169 Metastatic cancer, 58, 169 Microbe, 169, 186 Microorganism, 151, 170, 174, 189 Microscopy, 146, 170 Mitochondrial Swelling, 170, 171 Mitomycin, 76, 81, 84, 170 Mitosis, 144, 170 Mitotic, 157, 170, 188
197
Modeling, 6, 16, 170 Modification, 170, 178 Molecular, 13, 16, 17, 20, 22, 123, 125, 146, 152, 167, 170, 184, 187 Molecular Structure, 170, 187 Molecule, 144, 145, 151, 155, 157, 158, 170, 179, 188 Monitor, 13, 41, 105, 170, 173 Monoclonal, 12, 166, 170, 179, 189 Mononuclear, 170, 187 Morphine, 43, 50, 53, 58, 150, 163, 170, 171, 173 Morphological, 28, 170 Morphology, 162, 170 Motility, 109, 170, 181 Motion Sickness, 170, 171, 177 Motor nerve, 158, 170, 175 Mucociliary, 170, 182 Mucolytic, 147, 171 Mucosa, 171, 184 Mucus, 12, 23, 26, 170, 171 Multicenter Studies, 12, 171 Multicenter study, 171 Multivariate Analysis, 6, 171 Mydriatic, 154, 171 Myelosuppression, 171, 189 Myocardial infarction, 155, 171 Myocardial Ischemia, 143, 171 Myocarditis, 47, 154, 171 Myocardium, 143, 171 N Naloxone, 25, 171 Narcotic, 159, 170, 171 Nasogastric, 4, 171 Nausea, 3, 57, 80, 109, 171, 173, 174, 187 Necrosis, 35, 144, 171, 181 Neoplasm, 171, 181 Nerve Endings, 9, 27, 171 Nervous System, 141, 149, 168, 172, 176, 184, 185 Networks, 17, 172 Neural, 7, 17, 28, 59, 72, 141, 172 Neural Pathways, 7, 172 Neuroeffector Junction, 171, 172 Neuroleptic, 172, 173 Neuromuscular, 62, 141, 172 Neuronal, 17, 23, 172 Neurons, 9, 154, 158, 171, 172, 185 Neurophysiology, 23, 172 Neurotoxicity, 172, 189 Neurotransmitter, 141, 147, 161, 163, 166, 172, 184, 185
Neutrons, 166, 172, 178, 179 Nitric Oxide, 26, 172 Nitrogen, 142, 153, 172, 187 Nuclear, 16, 54, 68, 156, 160, 171, 173 Nuclear Medicine, 16, 54, 173 Nucleus, 144, 150, 153, 157, 160, 168, 169, 170, 172, 173, 177 Nutritional Status, 8, 173 O Oncogenic, 165, 173 Oncology, 18, 22, 42, 43, 46, 53, 55, 56, 70, 84, 173 Ondansetron, 43, 173 Opiate, 26, 170, 171, 173 Opium, 170, 173 Outpatient, 19, 173 Ovary, 173, 184 Overdose, 68, 173 Oximetry, 12, 173 Oxygen Consumption, 158, 173, 180 Oxygenation, 154, 164, 173 P Palliative, 3, 18, 19, 33, 42, 58, 80, 85, 173, 185 Pallor, 41, 173 Pancreas, 141, 146, 154, 160, 173, 187 Panic, 25, 83, 173 Panic Disorder, 83, 173 Papilla, 174 Papillary, 70, 174 Paranasal Sinuses, 174, 182 Parenchyma, 25, 174 Paresthesias, 174 Parietal, 174, 175 Parotid, 174, 181 Paroxysmal, 8, 48, 58, 60, 61, 143, 174 Particle, 174, 187 Patch, 17, 152, 174 Pathogen, 165, 174 Pathologic, 24, 38, 62, 144, 153, 163, 174, 182, 188 Pathologic Processes, 24, 144, 174 Pathophysiology, 16, 23, 62, 174 Pelvic, 174, 177 Pelvis, 141, 174, 188 Penicillin, 144, 174 Peptide, 35, 36, 38, 40, 63, 70, 71, 72, 174, 176, 177 Perception, 21, 48, 49, 53, 58, 59, 62, 65, 67, 69, 72, 82, 85, 102, 112, 154, 174 Perforation, 159, 174 Perfusion, 164, 174
198
Dyspnea
Peristalsis, 4, 175 Pernicious, 169, 175 Perspiration, 154, 175 Pharmacologic, 6, 10, 143, 175, 186 Phenotype, 15, 25, 27, 62, 175 Phospholipids, 103, 158, 169, 175 Phosphorus, 147, 175 Phrenic Nerve, 26, 175 Physical Examination, 107, 175 Physiologic, 21, 24, 31, 35, 42, 45, 49, 63, 66, 142, 146, 175, 179 Physiology, 50, 64, 71, 160, 162, 172, 175 Pilot study, 25, 43, 65, 82, 83, 175 Pitch, 64, 175 Plants, 142, 145, 148, 150, 161, 170, 175, 183, 187 Plasma, 35, 144, 149, 159, 161, 162, 168, 175, 181 Platelet Aggregation, 172, 175 Platelets, 171, 172, 175, 181 Plethysmography, 76, 175 Pleura, 109, 175, 176 Pleural, 38, 40, 56, 109, 175, 176 Pleural cavity, 176 Pleural Effusion, 38, 40, 56, 109, 176 Pneumonectomy, 66, 71, 176 Pneumonia, 21, 36, 147, 152, 176 Podophyllotoxin, 157, 176 Poisoning, 88, 169, 171, 176 Polymorphic, 10, 16, 176 Polyneuritis, 154, 176 Polypeptide, 142, 151, 176 Polysaccharide, 144, 176, 177 Postoperative, 66, 176 Postsynaptic, 172, 176, 185 Post-traumatic, 20, 176 Postural, 61, 176 Potassium, 17, 176 Potassium Channels, 17, 176 Practice Guidelines, 124, 176 Precursor, 150, 157, 176, 187 Presynaptic, 172, 176, 185 Presynaptic Terminals, 172, 176 Prevalence, 16, 63, 177 Procaine, 167, 177 Progression, 8, 25, 27, 143, 177 Progressive, 10, 24, 32, 38, 48, 54, 62, 63, 64, 65, 82, 150, 155, 157, 171, 177, 178, 180 Proline, 151, 163, 177 Promethazine, 76, 177 Prophase, 177, 185
Prostate, 9, 146, 177, 187 Protease, 25, 151, 177 Protease Inhibitors, 25, 177 Protein S, 108, 146, 177 Proteins, 142, 143, 144, 149, 150, 151, 160, 162, 169, 170, 173, 174, 175, 177, 181, 186 Proteoglycans, 146, 177 Proteolytic, 142, 151, 177 Protocol, 9, 14, 29, 33, 50, 177 Proximal, 155, 176, 177, 181 Pruritus, 177 Psychiatry, 8, 25, 177, 188 Psychic, 169, 177, 181 Psychogenic, 36, 177 Psychology, 155, 178 Public Health, 10, 15, 16, 25, 124, 178 Public Policy, 123, 178 Publishing, 31, 178 Pulmonary Artery, 10, 12, 146, 178, 188 Pulmonary Circulation, 26, 29, 178 Pulmonary Edema, 26, 90, 109, 178 Pulmonary Fibrosis, 21, 22, 23, 27, 28, 39, 41, 128, 178 Pulmonary hypertension, 10, 178 Pulmonary Stretch Receptors, 26, 178 Pulmonary Ventilation, 164, 178, 180 Pulse, 12, 170, 173, 178 Pupil, 153, 154, 171, 178 Purines, 178, 181 Pyrimidines, 178, 181 Q Quality of Life, 5, 6, 8, 9, 12, 14, 15, 18, 20, 21, 23, 24, 28, 41, 43, 45, 56, 57, 80, 82, 84, 178 R Race, 142, 178 Racemic, 142, 178 Radiation, 22, 143, 158, 159, 160, 163, 165, 166, 178, 179, 189 Radiation therapy, 158, 163, 165, 166, 179, 189 Radioactive, 163, 164, 165, 166, 173, 179, 189 Radioimmunotherapy, 179 Radiolabeled, 166, 179, 189 Radiology, 7, 16, 173, 179 Radiolucent, 52, 179 Radiopharmaceutical, 160, 179 Radiotherapy, 22, 147, 166, 179, 189 Randomized, 6, 8, 14, 18, 20, 23, 25, 28, 33, 48, 156, 179 Randomized clinical trial, 20, 179
199
Receptor, 7, 12, 22, 25, 28, 144, 149, 173, 179, 181 Recombination, 160, 179 Rectum, 147, 154, 159, 160, 166, 177, 179 Recurrence, 150, 179 Red blood cells, 157, 162, 171, 179 Refer, 1, 151, 155, 172, 179, 187 Reflex, 7, 26, 28, 178, 179 Reflux, 4, 66, 180 Refraction, 180, 183 Regimen, 12, 155, 180 Regurgitation, 4, 162, 180 Reliability, 66, 102, 180 Renal failure, 46, 180 Resection, 35, 180 Respiration, 17, 28, 33, 144, 148, 149, 170, 178, 180 Respirator, 168, 180 Respiratory distress syndrome, 20, 180 Respiratory failure, 27, 42, 53, 109, 180 Respiratory Physiology, 42, 57, 180, 188 Respiratory System, 9, 17, 129, 142, 170, 180 Retina, 152, 180, 188 Retrospective, 15, 18, 180 Rhinitis, 166, 180 Ribose, 141, 180 Risk factor, 20, 25, 49, 51, 60, 180 Rod, 145, 150, 180 S Saline, 25, 147, 180 Sanatorium, 43, 104, 105, 180 Saphenous, 153, 180 Saphenous Vein, 153, 180 Sarcoidosis, 67, 90, 181 Sarcoma, 56, 181 Sclera, 152, 181, 188 Scleroderma, 7, 23, 28, 90, 181 Screening, 12, 63, 150, 181, 187 Secretion, 9, 23, 26, 150, 163, 171, 175, 181 Secretory, 9, 172, 181, 185 Sedative, 151, 177, 181 Sediment, 181, 188 Seizures, 174, 181 Semen, 92, 93, 94, 177, 181 Semisynthetic, 157, 181 Sensor, 9, 181 Septal, 68, 181 Serine, 24, 181 Serotonin, 172, 173, 181, 187 Serous, 157, 175, 181 Serum, 151, 168, 181, 187
Shock, 68, 163, 181, 187 Shoulder Pain, 59, 182 Shunt, 54, 182 Side effect, 115, 141, 171, 182, 186, 189 Signs and Symptoms, 109, 182 Sinusitis, 65, 182 Skeletal, 150, 182 Skin test, 13, 182 Skull, 182, 185 Sleep apnea, 17, 109, 182 Small intestine, 109, 155, 163, 166, 171, 182 Smooth muscle, 4, 26, 147, 163, 170, 182, 184 Sneezing, 23, 182 Social Environment, 178, 182 Social Support, 21, 182 Social Work, 20, 182 Sodium, 103, 104, 182 Soft tissue, 30, 146, 150, 182 Solid tumor, 155, 182 Solvent, 161, 183 Soma, 10, 183 Specialist, 70, 80, 130, 154, 183 Species, 145, 169, 170, 178, 183, 184, 187, 189 Spectrum, 107, 183 Sperm, 150, 183 Sphincter, 4, 167, 183 Spinal cord, 149, 169, 172, 179, 183 Spirometry, 12, 129, 183 Spleen, 168, 181, 183 Sporadic, 10, 183 Spores, 165, 183 Sprue, 109, 183 Sputum, 42, 49, 183 Squamous, 183, 188 Standard therapy, 12, 183 Steel, 150, 183 Stenosis, 32, 42, 54, 69, 183, 184 Sterile, 12, 183, 187 Steroids, 12, 16, 153, 161, 183 Stimulant, 155, 163, 183 Stimulus, 152, 155, 158, 165, 166, 167, 174, 179, 183, 186 Stomach, 141, 154, 157, 160, 163, 167, 171, 180, 182, 183 Stool, 109, 166, 184 Streptococcal, 37, 184 Streptococcus, 184 Stress, 5, 20, 42, 51, 68, 90, 148, 159, 171, 184 Stricture, 183, 184
200
Dyspnea
Stridor, 4, 51, 184 Stroke, 25, 122, 148, 184 Stroke Volume, 148, 184 Stroma, 25, 174, 184 Stromal, 22, 184 Stromal Cells, 22, 184 Subacute, 164, 182, 184 Subclinical, 16, 164, 181, 184 Subcutaneous, 21, 155, 184 Substance P, 181, 184 Sudden cardiac death, 25, 184 Superoxide, 22, 184 Superoxide Dismutase, 22, 184 Supplementation, 8, 184 Suppression, 17, 184 Supraventricular, 7, 184 Surfactant, 103, 184 Survival Rate, 15, 184 Symphysis, 150, 177, 185 Symptomatic, 16, 69, 104, 105, 185 Symptomatic treatment, 104, 105, 185 Synapse, 141, 172, 176, 185, 187 Synapsis, 185 Synaptic, 17, 172, 185 Synaptic Transmission, 17, 185 Systemic, 20, 23, 28, 69, 116, 117, 144, 146, 151, 154, 162, 165, 166, 179, 181, 185, 189 Systolic, 71, 164, 185 T Tachycardia, 7, 52, 145, 155, 185 Tachypnea, 27, 145, 185 Telecommunications, 185 Telemedicine, 105, 185 Temporal, 24, 185 Theophylline, 7, 116, 117, 178, 185 Therapeutics, 11, 117, 185 Thermal, 155, 172, 185 Thermodilution, 29, 185 Thoracic, 22, 33, 40, 53, 61, 66, 70, 154, 175, 186 Threonine, 181, 186 Threshold, 11, 18, 50, 164, 186 Thrombectomy, 156, 186 Thrombin, 175, 186 Thrombomodulin, 35, 186 Thrombosis, 165, 171, 177, 184, 186 Thymus, 168, 186 Thyroid, 161, 186 Thyroid Gland, 161, 186 Tidal Volume, 25, 102, 164, 186 Tissue Donors, 23, 186 Tolerance, 8, 31, 85, 186
Tomography, 186 Tone, 26, 186 Tonus, 186 Toxic, iv, 145, 148, 153, 154, 164, 176, 186, 187 Toxicity, 22, 41, 155, 169, 186 Toxicology, 16, 20, 124, 186 Toxin, 154, 157, 186, 187 Trachea, 28, 147, 166, 184, 186, 187 Tracheitis, 35, 187 Traction, 150, 187 Transduction, 9, 187 Transfection, 146, 187 Transmitter, 9, 141, 166, 168, 187 Transplantation, 22, 24, 63, 150, 186, 187 Trauma, 46, 59, 157, 171, 187 Tricyclic, 68, 187 Tryptophan, 151, 181, 187 Tubercle, 187 Tuberculin, 13, 187 Tuberculosis, 13, 47, 90, 180, 187 Tumor marker, 146, 187 Tumor Necrosis Factor, 35, 187 U Uncontrolled study, 6, 187 Uremia, 180, 187 Urethra, 177, 187, 188 Urinalysis, 13, 187 Urine, 13, 65, 145, 146, 155, 187, 188 Uterus, 149, 188 Uvea, 188 Uveitis, 43, 188 V Vaccine, 177, 188 Vagal, 7, 188 Vagus Nerve, 188 Vascular, 11, 71, 109, 157, 161, 165, 172, 186, 188 Vasoconstriction, 155, 188 Vasodilator, 12, 147, 163, 188 VE, 51, 188 Vector, 187, 188 Vein, 143, 145, 166, 173, 174, 180, 188 Venous, 26, 145, 177, 188 Ventilation, 7, 16, 30, 56, 148, 163, 188 Ventricle, 145, 178, 185, 188 Ventricular, 26, 68, 71, 156, 162, 188 Ventricular Dysfunction, 26, 156, 188 Veterinary Medicine, 123, 188 Vinblastine, 81, 188 Vinca Alkaloids, 188 Vindesine, 81, 188
201
Viral, 16, 107, 173, 187, 189 Virulence, 186, 189 Virus, 88, 107, 165, 187, 189 Vital Capacity, 22, 23, 28, 102, 159, 189 Vitro, 189 Vivo, 27, 189 W War, 51, 189 Weight Lifting, 30, 189
Wheezing, 13, 26, 50, 73, 76, 189 White blood cell, 144, 168, 171, 189 Wound Healing, 165, 189 X Xenograft, 143, 189 X-ray, 30, 152, 159, 160, 166, 173, 179, 189 X-ray therapy, 166, 189 Y Yeasts, 175, 189
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Dyspnea
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