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

ESTROGEN THERAPY A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J A...

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ESTROGEN THERAPY 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., 1960Estrogen Therapy: 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: 0-497-00424-0 1. Estrogen Therapy-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on estrogen therapy. 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 ESTROGEN THERAPY ................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Estrogen Therapy .......................................................................... 5 The National Library of Medicine: PubMed ................................................................................ 16 CHAPTER 2. NUTRITION AND ESTROGEN THERAPY....................................................................... 61 Overview...................................................................................................................................... 61 Finding Nutrition Studies on Estrogen Therapy......................................................................... 61 Federal Resources on Nutrition ................................................................................................... 62 Additional Web Resources ........................................................................................................... 62 CHAPTER 3. ALTERNATIVE MEDICINE AND ESTROGEN THERAPY ................................................ 65 Overview...................................................................................................................................... 65 National Center for Complementary and Alternative Medicine.................................................. 65 Additional Web Resources ........................................................................................................... 66 General References ....................................................................................................................... 67 CHAPTER 4. PATENTS ON ESTROGEN THERAPY ............................................................................. 69 Overview...................................................................................................................................... 69 Patents on Estrogen Therapy....................................................................................................... 69 Patent Applications on Estrogen Therapy ................................................................................... 72 Keeping Current .......................................................................................................................... 73 CHAPTER 5. BOOKS ON ESTROGEN THERAPY ................................................................................. 75 Overview...................................................................................................................................... 75 Book Summaries: Federal Agencies.............................................................................................. 75 Book Summaries: Online Booksellers........................................................................................... 76 Chapters on Estrogen Therapy..................................................................................................... 76 CHAPTER 6. PERIODICALS AND NEWS ON ESTROGEN THERAPY ................................................... 79 Overview...................................................................................................................................... 79 News Services and Press Releases................................................................................................ 79 Academic Periodicals covering Estrogen Therapy ....................................................................... 81 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 85 Overview...................................................................................................................................... 85 NIH Guidelines............................................................................................................................ 85 NIH Databases............................................................................................................................. 87 Other Commercial Databases....................................................................................................... 89 APPENDIX B. PATIENT RESOURCES ................................................................................................. 91 Overview...................................................................................................................................... 91 Patient Guideline Sources............................................................................................................ 91 Finding Associations.................................................................................................................... 94 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 97 Overview...................................................................................................................................... 97 Preparation................................................................................................................................... 97 Finding a Local Medical Library.................................................................................................. 97 Medical Libraries in the U.S. and Canada ................................................................................... 97 ONLINE GLOSSARIES................................................................................................................ 103 Online Dictionary Directories ................................................................................................... 103 ESTROGEN THERAPY DICTIONARY .................................................................................... 105 INDEX .............................................................................................................................................. 147

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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 estrogen therapy 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 estrogen therapy, 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 estrogen therapy, 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 estrogen therapy. 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 estrogen therapy, 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 estrogen therapy. The Editors

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

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

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

Prospective Study of Postmenopausal Estrogen Therapy and Subsequent Incidence of Non-Insulin-Dependent Diabetes Mellitus Source: Annals of Epidemiology. 2(5): 665-673. September 1992. Summary: This article reports on a study that examined the association between postmenopausal hormone use and the subsequent incidence of noninsulin-dependent diabetes mellitus (NIDDM) in a prospective cohort of 21,028 postmenopausal American women aged 30 to 55 years and free of diagnosed diabetes, cardiovascular disease, and cancer in 1976. During 12 years of follow-up (422,991 person-years), the researchers confirmed 1249 cases of NIDDM. Current users of postmenopausal hormones had a relative risk of NIDDM of 0.80 as compared with never users, after adjustment for age and body-mass index (BMI). Past users of these hormones had an age-and BMI-adjusted relative risk of 1.07. These results were not materially altered by multivariate adjustment

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for age, BMI, family history of diabetes, and coronary risk factors. The authors conclude that these prospective data indicate that postmenopausal hormone therapy is unlikely to be associated with a material increase in the incidence of NIDDM among women. 4 tables. 15 references. (AA-M). •

Estrogen Therapy and Noncognitive Psychiatric Signs and Symptoms in Elderly Patients With Dementia Source: American Journal of Psychiatry. 159(7): 1225-1227. July 2002. Summary: This article reports the efficacy and safety of short-term estrogen therapy in decreasing the noncognitive signs and symptoms of dementia. Sixteen elderly patients with moderate to severe dementia and aggressive behavioral disturbances were randomly assigned to receive conjugated equine estrogens or placebo in a 4-week clinical trial. Patients assigned to estrogen received dosages of 0.625, 1.250, 1.875, and 2.500 mg/day over weeks 1 through 4, respectively. The frequency and severity of noncognitive signs and symptoms of dementia were assessed with the Dementia Signs and Symptoms Scale. Data were analyzed with intent to treat and regression modeling methods. The estrogen group had a significantly greater improvement than the placebo group on the Dementia Signs and Symptoms Scale total score. All five subscale comparisons favored estrogen therapy as well. No adverse effects were observed. These findings suggest that short-term estrogen therapy may decrease the frequency and severity of noncognitive symptoms in elderly patients with dementia. 1 figure, 10 references. (AA-M).

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Open Trial on Transdermal Estrogen Therapy in Post-Menopausal Woman With Alzheimer's Disease Source: Alzheimer's Reports. 2(1): 17-22. January 1999. Summary: This journal article describes a study that tested the effects of brief transdermal estrogen therapy in 20 postmenopausal women with mild or moderate probable Alzheimer's disease (AD). Participants received 17-beta-estradiol via a transdermal patch plus oral medroxyprogesterone daily for 3 months. Researchers conducted gynecological and neurological examinations, blood parameter tests, caregiver interviews, functional rating scales, and psychometric tests during therapy and 4 weeks after withdrawal. Patients and caregivers reported on diary cards all adverse effects and new events. Caregivers completed monthly interviews on patients' cognitive and behavioral status. Researchers assessed tolerability, safety, and compliance, and evaluated changes in self-maintenance and cognition by comparing baseline scores with scores from the end of treatment and after washout. Results indicated patients had only minor side effects. Cognition assessment showed no changes in verbal performance and improvement in visuo-spatial performance. Functional rating scales showed no worsening and a trend to improvement. Three patients shifted from moderate to mild dementia. Positive effects remained 1 month after washout. Most caregivers reported a favorable global impression. The researchers conclude that transdermal estrogen therapy for mild and moderate AD is safe and tolerable with fairly good compliance and has a favorable effect on cognition and physical and daily living activity and self-maintenance. 5 tables, 26 references. (AA-M).

Studies

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Estrogen Therapy in Postmenopausal Women: Effects on Cognitive Function and Dementia Source: JAMA. Journal of the American Medical Association. 279(9): 688-695. March 4, 1998. Summary: This journal article reviews research on the effects of estrogen replacement therapy on cognition and dementia in postmenopausal women. The authors performed a MEDLINE search of studies published from January 1966 through June 1997, reviewed bibliographies of identified articles, and consulted experts. Biochemical and neurophysiologic studies suggest several mechanisms by which estrogen may affect cognition, including promotion of cholinergic and serotonergic activity in specific brain regions, maintenance of neural circuitry, favorable lipoprotein alterations, and prevention of cerebral ischemia. Thirteen studies examined the effect of estrogen use on cognitive function in postmenopausal women without dementia. The findings suggest that estrogen improves cognitive performance in recently menopausal women, but there is no clear benefit in asymptomatic women. Meta-analysis of 10 studies of estrogen use and dementia risk suggests a 29-percent decreased risk of developing dementia among estrogen users, but the study findings are heterogeneous. Four trials of estrogen use in women with Alzheimer's disease (AD) have been conducted and have had primarily positive results, but most were small, nonrandomized, uncontrolled, and of short duration. The authors conclude that large placebo-controlled trials are needed to determine estrogen's role in the prevention and treatment of AD and other dementias. 1 figure, 6 tables, 89 references. (AA-M).

Federally Funded Research on Estrogen Therapy The U.S. Government supports a variety of research studies relating to estrogen therapy. 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 estrogen therapy. 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 estrogen therapy. The following is typical of the type of information found when searching the CRISP database for estrogen therapy: •

Project Title: AGE & SKIN BLOOD FLOW Principal Investigator & Institution: Kenney, William L.; Pennsylvania State Univ Hershey Med Ctr 500 University Drive Hershey, Pa 170332390 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (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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Summary: In men and women over the age of 65, the skin blood flow (SkBF) in response to hyperthermia is severely attenuated. To date, we have elucidated the efferent neural pathway (the cutaneous active vasodilator system, a non-adrenergic efferent pathway unique to human skin) through which aging acts to decreaseSkBF at a given core temperature (TC) and put this decreased SkBF within the context of overall cardiovascular regulation and blood flow distribution. We have also demonstrated that unopposed exogenous estrogen therapy (acute or chronic) increases the SkBF response to an elevated TC in postmenopausal women. We plan to systematically examine potential mechanisms through whichthese negative (aging) and positive (estrogen) effects are exerted using new approaches and technology. We plan to compare older and younger men and women to examine the mechanism by which aging attenuates reflex active cutaneous vasodillation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AGE AND CONTROL OF HUMAN SKIN BLOOD FLOW Principal Investigator & Institution: Kenney, W. L.; Professor of Physiology and Kinesiology; Noll Physiological Res Ctr; Pennsylvania State University-Univ Park 110 Technology Center University Park, Pa 16802 Timing: Fiscal Year 2002; Project Start 30-SEP-1987; Project End 31-MAR-2004 Summary: (Adapted from the Applicant's Abstract): In men and women over the age of 65, the non-acral skin blood flow (SkBF) response to hyperthermia is significantly attenuated. The site of this age-related defect involves the active vasodilator system, a non-adrenergic efferent pathway unique to human skin. The proposed series of studies will systematically examine potential mechanisms through which the negative effects of aging and the positive effects of estrogen therapy are exerted. In older and younger men and women and in post-menopausal women taking various types of hormone replacement therapy or no therapy, the PI plans to (a) examine spatial distribution and heterogeneity of active cutaneous vasodilation to determine whether changes in functional capillary plexus unit density and/or flow contribute to alterations in SkBF using scanning laser-Doppler imaging; (b) examine the magnitude, spatial distribution, and heterogeneity of reflex-mediated noradrenergic cutaneous vasoconstriction during whole-body cooling and baroreceptor unloading using scanning laser-Doppler imaging; and (c) determine the role of nitric oxide (NO) in the control of active vasodilation by examining NO-dependent and independent changes in SkBF during hyperthermia using intradermal microdialysis. In addition, a fourth series of studies is proposed to quantify the upper limit of the prescriptive zone (ULPZ) and age-specific heat exchange coefficients in older versus younger healthy men and women during low-intensity activity. Data from this last proposed investigation operationalizes the SkBF decrement to allow policy-making by health organizations and for modeling biophysical and physiological responses of the elderly to extreme environments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ESTROGEN

ALZHEIMER'S

DISEASE:

THERAPEUTIC

POTENTIAL

OF

Principal Investigator & Institution: Asthana, Sanjay; Associate Professor & Head of Geriatrics; Medicine; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 01-MAY-2000; Project End 30-APR-2005

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Summary: Estrogen has multiple salutary neuromodulatory, neurotrophic, and neuroprotective properties. These salutary effects are presumable mediated through the estrogen receptors that are widely, but selectively distributed throughout the brain. In particular, estrogen receptors are densely populated in the neocortex, hippocampus, amygdala, and basal forebrain; areas of the brain that afflicted by Alzheimer's disease (AD) and underlie specific cognitive functions impaired in patients with AD. Moreover, these cognition-mediating regions of the brain demonstrate neurotrophic activity in response to estrogen release. Preliminary evidence from clinical studies indicates that administration of estrogen improves memory in postmenopausal women with AD. In addition, results of epidemiological studies suggest that estrogen therapy might reduce the risk of developing AD. However, several issues of critical clinical significance need to be further evaluated before the potential role of estrogen for the treatment of AD can be firmly established. These issues include the following: 1) whether the cognitionenhancing actions of estrogen are dose-dependent and persist over an extended period of administration, 2) if the salutary effects of estrogen on cognitive function will effectively translate into improved skills of independent living, 3) whether the potential beneficial effects on cognition and physical function will persist when estrogen is coadministered with a progestin over both short and extended periods, and finally, 4) whether ApoE genotype influences the therapeutic response of an individual to treatment with estrogen. The proposed randomized, double-blind, placebo-controlled, parallel-group design clinical study will evaluate the dose-dependent effects of prolonged administration of both unopposed and opposed (i.e., with a progestin) estrogen on cognitive function and skills of independent living in postmenopausal women with AD. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CENTER FOR CAM RESEARCH IN AGING Principal Investigator & Institution: Kronenberg, Fredi; Rehabilitation Medicine; Columbia University Health Sciences Po Box 49 New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 30-SEP-1999; Project End 31-JUL-2004 Summary: In recent years increasing numbers of Americans are using alternative approaches to conventional medicine. This includes 39% of people age 50 and older. Aging does not begin at age 65 but occurs across our life span. Physiological, social and psychological changes that occur during midlife can have major effects on health and thereby, the quality and duration of the rest of life. Such changes are particularly significant for women, where declining estrogen levels result in changes in the physiologic profile. Although estrogen therapy is widely recommended to midlife women with long term protection against heart disease, osteoporosis and Alzheimer's disease in mind, estrogen therapy is also associated with increased cancer risk and has side effects and most women choose not to take it. The initial focus of our proposed Center for CAM Research in Aging at Columbia University is on botanical and dietary approaches to clinical concerns of post menopausal women with the goal of rigorous evaluation of the efficacy, mechanisms of action, and possible risks of these approaches. The proposed Center contains three highly interactive clinical research projects and one basic science project, supported by administrative, biostatistical, and clinical research cores. Project One examines the influence of a macrobiotic diet, as compared to the addition of a single food to a typical diet, on various biochemical and cardiovascular parameters that may be influenced by estrogens. Project Two assesses whether these natural, dietary sources of estrogen prevent postmenopausal bone loss, one of the most important current public health challenges. State-of-the-art approaches to measurement

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of markers of bone formation and bone resorption will be combined with highly sensitive quantitation of bone mass. Project Three is designed to determine whether treatment with herb black cohosh is effective in reducing the frequency and intensity of menopausal host flashes. Project Four examines the bioactivity, mechanisms of action, and potential risks of a widely-used Chinese Herbal formula in cell culture and in vivo. All of the Program Projects are led by Principal Investigators with an active interest in complementary and alternative medicine and extensive experience with both clinical populations and basic research. While the proposed Center for CAM in Aging will initially evaluate dietary and herbal treatments in postmenopausal women, the score of work will be expanded through the Developmental Research Program to include other CAM modalities. In addition, a strong Career Development Program is proposed that will provide a critical link between researchers with an interest in CAM at Columbia and the larger CAM community. The proposed Center will take advantage of the unique institutional resources available at Columbia, will develop an interdisciplinary research program that targets significant health problems of aging, and will conduct the timely education and training of future CAM researchers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CEREBRAL ISCHEMIA IN THE FEMALE Principal Investigator & Institution: Hurn, Patricia D.; Professor and Vice Chairman for Research; Anesthesiology/Crit Care Med; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-FEB-1995; Project End 31-JAN-2004 Summary: In this animal research protocol, the investigators propose to ascertain the cerebral blood flow and metabolic effects of the presumed neuroprotective female hormones during and following global cerebral ischemia. Specifically, the proposed study will determine the effect of global cerebral ischemia on cerebral blood flow (CBF), energy metabolism, and pial vessel reactivity in female animals compared to their male counterparts. The investigators also will evaluate whether or not the female hormone, beta- estradiol, plays an important role in recovery mechanisms from ischemia. Unneutered males also will be studied to determine if there are important gender-specific recovery responses during ischemia/reperfusion and if any therapeutic benefit from reproductive steroid administration is limited to females. The proposed experiments will explore two specific mechanisms of ischemic injury in vivo; specifically, 1) acidosis leading to depressed recovery of energy metabolism, loss of pH regulation, and related iron- catalyzed oxidant injury; and 2) microvascular endothelial dysfunction. To study these variables, the investigators will use magnetic resonance (MR) spectroscopy and intravital microscopy to determine if estradiol acts via specific cellular mechanisms. Four Specific Aims are presented. In Specific Aim #1, the investigators will test the hypothesis that ischemic acidosis is less in females, with consequently more complete recovery of brain energy phosphates compared to males; and that chronic estrogen therapy further improves post-ischemic recovery of energy metabolism and intracellular pH. Specific Aim #2 will examine the effect of pre-ischemic hyperglycemia and its consequent exaggerated tissue acidosis on metabolic recovery, testing the hypothesis that the anti- oxidant activity of estradiol decreases vulnerability to hyperglycemiamediated reperfusion injury. Intravital microscopy will be employed in Specific Aim #3 to determine if post-ischemic pial vessel reactivity to endothelium-dependent pharmacologic agents is impaired in females and estradiol-treated animals. Finally, Specific Aim #4 will test the hypothesis that chronic estradiol therapy increases brain cGMP, nitric oxide synthase activity and pial vessel responsivity to NO-mediated agents

Studies

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in a dose-dependent manner. The information derived from these experiments should contribute to our understanding of vascular function in females at decreased risk for cerebrovascular disease relative to males and of the role of estrogen as potential neuroprotective therapy for patients of either sex. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECT OF IRBESARTAN PLUS ESTRACE COMPARED TO IRBESARTAN ALONE Principal Investigator & Institution: Seely, Ellen W.; Professor; Brigham and Women's Hospital 75 Francis Street Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: The purpose of this study is to test the hypothesis that combined irbesarten and estrogen therapy has an additive effect on improving vascular reactivity, renal blood flow, blood pressure lowering, and lipid profile when compared to either agent alone. Irbesarten is an investigational new drug to treat high blood pressure. This is an investigator-initiated, industry sponsored study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ENVIRONMENTAL FACTORS AND INFLAMMATORY BOWEL DISEASE Principal Investigator & Institution: Higuchi, Leslie M.; Children's Hospital (Boston) Boston, Ma 021155737 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-JUL-2008 Summary: (provided by applicant): This K08 award application is designed to enrich the candidate's career development in the epidemiology of gastrointestinal diseases. The program integrates mentored "hands on" experience in the proposed research plan on inflammatory bowel disease (IBD), didactic coursework to advance the knowledge and skills of the candidate, and enhanced interactions with other investigators through seminars, conferences, and scientific meetings. In the later years of the 5-year proposed program, the candidate plans to expand her work in the epidemiology of pediatric gastrointestinal illnesses. The candidate's sponsor is Dr. Richard J. Grand, an accomplished pediatric gastroenterologist with significant established experience in the field of IBD. Her co-sponsor is Dr. Graham A. Colditz, the Principal Investigator of the Nurses' Health Study at the Channing Laboratory. The program combines the institutional resources of the Children's Hospital, Boston and the Channing Laboratory of the Brigham and Women's Hospital, Harvard medical School. The Research proposal is a prospective cohort study to examine the association of environmental factors and the two types of IBD, Crohn's disease (CD) and ulcerative colitis (UC). The study base population will be composed of the Nurses' Health Study (NHS I) and the Nurses' Health Study II (NHS II) cohorts. Specific Aim 1 is to establish a database of confirmed cases of CD and UC in the NHS I and NHS II cohorts. Specific aims 2 through 4 will examine the association of specific dietary factors, smoking, and exogenous estrogen therapy and the development of CD or UC. Since the establishment of the NHS I in 1976 and the NHS II in 1989, information pertaining to participants' dietary intake and lifestyle factors has been updated at regular intervals, prior to the onset of CD or UC. Cases of CD and UC will be identified by biennial questionnaires and confirmed by medical chart review using established criteria. Analyses will compare age-specific incidence rates of CD and UC within different exposure categories, multivariate analyses, using the Cox proportional hazards model, will be performed. The proposed

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study will establish a unique database of repeated dietary and lifestyle assessments over several decades and will provide the opportunity to examine the influence of nutritional and lifestyle risk factors on IBD risk, improve our understanding of IBD pathogenesis, and define potential methods of prevention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ESTROGEN AND THE AGING BLOOD BRAIN BARRIER Principal Investigator & Institution: Chi, Oak Z.; Associate Professor; Anesthesiology; Univ of Med/Dent Nj-R W Johnson Med Sch Robert Wood Johnson Medical Sch Piscataway, Nj 088545635 Timing: Fiscal Year 2002; Project Start 01-JUL-2002; Project End 30-JUN-2004 Summary: The purpose of this project is to investigate the health related consequences of female reproductive aging. An intact blood-barrier (BBB) is essential in maintaining the homeostasis of the brain. With aging, even through the baseline permeability of the BBB may not change, there are reports that it could become more vulnerable to pathophysiological insults and could easily be disrupted. Even though the benefit of postmenopausal estrogen replacement therapy for stroke is not yet established clinically, in most studies using laboratory animals, the size of infarction and the neurological deficit are significantly reduced after middle cerebral artery (MCA) occlusion when treated with estrogen. The mechanism of neuroprotection by estrogen could be of vascular and/or non-vascular origin. Our preliminary data suggest that estrogen may protect the BBB. During cerebral ischemia, BBB disruption is a critical event leading to vasogenic edema and secondary brain injury. We hypothesize the following: 1. One of the mechanisms of neuroprotection by estrogen would be through attenuating the degree of BBB disruption caused by focal cerebral ischemia. 2. When the BBB is damaged, the degree of disruption could be greater in the senescent than in the young brain. 3. Pretreatment with estrogen would decrease the degree of the BBB disruption in the senescent brain. These hypotheses will be studied in ovariectomized young (4-5 months) and old (22-24 months) and very old (30-32 months) female rats. The BBB will be disrupted by MCA ligation. Rats will be chronically treated with low and high doses of estrogen. Since estrogen may alter the BBB itself and/or perfused capillary surface area, the transfer coefficient, perfused capillary surface area, and permeability for both small and large molecules will be determined in this proposal. Quantitative tissue analysis to determine the effects of estrogen on distribution on distribution and changes in the permeability of cerebral capillaries during BBB disruption will be performed. We will also examine whether the interaction between estrogen and excitatory amino acids in BBB protection. These studies will answer whether estrogen protects BBB in the senescent brain. This study will form the basis of future studies on the BBB of the senescent brain in order to determine the mechanism by which estrogen protects the BBB and the effects of estrogen on receptors, messages, and protein levels, and their changes with aging. We thing this is related, in part, to reduced excitotoxicity. The information obtained from our study will be crucially important for the clinical application of estrogen therapy for stroke as well as understanding the pathophysiology of age related cerebrovascular changes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ESTROGEN STATUS AND THE FUNCTION OF CORONARY ARTERIES Principal Investigator & Institution: Miller, Virginia M.; Professor of Surgery and Physiology; Mayo Clinic Coll of Medicine, Rochester 200 1St St Sw Rochester, Mn 55905

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Timing: Fiscal Year 2002; Project Start 01-DEC-1993; Project End 30-JUN-2004 Summary: Epidemiological and experimental studies indicate that estrogen treatment reduces cardiovascular disease in women and female experimental animals. Estrogen directly affects functions of endothelial and smooth muscle cells. Estrogen could also influence development of cardiovascular disease through modulating functions of blood elements. Effects of estrogen on platelets are little known and controversial. Understanding how estrogen therapy modulates platelets is important as platelets are physiological "first-responders" at the site of vascular injury be it mechanical denudation or endothelial dysfunction. Since platelets release both vasoactive and mitogenic factors, they are key in establishing conditions for immediate vasoconstriction and long-term remodeling of the vascular wall. The central hypothesis of this renewal application is that estrogen replacement REDUCES vascular response to injury by reducing platelet activation, release of platelet- derived vasoactive and mitogenic factors and responses of endothelium and vascular smooth muscle to platelet-derived factors. These actions of estrogen require both genomic and non-genomic receptor-mediated mechanisms. A unique approach will be taken to examine effects of estrogen on platelet count, irritability, contents and turnover in vitro and in vivo. Relationship between platelet functions and expression of estrogen receptors will be identified in estrogentreated animals and mice lacking estrogen receptors (estrogen receptor knockout mice). Production of endothelium-derived nitric oxide and endothelin-l will be examined in response to platelet-derived factors from estrogen-treated animals. In addition, regulation of intracellular calcium, contraction and proliferation of the smooth muscle to platelet- factors will be examined. As thrombosis is a major side-effect in women taking estrogen replacement therapy including the new selective estrogen receptor modulators (SERMS), systematic studies are needed in order to better understand specific effects of estrogens on platelet function and interaction of platelets with the vascular wall. The experiments of this proposal take such an approach using molecular to integrated whole animal physiology. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ESTROGEN, CYTOKINES AND HEART FAILURE IN WOMEN Principal Investigator & Institution: Reis, Steven E.; Medicine; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 10-DEC-2001; Project End 30-NOV-2006 Summary: (provided by applicant): Congestive heart failure (CHF) is a leading cause of morbidity, mortality, and hospitalization in women. The observation that women with nonischemic cardiomyopathy have an age-related increase in mortality suggests that postmenopausal estrogen loss may alter the phenotypic expression of CHF. Because estrogen is a potent in vitro inhibitor of pro-inflammatory cytokines (e.g., TNFa, IL-1B, IL-6), which are re-expressed by the failing myocardium in patients with CHF and are related to an adverse prognosis, we postulate that estrogen replacement will improve the outcome of postmenopausal women with CHF. This hypothesis is supported by our preliminary data that demonstrate 1) female sex confers a survival advantage in transgenic mice with CHF due to over-expression of TNFa, 2) female sex is associated with an attenuated pathologic response of cardiac myocytes to TNFa, 3) estrogen and progesterone inhibit TNFa production by rat cardiac myocytes, 4) estrogen replacement therapy in postmenopausal women with CHF abrogates an age-related increase in TNFa, and 5) estrogen therapy in women with severe CHF is associated with a significant decrease in mortality. Our proposed randomized placebo-controlled doubleblind study of hormone replacement therapy in women with CHF will evaluate the

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hypothesis that estrogen has a protective effect in postmenopausal women with CHF related to modulation of TNFa and associated "downstream" cytokines (i.e., IL-lB. IL-6) and/or myocardial expression of cytokine receptors. We plan to compare the effects of hormones on functional capacity, biventricular mass and function, and quality of life with their effects on circulating cytokines in postmenopausal women with CHF. To determine the degree of hormone-induced cytokine suppression that is associated with favorable outcome, we will compare post-treatment cytokine levels in women with CHF with cytokine levels in a "control" group of women from the NHLBI WISE study who have no evidence of CHF and normal ventricular function. The results of this study will define the mechanism of estrogen's beneficial effect in postmenopausal women with CHF. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ESTROGEN/PLATELET INTERACTION IN CEREBRAL ISCHEMIA Principal Investigator & Institution: Kearney, Marguerite L.; Associate Professor; Anesthesiology/Crit Care Med; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-MAR-2000; Project End 28-FEB-2005 Summary: Platelet activation in the cerebrovasculature has been implicated as a mediator of tissue injury following stroke or other ischemic events. Data suggest that pre-menopausal women are at lower risk than men for cardiovascular diseases including stroke and transient ischemic attacks, conceivably due to the effects of estrogenic hormones on platelet biology or vascular function. Many women make a choice to receive hormone replacement therapy, but controversy surrounds the risks versus the benefits of estrogen therapy. Recent studies indicate that increasing estrogen levels promotes expression of the antiaggregant vasodilator, nitric oxide (NO), while depressing platelet elaboration of the adhesion molecule, P-selectin. We propose to study the effects of elevated estrogen on platelet biology to determine if the hormone moderates alterations in pre and post-ischemic platelet function or microvascular vasodilator capacity via the expression of vasoconstrictive platelet products. In Aim 1 we will determine if chronic estrogen in two physiologic doses modulates platelet biologic via a P-selectin mediated mechanism at baseline or after global cerebral ischemia. In Aim 2 we will test if chronic estrogen in two physiologic doses modulates changes in post-ischemia pial vessel vasodilatory capacity via attenuation of the release of adhesive or vasoactive platelet products. In Aim 3 we study the interrelationship between NO and P-selectin expression. We will determine, if the effects of chronic estrogen treatment in two physiologic doses improves microvascular perfusion by depressing post-ischemic platelet and endothelial P-selectin as a result of increased nitric oxide production. We will use whole blood platelet aggregometry, intravital microscopy, immunological and biochemical techniques to ascertain how estrogen affects platelet biology and microvascular endothelial function. The studies proposed in this project will clarify the contribution of exogenous estrogen therapy in ischemic brain injury both mechanistically and according to dosage. These are important considerations which impact nursing therapeutics given the controversy surrounding the safety and efficacy of estrogen replacement regimens. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HORMONE REPLACEMENT THERAPY AND BREAST CANCER Principal Investigator & Institution: Paganini-Hill, Annlia; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033

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Timing: Fiscal Year 2002 Summary: Combination estrogen-progestogen therapy for postmenopausal women has become increasingly popular since the mid-1970s. Early on, clinicians widely believed that, in addition to reducing the risk of endometrial cancer associated with unopposed estrogen therapy, such therapy would reduce the risk of breast cancer. It was assumed that progestogens had an "anti-estrogen" effect on breast tissue comparable to that on the endometrium, with the results of a large prospective study of women receiving various modes of therapy widely quoted as supporting this view. However, the finding of an increased risk of breast cancer associated with combination oral contraceptive therapy given around the time of menopause and the observation that breast tissue mitotic activity peaks during the luteal phase of the menstrual cycle suggest estrogenprogestogen therapy may actually increase breast cancer risk in postmenopausal women. Experimental data support this notion, as does suggestive but inadequate data on use of progestogen-only contraceptives. One prospective epidemiologic study of combination therapy and breast cancer also suggests an increased risk but the number of cases was small. To determine the effect on breast cancer risk of combination estrogenprogestogen hormonal replacement therapy as well as of unopposed estrogen replacement therapy, we have been conducting a large case-control study. Preliminary analysis from 1355 cases and 884 controls indicate that unopposed estrogen therapy moderately increases breast cancer risk overall, but in a duration and dose-related fashion. The addition of a progestogen appears to enhance these estrogen-related effects and leads to a further increase in breast cancer risk. We wish to expand this study to address more adequately duration and latency effects, the possible interaction between use of hormone replacement therapy and other breast cancer risk factors, and to confidently assess differences in risk levels with use of combination versus unopposed replacement therapy. Breast cancer patients are English- or Spanish-speaking women aged 55 and over, of all races except Asian, born in 1923 or later, and identified by our population-based tumor registry over a six year period. Controls are individually matched to cases by age (+3 years), race and neighborhood of residence. A structured interview form supplemented by a comprehensive manual containing color photographs of all types of estrogen and progestogen pills is employed for the in-person interviews. Validation of hormone therapy is accomplished by a review of physician records. The 3000 case-control pairs to be interviewed will allow for the evaluation of the effects of estrogen and estrogen- progestogen therapy on breast cancer risk in the presence of possible confounding variables, such as age at and type of menopause and weight, and for testing for interactions between hormone therapy and other breast cancer risk factors, such as benign breast disease, and for careful evaluation of the effects of duration and latency. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IGF-1 AND BONE LOSS IN WOMEN ANOREXIA NERVOSA Principal Investigator & Institution: Klibanski, Anne; Professor of Medicine; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2003; Project Start 19-MAY-1997; Project End 31-AUG-2008 Summary: (provided by applicant): Anorexia nervosa is an increasingly common disorder among young women, characterized by self-imposed restrictive nutritional practices, which occurs in 0.5 to 1% of college-age women in the United States. This psychiatric disorder results in significant medical complications, which cause morbidity and increased mortality. Bone loss is a severe, frequent and often permanent co-morbid medical complication of anorexia nervosa, resulting in crush fractures. The majority of

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young women have evidence of bone loss and 50% of women have bone density measurements greater than 2 SD below normal and below the fracture threshold. The extreme rapidity of bone loss in anorexia nervosa is well documented. Of importance, bone loss can occur in less than one year. Reduced bone mass is often permanent, despite recovery and such young women will have a permanent increased risk of fractures throughout life. Anorexia nervosa is a unique state of imbalanced bone turnover with decreased bone formation and increased resorption. In contrast to other states of bone loss associated with estrogen deficiency, estrogen therapy is ineffective in stabilizing or improving bone mass. Therefore, the bone loss seen in anorexia nervosa is unique in terms of severity and pathogenesis. Given the complex medical issues in patients with this disorder, approaches to the prevention and treatment of osteoporosis differ from other populations. Effective therapy of bone loss during acute illness would reduce fracture risk throughout life. Of importance, a therapeutic intervention may only need to be used for a relatively short period of time while the disease is still active in many patients. Because there are currently no treatments for this serious medical sequelae of anorexia nervosa, it is critical to develop efficacious treatment strategies to prevent the significant morbidity associated with osteopenia in this population. Testosterone is a nutritionally regulated endogenous anabolic hormone which stimulates bone formation and has anti-resorptive effects. Anorexia nervosa leads directly to testosterone deficiency. We hypothesize that testosterone plays a critical role in bone turnover and long-term, it's administration will improve bone density and prevent the progressive debilitating osteopenia in young women with anorexia nervosa. We have now demonstrated an effect of short-term testosterone administration to increase markers of bone formation and/or resorption. Because of its effects on bone formation, testosterone may represent a novel approach to treating the severe osteoporosis resulting from anorexia nervosa in young women. We now have preliminary data demonstrating that Actonel, a bisphosphonate, can decrease bone resorption and increase bone mass in these women. In the current proposal we will investigate the physiology of the effects of testosterone administration of rhlGF-I to reverse the androgen deficiency state. We will investigate the effects of testosterone on bone turnover and whether it has prolonged effects on bone density. We will determine whether a combined anabolic and anti-resorptive strategy using testosterone and Actonel will increase bone formation, decrease resorption and increase bone density. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISMS OF HORMONE THERAPY IN POSTMENOPAUSAL WOMEN Principal Investigator & Institution: Newby, L K.; Medicine; Duke University Durham, Nc 27710 Timing: Fiscal Year 2002; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: The use of unopposed estrogen of combined estrogen/progestin therapy for primary and secondary prevention of coronary disease events in post- menopausal women is gaining favor in the United States. Support for this practice is based largely on epidemiological association of a reduction in the risk of death and non-fatal myocardial infarction in populations of women mostly without prior coronary artery disease who took estrogen for a variety of reasons. The effects of adding a progestin to estrogen are less well studied. Because the potential public health impact from treatment of postmenopausal women with hormone replacement therapy for prevention of coronary artery disease events is enormous, it is imperative to establish a fund of knowledge that supports and aids in the interpretation of clinical trials data to help establish the group

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or groups for whom treatment should be recommended and when it should be initiated. To accomplish these goals we propose: 1. Using non-invasive measurement of vascular reactivity, to quantify the effect on vascular endothelial function of the addition of progesterone to estrogen therapy in post-menopausal women with and without coronary artery disease. 2. To study the effect of various combinations of postmenopausal hormone therapy on the coagulation system. 3. To use accumulated clinical trials databases to study clinical factors that may influence the efficacy of hormone replacement therapy for secondary prevention of coronary artery disease in postmenopausal women. The propose work will provide additional understanding of the mechanism of estrogen action on endothelial function (which is postulated to be the major mechanism of the beneficial effects of estrogen) and the effects of adding progestins to estrogen replacement regimens. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THROMBOSIS GENE POLYMORPHISMS AND EARLY CHD RISK IN HERS Principal Investigator & Institution: Herrington, David M.; Professor; Internal Medicine; Wake Forest University Health Sciences Winston-Salem, Nc 27157 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2004 Summary: (provided by applicant): The Heart and Estrogen/progestin Replacement Study (HERS) and several other clinical studies and clinical trials have observed a transient increase in risk for coronary heart disease (CHD) events after initiation of hormone replacement therapy (HRT). Some evidence suggests that this adverse effect of HRT may be limited to a subgroup of women who are uniquely at risk for a thrombotic complication of estrogen therapy. There are several well-described polymorphisms in genes whose products regulate coagulation or fibrinolysis that could augment thrombotic risk in the setting of estrogen therapy. These polymorphisms include Factor V Leiden, prothrombin 20210A, Factor VII R353Q. plasminogen activator inhibitor-1 (PAI-1) 4G/5G, fibrinogen B-beta-455A, and platelet GP IIIa P1-A1.A2. We propose a nested case-control study among HERS women with CHD (n = 361) or venous thrombotic events (VTEs) (n = 95) and two clinic-matched controls to assess the relation between the above listed polymorphisms, HRT, and risk for CHD or VTEs. We will estimate the absolute and relative risk of HRT among women with and without the six candidate thrombosis gene polymorphisms and test for evidence of a genotype * HRT interaction. In secondary analyses, we will focus on events that occurred in the first year, evaluate the effect of triglycerides on risk associated with the Factor VII and PAI-1 polymorphisms, and explore the impact of combinations of polymorphisms on risk. DNA for this project will be acquired from centrally stored Pap smears that were collected during the trial. If this project reveals a high-risk subgroup based on thrombosis gene polymorphisms, women could be screened for this condition and cautioned not to use HRT. Conversely, low-risk women might be able to use HRT more safely in pursuit of various health benefits, including a possible reduction in CHD risk. Thus, this project may lead to more effective strategies to prevent CHD in women, enhance the safety of HRT, and add to the expanding body of knowledge concerning drug/gene interactions as they relate to treatment and prevention of disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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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.3 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 estrogen therapy, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “estrogen therapy” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for estrogen therapy (hyperlinks lead to article summaries): •

A case of fatal pulmonary thromboembolism associated with the use of intravenous estrogen therapy. Author(s): Zreik TG, Odunsi K, Cass I, Olive DL, Sarrel P. Source: Fertility and Sterility. 1999 February; 71(2): 373-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9988414

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A case-control study of menopausal estrogen therapy and breast cancer. Author(s): Ross RK, Paganini-Hill A, Gerkins VR, Mack TM, Pfeffer R, Arthur M, Henderson BE. Source: Jama : the Journal of the American Medical Association. 1980 April 25; 243(16): 1635-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7359751

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A cohort study of topical vaginal estrogen therapy in women previously treated for breast cancer. Author(s): Dew JE, Wren BG, Eden JA. Source: Climacteric : the Journal of the International Menopause Society. 2003 March; 6(1): 45-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12725664

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A prospective study of postmenopausal estrogen therapy and coronary heart disease. Author(s): Stampfer MJ, Willett WC, Colditz GA, Rosner B, Speizer FE, Hennekens CH. Source: The New England Journal of Medicine. 1985 October 24; 313(17): 1044-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4047106

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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 prospective study of postmenopausal estrogen therapy and subsequent incidence of non-insulin-dependent diabetes mellitus. Author(s): Manson JE, Rimm EB, Colditz GA, Willett WC, Nathan DM, Arky RA, Rosner B, Hennekens CH, Speizer FE, Stampfer MJ. Source: Annals of Epidemiology. 1992 September; 2(5): 665-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1342318

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A risk-benefit analysis of elective bilateral oophorectomy: effect of changes in compliance with estrogen therapy on outcome. Author(s): Speroff T, Dawson NV, Speroff L, Haber RJ. Source: American Journal of Obstetrics and Gynecology. 1991 January; 164(1 Pt 1): 16574. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1986605

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A risk-benefit assessment of estrogen therapy in postmenopausal women. Author(s): Cust MP, Gangar KF, Hillard TC, Whitehead MI. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 1990 September-October; 5(5): 345-58. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2222868

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A safe and effective alternative to estrogen therapy. Author(s): Glass SJ. Source: American Journal of Obstetrics and Gynecology. 1977 April 15; 127(8): 895. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=851154

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A systematic review of the skeletal effects of estrogen therapy in postmenopausal women. I. An assessment of the quality of randomized trials published between 1977 and 1995. Author(s): Henry D, Robertson J, O'Connell D, Gillespie W. Source: Climacteric : the Journal of the International Menopause Society. 1998 June; 1(2): 92-111. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11907921

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A systematic review of the skeletal effects of estrogen therapy in postmenopausal women. II. An assessment of treatment effects. Author(s): O'Connell D, Robertson J, Henry D, Gillespie W. Source: Climacteric : the Journal of the International Menopause Society. 1998 June; 1(2): 112-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11907914

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Actions of progestins on the morphology and biochemistry of the endometrium of postmenopausal women receiving low-dose estrogen therapy. Author(s): Whitehead MI, Townsend PT, Pryse-Davies J, Ryder T, Lane G, Siddle N, King RJ. Source: American Journal of Obstetrics and Gynecology. 1982 March 15; 142(6 Pt 2): 7915. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6278933

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Aging, Alzheimer's disease, and estrogen therapy. Author(s): Giacobini E. Source: Experimental Gerontology. 1998 November-December; 33(7-8): 865-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9951629

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Application of cost-effectiveness analysis to post-menopausal estrogen therapy. Author(s): Utian WH. Source: Frontiers of Hormone Research. 1977; 5: 26-39. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=208881

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ARS Presidential Address: Estrogen therapy: a causal role in endometrial cancer? Author(s): Rutledge FN. Source: Am J Roentgenol. 1976 December; 127(6): 897-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=998825

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Associations of age, adiposity, alcohol intake, menstrual status, and estrogen therapy with high-density lipoprotein subclasses. Author(s): Williams PT, Vranizan KM, Austin MA, Krauss RM. Source: Arterioscler Thromb. 1993 November; 13(11): 1654-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8218107

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Atrial natriuretic peptide, plasma renin activity, and aldosterone in women on estrogen therapy and with premenstrual syndrome. Author(s): Davidson BJ, Rea CD, Valenzuela GJ. Source: Fertility and Sterility. 1988 November; 50(5): 743-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2972566

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Benefit/risk of estrogen therapy in cardiovascular disease: current knowledge and future challenges. Author(s): Chow MS. Source: Journal of Clinical Pharmacology. 1995 September; 35(9 Suppl): 11S-17S. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8530712

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Benign breast disease in women on estrogen therapy. A pathologic study. Author(s): Fechner RE. Source: Cancer. 1972 February; 29(2): 273-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5013532

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Bilateral orchiectomy for carcinoma of prostate. Response of serum testosterone and clinical response to subsequent estrogen therapy. Author(s): Klugo RC, Farah RN, Cerny JC. Source: Urology. 1981 January; 17(1): 49-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7456197

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Bilateral synchronous carcinoma of the male breast in a patient receiving estrogen therapy for carcinoma of the prostate: cause or coincidence? Author(s): Coard K, McCartney T. Source: Southern Medical Journal. 2004 March; 97(3): 308-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15043344

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Body fluid and electrolyte balance during estrogen therapy of prostatic cancer. Author(s): Konitturi MJ, Sotaniemi EA, Larmi TK. Source: The Journal of Urology. 1974 May; 111(5): 652-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4363078

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Bone remodeling and structure in postmenopausal women treated with long-term, high-dose estrogen therapy. Author(s): Vedi S, Purdie DW, Ballard P, Bord S, Cooper AC, Compston JE. Source: Osteoporosis International : a Journal Established As Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the Usa. 1999; 10(1): 52-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10501780

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Breast cancer and estrogen therapy. Author(s): Blair V. Source: Jama : the Journal of the American Medical Association. 1994 October 5; 272(13): 1004-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8089881

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Breathing during sleep in menopause: a randomized, controlled, crossover trial with estrogen therapy. Author(s): Polo-Kantola P, Rauhala E, Helenius H, Erkkola R, Irjala K, Polo O. Source: Obstetrics and Gynecology. 2003 July; 102(1): 68-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12850609

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Bronchospasm secondary to replacement estrogen therapy. Author(s): Collins LC, Peiris A. Source: Chest. 1993 October; 104(4): 1300-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8404220

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By the way, doctor. I went through menopause about 10 years ago and have been taking estrogen therapy ever since. My uterus was removed because of fibroids, so there is no risk of endometrial cancer, which is why I am taking estrogen without progesterone. Should I have a bone density scan? A lot of my friends are having them, but I'm not sure how this test could alter my therapy. Author(s): Lee TH. Source: Harvard Health Letter / from Harvard Medical School. 2000 March; 25(5): 7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10677201

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Calcium supplements increase bone mineral density in women with low serum calcium levels during long-term estrogen therapy. Author(s): Mizunuma H, Okano H, Soda M, Tokizawa S, Kagami I, Miyamoto S, Honjo S, Ibuki Y. Source: Endocrine Journal. 1996 August; 43(4): 411-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8930529

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Cardiovascular complications of estrogen therapy for nondisseminated prostatic carcinoma. A preliminary report from a randomized multicenter study. Author(s): Lundgren R, Sundin T, Colleen S, Lindstedt E, Wadstrom L, Carlsson S, Hellsten S, Pompeius R, Holmquist B, Nilsson T, et al. Source: Scandinavian Journal of Urology and Nephrology. 1986; 20(2): 101-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3529368

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Cellular estrogen activity: implications for pulsed estrogen therapy. Author(s): Carlstedt-Duke J. Source: Maturitas. 2001 June 15; 38 Suppl 1: S7-S13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11390119

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Changes in psychological well-being during postmenopause as a result of estrogen therapy. Author(s): Durst N, Maoz B. Source: Maturitas. 1979 June; 1(4): 301-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=233111

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Changing trends and prognostic features in endometrial cancer associated with exogenous estrogen therapy. Author(s): Robboy SJ, Bradley R. Source: Obstetrics and Gynecology. 1979 September; 54(3): 269-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=471366

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Clear-cell adenocarcinoma ("mesonephroma") of the vagina. 3 cases associated with maternal synthetic nonsteroid estrogen therapy. Author(s): Tsukada Y, Hewett WJ, Barlow JJ, Pickren JW. Source: Cancer. 1972 May; 29(5): 1208-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5021613

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Clinical evaluation, dose-finding and acceptability of AERODIOL, the pulsed estrogen therapy for treatment of climacteric symptoms. Author(s): Pelissier C, de Kervasdoue A, Chuong VT, Maugis EL, de Mouillac F, Breil MH, Moniot G, Zeitoun-Lepvrier G, Robin M, Rime B. Source: Maturitas. 2001 January 31; 37(3): 181-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11173180

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Comparison of Alora estradiol matrix transdermal delivery system with oral conjugated equine estrogen therapy in relieving menopausal symptoms. Alora Study Group. Author(s): Good WR, John VA, Ramirez M, Higgins JE. Source: Climacteric : the Journal of the International Menopause Society. 1999 March; 2(1): 29-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11915854

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Comparison of alveolar bone loss, alveolar bone density and second metacarpal bone density, salivary and gingival crevicular fluid interleukin-6 concentrations in healthy premenopausal and postmenopausal women on estrogen therapy. Author(s): Streckfus CF, Johnson RB, Nick T, Tsao A, Tucci M. Source: The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 1997 November; 52(6): M343-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9402940

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Comparison of prostatic cancer tissue dihydrotestosterone levels at the time of relapse following orchiectomy or estrogen therapy. Author(s): Geller J, Albert JD, Nachtsheim DA, Loza D. Source: The Journal of Urology. 1984 October; 132(4): 693-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6471215

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Comparison of transdermal and oral estrogen therapy in girls with Turner's syndrome. Author(s): Jospe N, Orlowski CC, Furlanetto RW. Source: J Pediatr Endocrinol Metab. 1995 April-June; 8(2): 111-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7584704

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Concomitant medication use in postmenopausal women using estrogen therapy. Author(s): Small R, Friedman GD, Ettinger B. Source: Menopause (New York, N.Y.). 2001 Summer; 8(2): 120-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11256872

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Concurrent administration of sustained-release bezafibrate may counteract the increased thrombotic risk associated with oral estrogen therapy. Author(s): McCarty MF. Source: Medical Hypotheses. 2001 August; 57(2): 216-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11461176

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Conjugated estrogen therapy and tests of thyroid function. Author(s): Heath H 3rd, Lee RB, Dimond RC, Wartofsky L. Source: Annals of Internal Medicine. 1974 September; 81(3): 351-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4368533

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Continuation of postmenopausal hormone replacement therapy in a large health maintenance organization: transdermal matrix patch versus oral estrogen therapy. Author(s): Ettinger B, Pressman A. Source: Am J Manag Care. 1999 June; 5(6): 779-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10538456

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Cost-effectiveness comparison of estrogen therapy and orchidectomy in patients with prostatic cancer. Author(s): Henriksson P, Edhag O. Source: International Journal of Technology Assessment in Health Care. 1987; 3(4): 5239. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10312366

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Criteria for successful estrogen therapy in osteoporosis. Author(s): Lindsay R. Source: Osteoporosis International : a Journal Established As Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the Usa. 1993; 3 Suppl 2: S9-12; Discussion S12-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8481598

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Current status of estrogen therapy for prostatic carcinoma. Author(s): Blackard CE, Mellinger GT. Source: Postgraduate Medicine. 1972 March; 51(3): 140-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4553219

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Current status of estrogen therapy for the menopause. Author(s): Hammond CB, Maxson WS. Source: Fertility and Sterility. 1982 January; 37(1): 5-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6277697

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Current status of menopause and postmenopausal estrogen therapy. Author(s): Utian WH. Source: Obstetrical & Gynecological Survey. 1977 April; 32(4): 193-204. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=322004

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Developing profiles of postmenopausal women being prescribed estrogen therapy to prevent osteoporosis. Author(s): Amonkar MM, Mody R. Source: Journal of Community Health. 2002 October; 27(5): 335-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12238732

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Differences in apolipoproteins and low-density lipoprotein subfractions in postmenopausal women on and off estrogen therapy: results from the Framingham Offspring Study. Author(s): Campos H, Wilson PW, Jimenez D, McNamara JR, Ordovas J, Schaefer EJ. Source: Metabolism: Clinical and Experimental. 1990 October; 39(10): 1033-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2120547

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Different effects of bisphosphonate and estrogen therapy on free and peptide-bound bone cross-links excretion. Author(s): Garnero P, Gineyts E, Arbault P, Christiansen C, Delmas PD. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1995 April; 10(4): 641-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7610936

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Differential responsiveness to LRF after estrogen therapy in women with hypothalamic amenorrhea. Author(s): Rebar RW, Harman SM, Vaitukaitis JL. Source: The Journal of Clinical Endocrinology and Metabolism. 1978 January; 46(1): 4854. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=376541

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Disseminated intravascular coagulation in carcinoma of prostate: role of estrogen therapy. Author(s): Goldenberg SL, Fenster HN, Perler Z, McLoughlin MG. Source: Urology. 1983 August; 22(2): 130-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6879882

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Dissociation of LH and FSH Responses to LHRH during estrogen therapy of patients with ovarian failure. Author(s): Linde R, Lindner J, Lorber D, Rabin D. Source: Hormone and Metabolic Research. Hormon- Und Stoffwechselforschung. Hormones Et Metabolisme. 1982 March; 14(3): 154-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6802737

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Does calcium potentiate the effect of estrogen therapy on postmenopausal bone loss? Author(s): Riis BJ, Nilas L, Christiansen C. Source: Bone Miner. 1987 February; 2(1): 1-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3504720

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Does estrogen therapy enhance memory? Author(s): Henderson VW. Source: Climacteric : the Journal of the International Menopause Society. 1999 September; 2(3): 162-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11910592

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Does estrogen therapy have a role in cardiovascular prevention? Author(s): Newnham HH, Silberberg J. Source: American Family Physician. 1999 March 1; 59(5): 1125-6, 1131. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10088872

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Dose reduction and discontinuation of alendronate in postmenopausal osteoporotic women who were receiving estrogen therapy. Author(s): Palomba S, Orio F Jr, Russo T, Colao A, Lombardi G, Zullo F. Source: Fertility and Sterility. 2004 February; 81(2): 476-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14967398

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Effect of 1 year of discontinuation of raloxifene or estrogen therapy on bone mineral density after 5 years of treatment in healthy postmenopausal women. Author(s): Neele SJ, Evertz R, De Valk-De Roo G, Roos JC, Netelenbos JC. Source: Bone. 2002 April; 30(4): 599-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11934652

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Effect of antiestrogen regimen on prostacyclin and thromboxane A2 in postmenopausal patients with breast cancer: evidence of significance of hypertension, smoking or previous use of estrogen therapy. Author(s): Marttunen MB, Pyrhonen S, Tiitinen AE, Viinikka LU, Ylikorkala O. Source: Prostaglandins. 1996 October; 52(4): 317-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8936586

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Effect of clomiphene citrate therapy on postcoital tests in successive treatment cycles including response to supplemental estrogen therapy. Author(s): Check JH, Adelson HG, Davies E. Source: Archives of Andrology. 1994 January-February; 32(1): 69-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8122940

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Effect of estrogen therapy on bone density in elderly women. Author(s): Seeman E. Source: The New England Journal of Medicine. 1994 March 10; 330(10): 715-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8107732

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Effect of estrogen therapy on bone density in elderly women. Author(s): Kanis JA, Stevenson JC. Source: The New England Journal of Medicine. 1994 March 10; 330(10): 715; Author Reply 716. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8107731

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Effect of hysterectomy, oophorectomy and estrogen therapy on libido. Author(s): Utian WH. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1975; 13(3): 97-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6351

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Effect of long-term estrogen therapy on brachial arterial endothelium-dependent vasodilation in women with Raynaud's phenomenon secondary to systemic sclerosis. Author(s): Lekakis J, Papamichael C, Mavrikakis M, Voutsas A, Stamatelopoulos S. Source: The American Journal of Cardiology. 1998 December 15; 82(12): 1555-7, A8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9874070

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Effect of orchidectomy performed after cessation of estrogen therapy on serum testosterone concentrations in patients with prostatic carcinoma. Author(s): Tomic R, Damber JE. Source: Urologia Internationalis. 1987; 42(6): 441-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3129850

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Effect of transdermal estrogen therapy on some vasoactive humoral factors and 24-h ambulatory blood pressure in normotensive postmenopausal women. Author(s): Zacharieva S, Atanassova I, Kirilov G, Kalinov K, Shigarminova R, Nachev E, Aslanova N. Source: Climacteric : the Journal of the International Menopause Society. 2002 September; 5(3): 293-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12419088

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Effectiveness of castration versus intravenous estrogen therapy in producing rapid endocrine control of metastatic cancer of the prostate. Author(s): Maatman TJ, Gupta MK, Montie JE. Source: The Journal of Urology. 1985 April; 133(4): 620-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3981712

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Effects of estrogen therapy of postmenopausal women on cytokines measured in peripheral blood. Author(s): Rogers A, Eastell R. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1998 October; 13(10): 1577-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9783546

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Effects of estrogen therapy on apolipoprotein E in type II hyperlipoproteinemia. Author(s): Falko JM, Schonfeld G, Witztum JL, Kolar J, Weidman SW. Source: Metabolism: Clinical and Experimental. 1979 November; 28(11): 1171-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=226834

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Effects of estrogen therapy on arterial resistance and pulsatility in postmenopausal women. Author(s): Federici A, Ciccone M, Cicinelli E, Lombardi M, Pitzalis MV, Galantino P, Pinto V. Source: Angiology. 2001 January; 52(1): 15-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11205927

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Effects of estrogen therapy on hearing in postmenopausal women. Author(s): Kilicdag EB, Yavuz H, Bagis T, Tarim E, Erkan AN, Kazanci F. Source: American Journal of Obstetrics and Gynecology. 2004 January; 190(1): 77-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14749639

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Effects of estrogen therapy on vaginal physiology during menopause. Author(s): Semmens JP, Tsai CC, Semmens EC, Loadholt CB. Source: Obstetrics and Gynecology. 1985 July; 66(1): 15-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2989746

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Effects of estrogen therapy on well-being in postmenopausal women without vasomotor complaints. Author(s): Skarsgard C, E Berg G, Ekblad S, Wiklund I, Hammar ML. Source: Maturitas. 2000 August 31; 36(2): 123-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11006499

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Effects of estrogen therapy on whole body proteins. Author(s): Mauras N. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 January; 81(1): 431. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8550791

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Effects of exercise and estrogen therapy on lipid profiles of postmenopausal women. Author(s): Klebanoff R, Miller VT, Fernhall B. Source: Medicine and Science in Sports and Exercise. 1998 July; 30(7): 1028-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9662669

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Effects of oral and transdermal low-dose estrogen therapy on echocardiographic parameters of cardiac function. Author(s): Vogelvang TE, van der Mooren MJ, Kamp O, Mijatovic V, Visser CA, Kenemans P. Source: Fertility and Sterility. 2003 September; 80(3): 546-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12969696

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Effects of withdrawal of chronic estrogen therapy on brachial artery vasoreactivity in women with coronary artery disease. Author(s): Greiner DZ, Personius BE, Andrews TC. Source: The American Journal of Cardiology. 1999 January 15; 83(2): 247-9, A5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10073827

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Effects on bone of surgical menopause and estrogen therapy with or without progesterone replacement in cynomolgus monkeys. Author(s): Jayo MJ, Weaver DS, Adams MR, Rankin SE. Source: American Journal of Obstetrics and Gynecology. 1990 August; 163(2): 614-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2386153

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Efficacy and tolerability of pulsed estrogen therapy: a 12-week double-blind placebocontrolled study in highly symptomatic postmenopausal women. Author(s): Rozenbaum H, Chevallier O, Moyal M, Durand G, Perineau M, This P; Aerodiol study group. Source: Climacteric : the Journal of the International Menopause Society. 2002 September; 5(3): 249-58. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12419083

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Efficacy of citalopram as a monotherapy or as an adjunctive treatment to estrogen therapy for perimenopausal and postmenopausal women with depression and vasomotor symptoms. Author(s): Soares CN, Poitras JR, Prouty J, Alexander AB, Shifren JL, Cohen LS. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 473-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12716252

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Endometrial "sarcomas" complicating ovarian thecoma, polycystic ovarian disease and estrogen therapy. Author(s): Press MF, Scully RE. Source: Gynecologic Oncology. 1985 June; 21(2): 135-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2985476

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Endometrial adenocarcinoma involving adenomyosis without true myometrial invasion is characterized by frequent preceding estrogen therapy, low histologic grades, and excellent prognosis. Author(s): Mittal KR, Barwick KW. Source: Gynecologic Oncology. 1993 May; 49(2): 197-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8504988

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Endometrial carcinoma in gonadal dysgenesis with and without estrogen therapy. Author(s): Acosta AA. Source: Gynecologic Oncology. 1979 December; 8(3): 384-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=511005

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Esterified estrogen therapy in postmenopausal women. Relationships of bone marker changes and plasma estradiol to BMD changes: a two-year study. Author(s): Watts NB, Nolan JC, Brennan JJ, Yang HM; ESTRATAB/Osteoporosis Study Group. Source: Menopause (New York, N.Y.). 2000 November-December; 7(6): 375-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11127759

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Estimated gains in life expectancy with use of postmenopausal estrogen therapy: a decision analysis. Author(s): Zubialde JP, Lawler F, Clemenson N. Source: The Journal of Family Practice. 1993 March; 36(3): 271-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8454973

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Estrogen therapy (ET) after menopause. Author(s): Peck WA. Source: J Am Med Womens Assoc. 1990 May-June; 45(3): 87-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2335696

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Estrogen therapy and aggressive behavior in elderly patients with moderate-to-severe dementia: results from a short-term, randomized, double-blind trial. Author(s): Kyomen HH, Satlin A, Hennen J, Wei JY. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 1999 Fall; 7(4): 339-48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10521168

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Estrogen therapy and breast cancer in postmenopausal women. Author(s): Gambrell RD Jr, Massey FM, Castaneda TA, Boddie AW. Source: Journal of the American Geriatrics Society. 1980 June; 28(6): 251-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7372968

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Estrogen therapy and breast cancer. Author(s): Gambrell RD Jr. Source: Int J Fertil. 1990 July-August; 35(4): 202-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1977710

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Estrogen therapy and cardiovascular risk in women. Author(s): Bass KM, Bush TL. Source: J La State Med Soc. 1991 May; 143(5): 33-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1861096

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Estrogen therapy and endometrial carcinoma. Author(s): Rosen PP. Source: Archives of Internal Medicine. 1979 July; 139(7): 831. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=454081

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Estrogen therapy and liver function--metabolic effects of oral and parenteral administration. Author(s): von Schoultz B, Carlstrom K, Collste L, Eriksson A, Henriksson P, Pousette A, Stege R. Source: The Prostate. 1989; 14(4): 389-95. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2664738

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Estrogen therapy and noncognitive psychiatric signs and symptoms in elderly patients with dementia. Author(s): Kyomen HH, Hennen J, Gottlieb GL, Wei JY. Source: The American Journal of Psychiatry. 2002 July; 159(7): 1225-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12091203

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Estrogen therapy and osteoporosis: principles & practice. Author(s): Notelovitz M. Source: The American Journal of the Medical Sciences. 1997 January; 313(1): 2-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9001160

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Estrogen therapy and risk of cardiovascular events among women with type 2 diabetes. Author(s): Newton KM, LaCroix AZ, Heckbert SR, Abraham L, McCulloch D, Barlow W. Source: Diabetes Care. 2003 October; 26(10): 2810-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14514584

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Estrogen therapy and the risk of breast cancer. Author(s): Meyer JE. Source: Jama : the Journal of the American Medical Association. 1993 December 8; 270(22): 2685-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8133584

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Estrogen therapy and variable-resistance weight training increase bone mineral in surgically menopausal women. Author(s): Notelovitz M, Martin D, Tesar R, Khan FY, Probart C, Fields C, McKenzie L. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1991 June; 6(6): 583-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1887821

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Estrogen therapy and variable-resistance weight training. Author(s): Seeman E. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1992 June; 7(6): 709-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1414489

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Estrogen therapy arrests bone loss in elderly women. Author(s): Quigley ME, Martin PL, Burnier AM, Brooks P. Source: American Journal of Obstetrics and Gynecology. 1987 June; 156(6): 1516-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3035927

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Estrogen therapy during menopause and the treatment of osteoporosis. Author(s): Noyes MA, Demmler RW. Source: Primary Care. 1990 September; 17(3): 647-66. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2236341

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Estrogen therapy during menopause. Author(s): Horwitz DL. Source: Compr Ther. 1980 March; 6(3): 3-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7363581

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Estrogen therapy during menopause. Practical treatment recommendations. Author(s): Sitruk-Ware R. Source: Drugs. 1990 February; 39(2): 203-17. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2183999

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Estrogen therapy enhances calcium absorption and retention and diminishes bone turnover in young girls with Turner's syndrome: a calcium kinetic study. Author(s): Mauras N, Vieira NE, Yergey AL. Source: Metabolism: Clinical and Experimental. 1997 August; 46(8): 908-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9258273

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Estrogen therapy for bleeding gastrointestinal telangiectasias. Author(s): Brinberg D, Green PH, Lebwohl O. Source: Annals of Internal Medicine. 1986 September; 105(3): 462-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3488704

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Estrogen therapy for depression in postmenopausal women. Author(s): Carranza-Lira S, Valentino-Figueroa ML. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1999 April; 65(1): 35-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10390097

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Estrogen therapy for geriatric osteoporosis: just one ball in a complex juggling act. Author(s): Hillner BE. Source: Southern Medical Journal. 1992 August; 85(8): 2S10-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1502606

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Estrogen therapy for gonadal dysgenesis: a rational approach. Author(s): Katayama KP, Mattingly RF. Source: Endocrinol Jpn. 1983 April; 30(2): 205-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6641641

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Estrogen therapy for migraine. Author(s): Chaudhuri TK, Chaudhuri ST. Source: Headache. 1975 July; 15(2): 139-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=168167

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Estrogen therapy for osteoporosis: is it effective? Author(s): Barzel US. Source: Hosp Pract (Off Ed). 1990 July 15; 25(7): 95-9, 102, 105-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2115537

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Estrogen therapy for osteoporosis--even in the elderly. Author(s): Ott SM. Source: Annals of Internal Medicine. 1992 July 1; 117(1): 85-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1596052

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Estrogen therapy for postmenopausal symptoms and prevention of osteoporosis. Author(s): Sagraves R. Source: Journal of Clinical Pharmacology. 1995 September; 35(9 Suppl): 2S-10S. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8530714

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Estrogen therapy for prevention and treatment of osteoporosis. Author(s): Doren M. Source: Maturitas. 2002 August 30; 43 Suppl 1: S53-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12361888

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Estrogen therapy for prostate carcinoma. Author(s): Presti JC Jr. Source: Jama : the Journal of the American Medical Association. 1996 April 17; 275(15): 1153. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8609673

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Estrogen therapy for stress incontinence. Author(s): Borrie MJ, Wilson PD, Campbell AJ. Source: Journal of the American Geriatrics Society. 1984 December; 32(12): 942-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6512137

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Estrogen therapy for the prevention of coronary heart disease: what are the facts? Author(s): Conti CR. Source: Clin Cardiol. 1993 October; 16(10): 699-700. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8222380

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Estrogen therapy for unstable angina: another bump for the bandwagon. Author(s): Waters DD. Source: Journal of the American College of Cardiology. 2002 January 16; 39(2): 238-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11788213

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Estrogen therapy in a male patient with chronic hepatitis C and irradiation-induced testicular dysfunction. Author(s): Shimizu I, Omoya T, Kondo Y, Kusaka Y, Tsutsui A, Shibata H, Honda H, Sano N, Ito S. Source: Intern Med. 2001 February; 40(2): 100-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11300139

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Estrogen therapy in keratoconjunctivitis sicca. Author(s): Akramian J, Wedrich A, Nepp J, Sator M. Source: Advances in Experimental Medicine and Biology. 1998; 438: 1005-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9635003

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Estrogen therapy in menopause and endometrial cancer. Author(s): Marchesoni D, Gangemi M, Di Lenardo L, Mozzanega B, Valente S. Source: Clin Exp Obstet Gynecol. 1980; 7(2): 122-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7249349

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Estrogen therapy in postmenopausal osteoporosis. What we know and what we don't. Author(s): Roux C. Source: Rev Rhum Engl Ed. 1997 June; 64(6): 402-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9513613

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Estrogen therapy in postmenopausal women: effects on cognitive function and dementia. Author(s): Yaffe K, Sawaya G, Lieberburg I, Grady D. Source: Jama : the Journal of the American Medical Association. 1998 March 4; 279(9): 688-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9496988

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Estrogen therapy in the management of problems associated with urogenital ageing: a simple diagnostic test and the effect of the route of hormone administration. Author(s): Notelovitz M. Source: Maturitas. 1995 December; 22 Suppl: S31-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8775774

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Estrogen therapy in the management of urinary incontinence in postmenopausal women: a meta-analysis. First report of the Hormones and Urogenital Therapy Committee. Author(s): Fantl JA, Cardozo L, McClish DK. Source: Obstetrics and Gynecology. 1994 January; 83(1): 12-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8272292

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Estrogen therapy in the prevention and management of osteoporosis. Author(s): Lindsay R. Source: American Journal of Obstetrics and Gynecology. 1987 May; 156(5): 1347-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3578455

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Estrogen therapy in Turner's syndrome. Author(s): Cutler GB Jr, Ross JL. Source: Acta Paediatr Jpn. 1992 April; 34(2): 195-202; Discussion 202-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1621525

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Estrogen therapy in women over 60 years of age. Author(s): Studd J, Zamblera D. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1994 September; 8(3): 191-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7847104

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Estrogen therapy in women undergoing coronary artery bypass grafting: effect on surgical complications. Author(s): Shackelford DP, Daniels S, Hoffman MK, Chitwood R. Source: Obstetrics and Gynecology. 2000 May; 95(5): 732-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10775739

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Estrogen therapy of perimenopausal and postmenopausal patients. Author(s): Magera BE, Amerson AB, Wilson E. Source: Am J Hosp Pharm. 1979 August; 36(8): 1062-71. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=384786

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Estrogen therapy of uremic bleeding. Author(s): McCarthy ML, Stoukides CA. Source: The Annals of Pharmacotherapy. 1994 January; 28(1): 60-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8123965

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Estrogen therapy, atherosclerosis, and clinical cardiovascular events. Author(s): Anderson HV. Source: Circulation. 1996 October 15; 94(8): 1809-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8873652

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Estrogen therapy. Author(s): Ferguson B. Source: American Family Physician. 1991 July; 44(1): 50, 54, 56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2058539

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Estrogen therapy: advantage and disadvantages. Author(s): Patel JC. Source: Indian Journal of Medical Sciences. 1999 September; 53(9): 407-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10710834

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Estrogen therapy: from women's choice to women's preference. Author(s): Lachowsky M. Source: Climacteric : the Journal of the International Menopause Society. 2002 June; 5 Suppl 2: 46-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12482111

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Evaluation of bone turnover and bone mass during tapering estrogen therapy: a preliminary report. Author(s): Cantatore FP, Cicinelli E, Galantino P, Pepe V, Popolizio A, Savino F, Balzano G, Epifani S. Source: Arthritis and Rheumatism. 1995 February; 38(2): 292-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7848323

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Exogenous estrogen therapy concurrent with clomiphene citrate--lack of effect on serum sex hormone levels and endometrial thickness. Author(s): Ben-Ami M, Geslevich Y, Matilsky M, Battino S, Weiner E, Shalev E. Source: Gynecologic and Obstetric Investigation. 1994; 37(3): 180-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8005548

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Exogenous estrogen therapy for treatment of clomiphene citrate-induced cervical mucus abnormalities: is it effective? Author(s): Bateman BG, Nunley WC Jr, Kolp LA. Source: Fertility and Sterility. 1990 October; 54(4): 577-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2209876

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Factors relating to morbidity and mortality of women on long-term estrogen therapy. Author(s): Rakoff AE. Source: Frontiers of Hormone Research. 1977; 5: 40-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=614946

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Family Practice Grand Rounds. Postmenopausal osteoporosis and estrogen therapy: who should be treated? Author(s): Palma LF. Source: The Journal of Family Practice. 1982 February; 14(2): 355-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7057156

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Female pelvic floor dysfunction and estrogen therapy. Author(s): Dwyer PL. Source: Climacteric : the Journal of the International Menopause Society. 2001 September; 4(3): 179-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11588940

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Final height of patients with Turner's syndrome treated with growth hormone (GH): indications for GH therapy alone at high doses and late estrogen therapy. Italian Study Group for Turner Syndrome. Author(s): Cacciari E, Mazzanti L. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 December; 84(12): 4510-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10599710

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Genetic variants of coagulation factor XIII, postmenopausal estrogen therapy, and risk of nonfatal myocardial infarction. Author(s): Reiner AP, Heckbert SR, Vos HL, Ariens RA, Lemaitre RN, Smith NL, Lumley T, Rea TD, Hindorff LA, Schellenbaum GD, Rosendaal FR, Siscovick DS, Psaty BM. Source: Blood. 2003 July 1; 102(1): 25-30. Epub 2002 November 27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12456499

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Granular cell tumor of the thyroid gland in a girl receiving high-dose estrogen therapy. Author(s): Mahoney CP, Patterson SD, Ryan J. Source: Pediatric Pathology & Laboratory Medicine : Journal of the Society for Pediatric Pathology, Affiliated with the International Paediatric Pathology Association. 1995 September-October; 15(5): 791-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8597864

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Growth of a microprolactinoma to a macroprolactinoma during estrogen therapy. Author(s): Garcia MM, Kapcala LP. Source: J Endocrinol Invest. 1995 June; 18(6): 450-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7594240

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Guidelines in estrogen therapy. Author(s): Ryan KJ. Source: Calif Med. 1972 April; 116(4): 56. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5019103

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Hemangioendothelial sarcoma of the liver associated with long-term estrogen therapy in a man. Author(s): Ham JM, Pirola RC, Crouch RL. Source: Digestive Diseases and Sciences. 1980 November; 25(11): 879-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7438959

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High-dose intravenous estrogen therapy in advanced prostatic carcinoma. Use of serum prostate-specific antigen to monitor response. Author(s): Ferro MA, Gillatt D, Symes MO, Smith PJ. Source: Urology. 1989 September; 34(3): 134-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2476882

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Hold the hormones? The good and the bad about postmenopausal estrogen therapy. Author(s): Nemecek S. Source: Scientific American. 1997 September; 277(3): 38, 40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9304196

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Hormones and the mind. Estrogen therapy could help women's memory. Author(s): Kalb C. Source: Newsweek. 1999 April 19; 133(16): 50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10351266

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Hypocalcemia associated with estrogen therapy for metastatic adenocarcinoma of the prostate. Author(s): Vogelgesang SA, McMillin JM. Source: The Journal of Urology. 1988 November; 140(5): 1025-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3172354

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Hysteroscopic patterns in women receiving replacement estrogen therapy. Author(s): Cittadini E, Perino A, Gullo D. Source: Acta Eur Fertil. 1982 March; 13(1): 43-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7124298

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Impact of estrogen therapy on Alzheimer's disease: a fork in the road? Author(s): Brinton RD. Source: Cns Drugs. 2004; 18(7): 405-22. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15139797

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Increased bone mass as a result of estrogen therapy in a man with aromatase deficiency. Author(s): Bilezikian JP, Morishima A, Bell J, Grumbach MM. Source: The New England Journal of Medicine. 1998 August 27; 339(9): 599-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9718379

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Increased cardiovascular response to caffeine in perimenopausal women before and during estrogen therapy. Author(s): Del Rio G, Menozzi R, Zizzo G, Avogaro A, Marrama P, Velardo A. Source: European Journal of Endocrinology / European Federation of Endocrine Societies. 1996 November; 135(5): 598-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8980163

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Increased hGH production rate after low-dose estrogen therapy in prepubertal girls with Turner's syndrome. Author(s): Mauras N, Rogol AD, Veldhuis JD. Source: Pediatric Research. 1990 December; 28(6): 626-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2284161

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Increased lysosomal fragility in the human uterine cervix following estrogen therapy. Author(s): Herczeg J, Borsodi A. Source: Arch Gynecol. 1985; 236(3): 131-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4015190

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Increased need for thyroxine in women with hypothyroidism during estrogen therapy. Author(s): Arafah BM. Source: The New England Journal of Medicine. 2001 June 7; 344(23): 1743-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11396440

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Influence of the Women's Health Initiative trial on the practice of prophylactic oophorectomy and the prescription of estrogen therapy. Author(s): Chan LY, Yuen PM. Source: Fertility and Sterility. 2004 June; 81(6): 1699-700. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15193501

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Insulin resistance is increased by transdermal estrogen therapy in postmenopausal women with cardiac syndrome X. Author(s): Assali AR, Jabara Z, Shafer Z, Solodky A, Herz I, Sclarovsky E, Strasberg B, Sclarovsky S, Fainaru M. Source: Cardiology. 2001; 95(1): 31-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11385189

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Is postmenopausal estrogen therapy associated with neuromuscular function or falling in elderly women? Study of Osteoporotic Fractures Research Group. Author(s): Seeley DG, Cauley JA, Grady D, Browner WS, Nevitt MC, Cummings SR. Source: Archives of Internal Medicine. 1995 February 13; 155(3): 293-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7832601

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Is Provera the ideal progestogen for addition to postmenopausal estrogen therapy? Author(s): Lane G, Siddle NC, Ryder TA, Pryse-Davies J, King RJ, Whitehead MI. Source: Fertility and Sterility. 1986 March; 45(3): 345-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3005052

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Is sexual life influenced by transdermal estrogen therapy? A double blind placebo controlled study in postmenopausal women. Author(s): Nathorst-Boos J, Wiklund I, Mattsson LA, Sandin K, von Schoultz B. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1993 November; 72(8): 656-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8259754

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Isoflavones and postmenopausal bone health: a viable alternative to estrogen therapy? Author(s): Scheiber MD, Rebar RW. Source: Menopause (New York, N.Y.). 1999 Fall; 6(3): 233-41. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10486794

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Letter: Estrogen therapy for periodic fever. Author(s): Kats BA. Source: Archives of Internal Medicine. 1974 May; 133(5): 868-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4362558

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Letter: Hyperlipemia during estrogen therapy. Author(s): Molitch ME, Oill PA, Odell WD. Source: Jama : the Journal of the American Medical Association. 1974 October 21; 230(3): 373-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4479179

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Letter: Myocardial infarction and estrogen therapy in premenopausal women. Author(s): Rosenberg L, Armstrong B, Jick H. Source: The New England Journal of Medicine. 1976 June 3; 294(23): 1290-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1264157

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Letter: Postmenopausal estrogen therapy. Author(s): Goldzieher JW. Source: Jama : the Journal of the American Medical Association. 1974 March 25; 227(12): 1382-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4406017

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Letter: Postmenopausal vaginal bleeding during estrogen therapy. Author(s): Marshall BR. Source: Jama : the Journal of the American Medical Association. 1974 January 7; 227(1): 76-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4859634

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Letter: The ancillary effects of estrogen therapy after rhytidectomy. Author(s): Gonzalez Vlloa M. Source: Plastic and Reconstructive Surgery. 1975 August; 56(2): 203-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1144559

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Leydig cell tumor in patient on estrogen therapy. Author(s): Deshmukh AS, Hartung WH. Source: Urology. 1983 May; 21(5): 538-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6857903

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Limited relationship of maturation index to estrogen therapy for menopausal symptoms. An analysis of 200 patients. Author(s): Kaufman SA. Source: Obstetrics and Gynecology. 1967 September; 30(3): 399-407. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6037699

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Liver damage and estrogen therapy of prostatic cancer. Case report. Author(s): Kontturi M, Sotaniemi E, Ahlqvist J. Source: Scandinavian Journal of Urology and Nephrology. 1972; 6(3): 289-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4629449

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Long-term estrogen therapy abolishes acute estrogen-induced coronary flow augmentation in postmenopausal women. Author(s): Blumenthal RS, Brinker JA, Resar JR, Gloth ST, Zacur HA, Coombs V, Gerstenblith G, Reis SE. Source: American Heart Journal. 1997 March; 133(3): 323-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9060801

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Long-term estrogen therapy improves vascular function in male to female transsexuals. Author(s): New G, Timmins KL, Duffy SJ, Tran BT, O'Brien RC, Harper RW, Meredith IT. Source: Journal of the American College of Cardiology. 1997 June; 29(7): 1437-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9180101

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Long-term transdermal estrogen therapy improves lipid profile but not insulin resistance in healthy postmenopausal women. Author(s): Lasco A, Alvaro S, Frisina N, Di Benedetto A, Denuzzo G, Cucinotta D. Source: Diabetes Care. 2000 March; 23(3): 422-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10868880

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Low-dose esterified estrogen therapy: effects on bone, plasma estradiol concentrations, endometrium, and lipid levels. Estratab/Osteoporosis Study Group. Author(s): Genant HK, Lucas J, Weiss S, Akin M, Emkey R, McNaney-Flint H, Downs R, Mortola J, Watts N, Yang HM, Banav N, Brennan JJ, Nolan JC. Source: Archives of Internal Medicine. 1997 December 8-22; 157(22): 2609-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9531230

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Low-dose estrogen therapy for menopausal women: a review of efficacy and safety. Author(s): Crandall C. Source: Journal of Women's Health (2002). 2003 October; 12(8): 723-47. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14588124

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Male breast carcinoma following estrogen therapy: report of a case. Author(s): Srinivasan G, Srinivasan U, Greiver P. Source: J Ky Med Assoc. 1979 January; 77(1): 9-10, 48. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=215683

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Massive estrogen therapy: phase I study of hexestrol (NSC-9894). Author(s): Weeth JB, Segaloff A. Source: Cancer Chemother Rep. 1965 October; 48: 53-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4953646

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Massive hyperlipemia during estrogen therapy. Author(s): Molitch ME, Oill P, Odell WD. Source: Jama : the Journal of the American Medical Association. 1974 February 4; 227(5): 522-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4358883

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Massive hypertriglyceridemia complicating estrogen therapy. Author(s): Pardo JM. Source: The Journal of Clinical Endocrinology and Metabolism. 1997 May; 82(5): 1649-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9141568

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Mechanisms by which high-dose estrogen therapy produces anabolic skeletal effects in postmenopausal women: role of locally produced growth factors. Author(s): Bord S, Beavan S, Ireland D, Horner A, Compston JE. Source: Bone. 2001 September; 29(3): 216-22. Erratum In: Bone 2002 April; 30(4): 651. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11557364

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Menopausal estrogen therapy and hip fractures. Author(s): Paganini-Hill A, Ross RK, Gerkins VR, Henderson BE, Arthur M, Mack TM. Source: Annals of Internal Medicine. 1981 July; 95(1): 28-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7247123

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Mesenteric venous thrombosis associated with estrogen therapy for treatment of prostatic carcinoma. Author(s): Sahdev P, Wolff M, Widmann WD. Source: The Journal of Urology. 1985 September; 134(3): 563-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4032559

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Meta-analysis of estrogen therapy in the management of urogenital atrophy in postmenopausal women: second report of the Hormones and Urogenital Therapy Committee. Author(s): Cardozo L, Bachmann G, McClish D, Fonda D, Birgerson L. Source: Obstetrics and Gynecology. 1998 October; 92(4 Pt 2): 722-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9764689

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Metabolic impact of adding medroxyprogesterone acetate to conjugated estrogen therapy in postmenopausal women. The Menopause Study Group. Author(s): Lobo RA, Pickar JH, Wild RA, Walsh B, Hirvonen E. Source: Obstetrics and Gynecology. 1994 December; 84(6): 987-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7970483

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Metabolic side-effects of estrogen therapy for prostatic cancer. Author(s): Kontturi M. Source: Scand J Urol Nephrol Suppl. 1991; 138: 127-30. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1784996

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Micronized 17 beta-estradiol for oral estrogen therapy in menopausal women. Author(s): Callantine MR, Martin PL, Bolding OT, Warner PO, Greaney MO Jr. Source: Obstetrics and Gynecology. 1975 July; 46(1): 37-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1153135

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Morphological criteria for the control of carcinoma of the prostate with estrogen therapy. Author(s): Ziegler H, Volter D, Schubert GE. Source: International Urology and Nephrology. 1974; 6(3-4): 195-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4142482

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Myocardial infarction and estrogen therapy in post-menopausal women. Author(s): Rosenberg L, Armstrong B, Jick H. Source: The New England Journal of Medicine. 1976 June 3; 294(23): 1256-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=177869

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New developments in topical estrogen therapy. Author(s): Jewelewicz R. Source: Fertility and Sterility. 1997 January; 67(1): 1-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8986674

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On the effect of castration and peroral estrogen therapy on the skin. Author(s): Punnonen R. Source: Acta Obstetricia Et Gynecologica Scandinavica. Supplement. 1971; 9: Suppl 9: 32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5287103

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Oral 1,25-dihydroxyvitamin D administration in osteoporotic women: effects of estrogen therapy. Author(s): Cosman F, Nieves J, Shen V, Lindsay R. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1995 April; 10(4): 594-600. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7610930

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Oral conjugated estrogen therapy for treatment of hemorrhagic cystitis. Author(s): Miller J, Burfield GD, Moretti KL. Source: The Journal of Urology. 1994 May; 151(5): 1348-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8158784

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Oral, more than transdermal, estrogen therapy improves lipids and lipoprotein(a) in postmenopausal women: a randomized, placebo-controlled study. Author(s): Hemelaar M, van der Mooren MJ, Mijatovic V, Bouman AA, Schijf CP, Kroeks MV, Franke HR, Kenemans P. Source: Menopause (New York, N.Y.). 2003 November-December; 10(6): 550-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14627865

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Orchiectomy, estrogen therapy and radiotherapy in locally advanced (T3-4 M0) prostatic cancer. Author(s): Aro J, Haapiainen R, Kajanti M, Rannikko S, Alfthan O. Source: Scand J Urol Nephrol Suppl. 1988; 110: 103-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3187397

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Ovarian function studies in active ankylosing spondylitis in women. Clinical response to estrogen therapy. Author(s): Jimenez-Balderas FJ, Tapia-Serrano R, Madero-Cervera JI, Murrieta S, Mintz G. Source: The Journal of Rheumatology. 1990 April; 17(4): 497-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2348430

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Panel on estrogen therapy. Author(s): Hunter RE, Hughes EC, Lloyd C, Robinson RW. Source: Trans N Engl Obstet Gynecol Soc. 1966; 20: 65-77. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5990497

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Percutaneous estrogen therapy. Endometrial response and metabolic effects. Author(s): Holst J. Source: Acta Obstetricia Et Gynecologica Scandinavica. Supplement. 1983; 115: 1-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6574685

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Percutaneous estrogen therapy--a semi-quantitative histologic study of the abdominal skin. Author(s): Holst J, Hofer PA, Cajander S, von Schoultz B. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1982; 61(6): 515-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7164779

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Persistence with estrogen therapy in a postmenopausal Medicaid population. Author(s): Kotzan JA, Martin BC, Wade WE. Source: Pharmacotherapy. 1999 March; 19(3): 363-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10221376

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Personal perspective on low-dosage estrogen therapy for postmenopausal women. Author(s): Ettinger B. Source: Menopause (New York, N.Y.). 1999 Fall; 6(3): 273-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10486799

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Pharmacodynamic model of testosterone suppression after intramuscular depot estrogen therapy in prostate cancer. Author(s): Johansson CJ, Gunnarsson PO. Source: The Prostate. 2000 June 15; 44(1): 26-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10861754

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Pharmacodynamics of follicle stimulating hormone (FSH) in postmenopausal women during pulsed estrogen therapy: Evidence that FSH release and synthesis are controlled by distinct pathways. Author(s): Christin-Maitre S, Laveille C, Collette J, Brion N, Reginster JY. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 November; 88(11): 5405-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14602781

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Phenotype, ovarian function, and growth in patients with 45,X/47,XXX Turner mosaicism: implications for prenatal counseling and estrogen therapy at puberty. Author(s): Blair J, Tolmie J, Hollman AS, Donaldson MD. Source: The Journal of Pediatrics. 2001 November; 139(5): 724-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11713453

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Placebo-controlled trial of transdermal estrogen therapy alone in postmenopausal women: effects on arterial compliance and endothelial function. Author(s): Teede HJ, Liang YL, Kotsopoulos D, Zoungas S, Craven R, McGrath BP. Source: Climacteric : the Journal of the International Menopause Society. 2002 June; 5(2): 160-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12051112

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Porphyria cutanea tarda induced by estrogen therapy. Author(s): Domonkos AN. Source: Archives of Dermatology. 1970 August; 102(2): 229. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5430319

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Possible suppression of host resistance by estrogen therapy for prostatic cancer. Author(s): Ablin RJ. Source: Can Med Assoc J. 1976 December 4; 115(11): 1082-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1000436

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Post menopausal bleeding related to estrogen therapy. An increasing problem. Author(s): Copenhaver EH. Source: Geriatrics. 1968 November; 23(11): 128-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4301353

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Postmenopausal estrogen therapy and cardiovascular disease. Author(s): MacLean DB, Bostom A. Source: The New England Journal of Medicine. 1992 March 5; 326(10): 707-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1736114

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Postmenopausal estrogen therapy and cardiovascular disease. Author(s): Atkins D. Source: The New England Journal of Medicine. 1992 March 5; 326(10): 706; Author Reply 707. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1736113

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Postmenopausal estrogen therapy and cardiovascular disease. Author(s): Prior JC. Source: The New England Journal of Medicine. 1992 March 5; 326(10): 705-6; Author Reply 707. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1736112

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Postmenopausal estrogen therapy and cardiovascular disease. Author(s): Fleming BJ. Source: The New England Journal of Medicine. 1992 March 5; 326(10): 705; Author Reply 707. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1736111

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Postmenopausal estrogen therapy and cardiovascular disease. Ten-year follow-up from the nurses' health study. Author(s): Stampfer MJ, Colditz GA, Willett WC, Manson JE, Rosner B, Speizer FE, Hennekens CH. Source: The New England Journal of Medicine. 1991 September 12; 325(11): 756-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1870648

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Postmenopausal estrogen therapy and depressive symptoms in older women. Author(s): Whooley MA, Grady D, Cauley JA. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 2000 August; 15(8): 535-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10940144

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Postmenopausal estrogen therapy and selected (less-often-considered) disease outcomes. Author(s): Barrett-Connor E. Source: Menopause (New York, N.Y.). 1999 Spring; 6(1): 14-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10100175

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Postmenopausal estrogen therapy and the risk for developing systemic lupus erythematosus. Author(s): Sanchez-Guerrero J, Liang MH, Karlson EW, Hunter DJ, Colditz GA. Source: Annals of Internal Medicine. 1995 March 15; 122(6): 430-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7856991

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Postmenopausal estrogen therapy selectively stimulates hepatic enlargement in women with autosomal dominant polycystic kidney disease. Author(s): Sherstha R, McKinley C, Russ P, Scherzinger A, Bronner T, Showalter R, Everson GT. Source: Hepatology (Baltimore, Md.). 1997 November; 26(5): 1282-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9362373

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Postmenopausal estrogen therapy. Author(s): Adlin EV. Source: Annals of Internal Medicine. 1979 September; 91(3): 488-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=475181

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Postmenopausal estrogen therapy. Author(s): Sedlacek TV. Source: American Family Physician. 1983 July; 28(1): 207-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6869171

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Postmenopausal estrogen therapy: a review. Author(s): Mosher BA, Whelan EM. Source: Obstetrical & Gynecological Survey. 1981 September; 36(9): 467-75. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7024881

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Postmenopausal ureteral endometriosis with atypical adenomatous hyperplasia following hysterectomy, bilateral oophorectomy, and long-term estrogen therapy. Author(s): Kapadia SB, Russak RR, O'Donnell WF, Harris RN, Lecky JW. Source: Obstetrics and Gynecology. 1984 September; 64(3 Suppl): 60S-63S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6472751

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Prevention of body fluid retention by furosemide during estrogen therapy of prostatic cancer. Author(s): Kontturi MJ, Sotaniemi EA. Source: The Journal of Urology. 1975 August; 114(2): 251-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1159921

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Prevention of platelet aggregation in patients with prostatic cancer during estrogen therapy. Author(s): Koiso K, Akima H, Niijima T. Source: Urology. 1982 June; 19(6): 579-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6283703

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Primary orchiectomy versus estrogen therapy in advanced prostatic cancer--a randomized study: results after 7 to 10 years of followup. Author(s): Johansson JE, Andersson SO, Holmberg L, Bergstrom R. Source: The Journal of Urology. 1991 March; 145(3): 519-22; Discussion 522-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1997702

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Progestogens, estrogen therapy, and endometrial cancer. Author(s): Kaunitz AM, Hogue CJ. Source: Annals of Internal Medicine. 1984 February; 100(2): 316. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6691683

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Protein S levels during the normal menstrual cycle and during estrogen therapy for premature ovarian failure. Author(s): Carr ME Jr, Steingold KA, Zekert SL. Source: The American Journal of the Medical Sciences. 1993 October; 306(4): 212-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8213888

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Psychological effects of hormone replacement therapy: a comparison of tibolone and a sequential estrogen therapy. Author(s): Ross LA, Alder EM, Cawood EH, Brown J, Gebbie AE. Source: Journal of Psychosomatic Obstetrics and Gynaecology. 1999 June; 20(2): 88-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10422040

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Pulsed estrogen therapy in prevention of postmenopausal osteoporosis. A 2-year randomized, double blind, placebo-controlled study. Author(s): Nielsen TF, Ravn P, Bagger YZ, Warming L, Christiansen C. Source: Osteoporosis International : a Journal Established As Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the Usa. 2004 February; 15(2): 168-74. Epub 2003 November 25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14647880

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Pulsed estrogen therapy: from cellular mode of action to tissue effects. Author(s): Al-Azzawi F. Source: Climacteric : the Journal of the International Menopause Society. 2002 June; 5 Suppl 2: 27-31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12482108

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Pulsed estrogen therapy: pharmacokinetics of intranasal 17-beta-estradiol (S21400) in postmenopausal women and comparison with oral and transdermal formulations. Author(s): Devissaguet JP, Brion N, Lhote O, Deloffre P. Source: Eur J Drug Metab Pharmacokinet. 1999 July-September; 24(3): 265-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10716066

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Pulsed estrogen therapy: relieving climacteric symptoms, preventing postmenopausal bone loss. Author(s): Palacios S. Source: Climacteric : the Journal of the International Menopause Society. 2002 June; 5 Suppl 2: 32-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12482109

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Rebound response after estrogen therapy for metastatic breast cancer. Author(s): Nesto RW, Cady B, Oberfield RA, Pazianos AG, Salzman FA. Source: Cancer. 1976 October; 38(4): 1834-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=991097

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Recurrent giant cell granuloma occurring in the mandible of a patient on high dose estrogen therapy for the treatment of Sotos' syndrome. Author(s): Flaggert JJ 3rd, Heldt LV, Gareis FJ. Source: Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons. 1987 December; 45(12): 1074-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3480341

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Recurrent hepatic hemangiomas. Possible association with estrogen therapy. Author(s): Conter RL, Longmire WP Jr. Source: Annals of Surgery. 1988 February; 207(2): 115-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2829759

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Reduced mortality associated with long-term postmenopausal estrogen therapy. Author(s): Ettinger B, Friedman GD, Bush T, Quesenberry CP Jr. Source: Obstetrics and Gynecology. 1996 January; 87(1): 6-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8532268

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Regression of Polycystic Ovaries by Estrogen Therapy. Author(s): Gambrell RD Jr. Source: Obstetrics and Gynecology. 1976 May; 47(5): 569-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=131262

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Relationship between estrogen therapy and cancer. Author(s): Geller W. Source: Mod Treat. 1968 May; 5(3): 564-70. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5690498

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Relationship of estrogen therapy for carcinoma of the prostate to atherosclerotic cardiovascular disease: a clinicopathologic study. Author(s): Hanash KA, Taylor WF, Greene LF, Kottke BA, Titus JL. Source: The Journal of Urology. 1970 April; 103(4): 467-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5437752

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Relative value of transdermal and oral estrogen therapy in various clinical situations. Author(s): Lufkin EG, Ory SJ. Source: Mayo Clinic Proceedings. 1994 February; 69(2): 131-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8309263

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Replacement estrogen therapy for menopausal vasomotor flushes. Comparison of quinestrol and conjugated estrogens. Author(s): Baumgardner SB, Condrea H, Daane TA, Dorsey JH, Jurow HN, Shively JP, Wachsman M, Wharton LR Jr, Zibel MJ. Source: Obstetrics and Gynecology. 1978 April; 51(4): 445-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=208034

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Risk of exogenous estrogen therapy and endometrial cancer. Author(s): Jelovsek FR, Hammond CB, Woodard BH, Draffin R, Lee KL, Creasman WT, Parker RT. Source: American Journal of Obstetrics and Gynecology. 1980 May 1; 137(1): 85-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7369293

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Safety and efficacy of estrogen therapy in preventing bone loss in primary biliary cirrhosis. Author(s): Menon KV, Angulo P, Boe GM, Lindor KD. Source: The American Journal of Gastroenterology. 2003 April; 98(4): 889-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12738473

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Safety and tolerability of pulsed estrogen therapy: key factors for an improved compliance. Author(s): Mattsson LA. Source: Climacteric : the Journal of the International Menopause Society. 2002 June; 5 Suppl 2: 40-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12482110

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Safety of estrogen therapy for women with fibrocystic breast disease. Author(s): Bauwens SF. Source: Clin Pharm. 1987 September; 6(9): 683. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3677568

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Selection of postmenopausal women for estrogen therapy. Author(s): Christiansen C. Source: Postgraduate Medicine. 1989 April; Spec No: 10-2; Discussion 33-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2726619

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Serum lipid changes after estrogen therapy in prostatic carcinoma. Author(s): Bulusu NV, Lewis SB, Das S, Clayton WE Jr. Source: Urology. 1982 August; 20(2): 147-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7112817

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Serum lipid levels and thromboembolic complications during estrogen therapy of prostatic cancer. Author(s): Sotanieme EA, Kontture MJ. Source: Scandinavian Journal of Urology and Nephrology. 1975; 9(2): 89-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1145147

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Serum lipids, lipoprotein lp(a), and plasminogen activator inhibitor-1 in patients with Turner's syndrome before and during growth hormone and estrogen therapy. Author(s): Lanes R, Gunczler P, Palacios A, Villaroel O. Source: Fertility and Sterility. 1997 September; 68(3): 473-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9314917

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Significance of postoperative estrogen therapy on the occurrence and clinical course of cancer. Author(s): Byrd BF Jr, Burch JC, Vaughn WK. Source: Annals of Surgery. 1973 May; 177(5): 626-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4350059

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Sjogren's syndrome induced by estrogen therapy. Author(s): Nagler RM, Pollack S. Source: Seminars in Arthritis and Rheumatism. 2000 December; 30(3): 209-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11124284

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Skeletal maturation in Turner's syndrome as related to genotype, estrogen therapy and environmental factors. Author(s): Krawczynski M, Flejsierowicz Z. Source: Endokrynol Pol. 1979 May-June; 30(3): 257-63. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=467390

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Skin collagen changes in postmenopausal women receiving different regimens of estrogen therapy. Author(s): Brincat M, Versi E, Moniz CF, Magos A, de Trafford J, Studd JW. Source: Obstetrics and Gynecology. 1987 July; 70(1): 123-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3601260

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Skin water-holding capacity and transdermal estrogen therapy for menopause: a pilot study. Author(s): Pierard-Franchimont C, Letawe C, Goffin V, Pierard GE. Source: Maturitas. 1995 September; 22(2): 151-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8538484

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Steroid-sensitive proteins, growth hormone and somatomedin C in prostatic cancer: effects of parenteral and oral estrogen therapy. Author(s): Stege R, Frohlander N, Carlstrom K, Pousette A, von Schoultz B. Source: The Prostate. 1987; 10(4): 333-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2440014

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Stricture of the anterior urethra following estrogen therapy in patients with prostatic cancer. Author(s): Yokoyama M, Fukutani K, Kawamura T, Shoji F, Ohtani M. Source: Urologia Internationalis. 1983; 38(4): 247-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6308871

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Studies of androgens in transsexual subjects. Effects of estrogen therapy. Author(s): Migeon CJ, Rivarola MA, Forest MG. Source: Johns Hopkins Med J. 1968 September; 123(3): 128-33. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5672930

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Successful estrogen therapy for post-adrenalectomy relapses of breast cancer. Author(s): Devitt JE, Catton GE. Source: Can Med Assoc J. 1966 April 30; 94(18): 929-32. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4952375

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Synchronous bilateral primary germ cell tumors in patient receiving estrogen therapy. Author(s): Hem E, Attramadal A, Tveter KJ. Source: Urology. 1988 January; 31(1): 70-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3336932

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Systemic estrogen therapy of acne. Author(s): Strauss JS, Pochi PE. Source: J Am Med Womens Assoc. 1969 April; 24(4): 337-41. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4239367

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Tamoxifen and natural progesterone as supplements to low-dose postmenopausal estrogen therapy. Author(s): Kauppila A, Kivinen S, Stenback F, Vihko R, Vuopala S. Source: Gynecologic and Obstetric Investigation. 1988; 25(1): 58-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3277903

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Technetium-99m DTPA localized in gynecomastia secondary to orchiectomy and estrogen therapy in a patient with carcinoma of the prostate. Author(s): Shih WJ, Wierzbinski B, Magoun S, Ryo UY. Source: Clinical Nuclear Medicine. 1988 April; 13(4): 306. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2836121

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The case for and against estrogen therapy. Author(s): Graber EA, Barber HR. Source: The American Journal of Nursing. 1975 October; 75(10): 1766-71, 1794. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1041553

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The effect of castration and peroral estrogen therapy on some psychological functions. Author(s): Rauramo L, Lagerspetz K, Engblom P, Punnonen R. Source: Acta Obstetricia Et Gynecologica Scandinavica. Supplement. 1976; (51): 3-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1065182

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The effect of castration and peroral estrogen therapy on some psychological functions. Author(s): Rauramo L, Lagerspetz K, Engblom P, Punnonen R. Source: Frontiers of Hormone Research. 1975; 3: 94-104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1234567

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The effect of estrogen therapy on somatic and psychical symptoms in postmenopausal women. Author(s): Furuhjelm M, Karlgren E, Carlstrom K. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1984; 63(7): 655-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6440406

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The effect of oral estrogen therapy on serum FSH and LH levels in young women with hyper-gonadotrophic ovarian failure. Author(s): Leis D, Braun S. Source: Arch Gynecol. 1981; 230(3): 225-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6264865

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The effect of postmenopausal estrogen therapy on bone density in elderly women. Author(s): Felson DT, Zhang Y, Hannan MT, Kiel DP, Wilson PW, Anderson JJ. Source: The New England Journal of Medicine. 1993 October 14; 329(16): 1141-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8377776

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The effect of postmenopausal estrogen therapy on the risk of non-insulin-dependent diabetes mellitus. Author(s): Gabal LL, Goodman-Gruen D, Barrett-Connor E. Source: American Journal of Public Health. 1997 March; 87(3): 443-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9096551

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The effect of short-term cyclophosphamide on estrogen therapy in metastatic breast cancer. Author(s): Kennedy BJ, Kiang DT. Source: Medical and Pediatric Oncology. 1975; 1(3): 265-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1232533

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The effects of postmenopausal estrogen therapy on the incidence of arteriosclerotic vascular disease. Author(s): Knopp RH. Source: Obstetrics and Gynecology. 1988 November; 72(5 Suppl): 23S-30S. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3050656

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The effects of transdermal estrogen therapy on bone mass and turnover in early postmenopausal smokers: a prospective, controlled study. Author(s): Valimaki MJ, Laitinen KA, Tahtela RK, Hirvonen EJ, Risteli JP. Source: American Journal of Obstetrics and Gynecology. 2003 November; 189(5): 121320. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14634543

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The menopause and estrogen therapy. Author(s): Chabon I, Connell EB, Rollins LR, Forbes AP, Sachs BC, Greenblatt RB, Sanchez R, Schwartz RW. Source: J Reprod Med. 1973 December; 11(6): 233-78. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4772411

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The prevention of bone loss in young women treated with GnRH analogues with "add-back" estrogen therapy. Author(s): Leather AT, Studd JW, Watson NR, Holland EF. Source: Obstetrics and Gynecology. 1993 January; 81(1): 104-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8416441

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The pros and cons of estrogen therapy. Author(s): Segaloff A. Source: Postgraduate Medicine. 1979 June; 65(6): 106-9, 112. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=450808

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The relationship between cardiovascular complications of estrogen therapy and fibrinolysis in patients with prostatic cancer. Author(s): Hasui Y, Marutsuka K, Nishi S, Kitada S, Osada Y, Sumiyoshi A. Source: The Prostate. 1992; 21(1): 35-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1641370

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The T61 human breast cancer xenograft: an experimental model of estrogen therapy of breast cancer. Author(s): Brunner N, Spang-Thomsen M, Cullen K. Source: Breast Cancer Research and Treatment. 1996; 39(1): 87-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8738608

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The treatment of severe premenstrual syndrome with goserelin with and without 'add-back' estrogen therapy: a placebo-controlled study. Author(s): Leather AT, Studd JW, Watson NR, Holland EF. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 1999 February; 13(1): 48-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10368798

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The use of estrogen therapy in men. Author(s): Sayed Y, Taxel P. Source: Current Opinion in Pharmacology. 2003 December; 3(6): 650-4. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14644018

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The usefulness of bone turnover in predicting the response to transdermal estrogen therapy in postmenopausal osteoporosis. Author(s): Gonnelli S, Cepollaro C, Pondrelli C, Martini S, Monaco R, Gennari C. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1997 April; 12(4): 624-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9101374

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The waning effect of postmenopausal estrogen therapy on osteoporosis. Author(s): Ettinger B, Grady D. Source: The New England Journal of Medicine. 1993 October 14; 329(16): 1192-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8377785

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The Women's Health Initiative Memory Study (WHIMS): a trial of the effect of estrogen therapy in preventing and slowing the progression of dementia. Author(s): Shumaker SA, Reboussin BA, Espeland MA, Rapp SR, McBee WL, Dailey M, Bowen D, Terrell T, Jones BN. Source: Controlled Clinical Trials. 1998 December; 19(6): 604-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9875839

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Therapeutic value and long-term safety of pulsed estrogen therapy. Author(s): Doren M, Azzawi FA, Donnez J, Van der Mooren MJ, Villero J, Gompel A. Source: Maturitas. 2001 June 15; 38 Suppl 1: S23-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11390121

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Thromboembolic events secondary to estrogen therapy. Author(s): Lee JR. Source: American Family Physician. 1998 May 1; 57(9): 2071. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9606299

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Thromboembolism during estrogen therapy of prostatic cancer. Report on two cases. Author(s): Kontturi M, Sotaniemi E. Source: Scandinavian Journal of Urology and Nephrology. 1971; 5(2): 108-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4255241

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Topical estrogen therapy for androgenetic alopecia in menopausal females. Author(s): Georgala S, Katoulis AC, Georgala C, Moussatou V, Bozi E, Stavrianeas NG. Source: Dermatology (Basel, Switzerland). 2004; 208(2): 178-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15057016

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Toxic shock syndrome and estrogen therapy. Author(s): Hooper PL. Source: Annals of Internal Medicine. 1989 August 1; 111(3): 263-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2751187

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Transdermal estrogen therapy improves lipid profile and osteoporosis in postmenopausal liver transplant patients. Author(s): Isoniemi H, Appelberg J, Nilsson C, Makela P, Risteli J, Hockerstedt K. Source: Transplantation Proceedings. 2001 February-March; 33(1-2): 1472-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11267379

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Transdermal estrogen therapy in menopause. Eighteen months follow-up. Author(s): Marchesoni D, Fiscon D, Bologna A, Dal Pozzo M, Dal Magro L, Mozzanega B. Source: Clin Exp Obstet Gynecol. 1991; 18(4): 281-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1838721

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Transdermal estrogen therapy. Author(s): Connell EB. Source: Postgraduate Medicine. 1997 June; 101(6): 115-6, 122, 128-30 Passim. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9194869

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Transdermal versus oral estrogen therapy in postmenopausal smokers: hemodynamic and endothelial effects. Author(s): Girdler SS, Hinderliter AL, Wells EC, Sherwood A, Grewen KM, Light KC. Source: Obstetrics and Gynecology. 2004 January; 103(1): 169-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14704262

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Transition from estrogen therapy to raloxifene in postmenopausal women: effects on treatment satisfaction and the endometrium-a pilot study. Author(s): Davis SR, O'Neill SM, Eden J, Baber R, Ekangaki A, Stocks JM, Thiebaud D. Source: Menopause (New York, N.Y.). 2004 March-April; 11(2): 167-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15021446

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Transition to raloxifene with and without low-dose estrogen therapy in postmenopausal women: effects on serum lipids and fibrinogen - a pilot study. Author(s): O'Neill SM, Eden J, Baber R, Ekangaki A, Stocks JM, Wolthers T, Davis SR. Source: Climacteric : the Journal of the International Menopause Society. 2003 December; 6(4): 347-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15006256

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Transvaginal ultrasound and surveillance on estrogen therapy. Author(s): Kiser WR, Runkle G, Ellis DD, Nusbaum MR, Kugler JP. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1993 September-October; 6(5): 526. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8213249

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Turner's syndrome: results of estrogen therapy. Author(s): Gidwani GP, Seiler JC, Ballard LA Jr. Source: Cleve Clin Q. 1979 Spring; 46(1): 19-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=436270

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Urogenital atrophy and low-dose vaginal estrogen therapy. Author(s): Notelovitz M. Source: Menopause (New York, N.Y.). 2000 May-June; 7(3): 140-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10810957

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Use of estrogen therapy in a patient with gastrointestinal bleeding secondary to arteriovenous malformations. Author(s): Siple JF, Joseph CL, Pagel KJ, Leigh S. Source: The Annals of Pharmacotherapy. 1997 November; 31(11): 1311-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9391685

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Uterine cancer and estrogen therapy. Author(s): Mack TM. Source: Frontiers of Hormone Research. 1977; 5: 104-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=614940

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Variability of serum estrogens among postmenopausal women treated with the same transdermal estrogen therapy and the effect on androgens and sex hormone binding globulin. Author(s): Kraemer GR, Kraemer RR, Ogden BW, Kilpatrick RE, Gimpel TL, Castracane VD. Source: Fertility and Sterility. 2003 March; 79(3): 534-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12620436

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When and how to use estrogen therapy in women over 60. Author(s): Notelovitz M. Source: Geriatrics. 1980 April; 35(4): 113-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6766892

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When and why to consider estrogen therapy. Author(s): Booher DL. Source: Cleve Clin J Med. 1992 July-August; 59(4): 345-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1525965

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Which studies of therapy merit credence? Vitamin E and estrogen therapy as cautionary examples. Author(s): Spector R, Vesell ES. Source: Journal of Clinical Pharmacology. 2002 September; 42(9): 955-62. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12211220

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CHAPTER 2. NUTRITION AND ESTROGEN THERAPY Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and estrogen therapy.

Finding Nutrition Studies on Estrogen Therapy 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.4 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 “estrogen therapy” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 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 “estrogen therapy” (or a synonym): •

Placebo-controlled trial of transdermal estrogen therapy alone in postmenopausal women: effects on arterial compliance and endothelial function. Author(s): Department of Medicine, Monash University, Dandenong Hospital, Dandenong, Australia. Source: Teede, H J Liang, Y L Kotsopoulos, D Zoungas, S Craven, R McGrath, B P Climacteric. 2002 June; 5(2): 160-9 1369-7137

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/

Nutrition

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

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

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

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The following is a specific Web list relating to estrogen therapy; 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 Copper Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,886,00.html Zinc Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10071,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND ESTROGEN THERAPY Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to estrogen therapy. 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 estrogen therapy 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 “estrogen therapy” (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 estrogen therapy: •

“Bust enhancing” herbal products. Author(s): Fugh-Berman A. Source: Obstetrics and Gynecology. 2003 June; 101(6): 1345-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12798545

•

Interaction of estrogen therapy and thyroid hormone replacement in postmenopausal women. Author(s): Mazer NA. Source: Thyroid : Official Journal of the American Thyroid Association. 2004; 14 Suppl 1: S27-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15142374

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The evolving role of estrogen therapy in prostate cancer. Author(s): Oh WK. Source: Clin Prostate Cancer. 2002 September; 1(2): 81-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15046698

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to estrogen therapy; 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 Bone Loss Source: Integrative Medicine Communications; www.drkoop.com Dementia Source: Integrative Medicine Communications; www.drkoop.com Osteoporosis Source: Healthnotes, Inc.; www.healthnotes.com Osteoporosis Source: Integrative Medicine Communications; www.drkoop.com

Alternative Medicine 67

Senile Dementia Source: Integrative Medicine Communications; www.drkoop.com •

Herbs and Supplements Estrogens (Combined) Source: Healthnotes, Inc.; www.healthnotes.com Progesterone Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. PATENTS ON ESTROGEN THERAPY 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.5 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 “estrogen therapy” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on estrogen therapy, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Estrogen Therapy By performing a patent search focusing on estrogen therapy, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. 5Adapted

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

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The following is an example of the type of information that you can expect to obtain from a patent search on estrogen therapy: •

Antiestrogen therapy for symptoms of estrogen deficiency Inventor(s): Young; Ronald L. (Houston, TX) Assignee(s): BCM Technologies (The Woodlands, TX) Patent Number: 4,729,999 Date filed: October 12, 1984 Abstract: The invention involves a method for treating symptoms secondary to estrogen deficiency without using estrogen. Weakly estrogenic antiestrogens are administered to estrogen deficient women in the absence of estrogen administration. Maximum estrogenic activity is therby obtained and the harmful side effects of estrogen therapy are avoided. Excerpt(s): This invention relates to therapeutic processes, and more particularly to a process for treating human postmenopausal symptoms. Women in the postmenopausal age range now number approximately 40,000,000 in the United States alone, and each of these women faces an average life expectancy of 28 years beyond the last menstrual period. A recent review estimates that 75% to 85% of postmenopausal women will develop symptoms secondary to estrogen deficiency. C. Hammond, M.D., et al., "Current Status of Estrogen Therapy for the Menopause," Fertil. Steril, 37(1):5-25 (1982). Perhaps the most common group of complaints of the patient following ovarian failure is the vasomotor symptom complex. The "hot flash" is classically described as a sudden onset of warmth in the face and neck which usually progresses to the chest. This sensation generally lasts several minutes and is often accompanied by a visible red flush. These episodes may be exceedingly uncomfortable and are frequently associated with dizziness, nausea, headaches, palpitations and diaphoresis. Estrogen supplementation will provide significant relief in over 90% of such patients. Web site: http://www.delphion.com/details?pn=US04729999__

•

Polymeric diffusion matrix containing estradiol diacetate Inventor(s): Keith; Alec D. (Miami, FL), Snipes; Wallace (State College, PA) Assignee(s): Key Pharmaceuticals, Inc. (Miami, FL) Patent Number: 4,291,014 Date filed: July 11, 1980 Abstract: There is disclosed a polymeric diffusion matrix for the sustained release of estradiol diacetate by delivery to a patient requiring uterine wall maintenance or other types of estrogen therapy wherein the matrix comprises a polar plasticizer, polyvinylalcohol, polyvinylpyrrolidone, and a pharmaceutically effective amount of estradiol diacetate. Excerpt(s): The present invention relates to a polymeric diffusion matrix containing estradiol diacetate. More particularly, the invention relates to a polymeric diffusion matrix containing estradiol diacetate characterized by a sustained release of estradiol diacetate. A self-supporting polymeric diffusion matrix is provided for the sustained release of estradiol diacetate in order to deliver said estradiol diacetate to a patient and

Patents 71

provide said patient with a uterine wall maintenence effect, said matrix comprising from about 2 to about 60% by weight of a polar plasticizer; from about 6 to about 20% by weight polyvinylalcohol; from about 2 to about 10% by weight polyvinylpyrrolidone; and a pharmaceutically effective amount of estradiol diacetate to provide a sustained release of said estradiol diacetate over a prolonged period. In one embodiment the polar plasticizer is glycerol present in an amount of from about 2 to about 60% by weight. In another embodiment the polar plasticizer is polyethylene glycol present in an amount of from about 2 to about 15% by weight. A still further embodiment contemplates a mixture of glycerol and polyethylene glycol wherein the latter is present in an amount by weight of from about 1 to about 5 parts per weight glycerol. Web site: http://www.delphion.com/details?pn=US04291014__ •

Regulation of amyloid precursor protein (APP) expression by administration of an estrogenic compound Inventor(s): Lee; Robert K. K. (Boston, MA), Wurtman; Richard J. (Boston, MA) Assignee(s): Massachusettes Institute of Technology () Patent Number: 6,333,317 Date filed: March 27, 1998 Abstract: It has been discovered that lipophilic hormones that interact with cytosolic or nuclear receptors regulate APP expression and synthesis, through modification of APP mRNA stability and/or regulation of APP gene transcription and translation activities. These studies demonstrate that the treatment of brain cells with estrone or 17.beta.estradiol results in a reduction in the level of APP holoprotein expression, without a concomitant change in the total level of cell protein. The reduction in the level of APP holoprotein caused by estrone or 17.beta.-estradiol is also expected to reduce the production of neurotoxic APP fragments. In as much as estrogen deficiency in postmenopausal women is associated with a higher incidence of Alzheimer's disease, this discovery opens the possibility that estrogen therapy may prevent some of the neurodegenerative and cognitive changes associated with Alzheimer's disease, aging and other disease conditions associated with such neurodegenerative and cognitive decline. Excerpt(s): The present invention relates to compositions and methods for the treatment of various neurological diseases and neurodegenerative disorders associated with aging, particularly those affected by an overabundance of Amyloid Precursor Protein (APP). In particular, this invention relates to the APP holoprotein synthesis and the effect of lipophilic compounds on regulating the expression of this protein. In particular, it has been discovered that certain neurodegenerative or cognitive changes are associated with developing an imbalance in the serum levels of endogenous, gynecologically relevant substances, including certain neurotransmitters, neurotransmitter substrates or hormones. It has also been found that the level of APP holoprotein is reduced by lipophilic estrogenic compounds in brain cells, and that this reduction is expected to reduce the neurotoxicity or neurodegeneration associated with APP over expression. Alzheimer's Disease (AD) is the most common neurodegenerative disorder of aging, and is characterized by progressive dementia and personality dysfunction. The abnormal accumulation of amyloid plaques in the vicinity of degenerating neurons and reactive astrocytes is a pathological characteristic of AD. Several lines of studies suggest that postmenopausal women with lower levels of endogenous estrogen may be predisposed to the development of AD. Studies in experimental animal models provide

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a convincing rational for the role of estrogen replacement therapy and prevention of dementia. See, for example, Birge, J. Am. Geriatric. Soc. 44, 865, (1996). These studies suggest that estrogen deficiency in postmenopausal women apparently increases their susceptibility to the neurodegenerative changes of aging and AD, and that this risk can be decreased by estrogenic replacement therapy. Peganini et al. Am. J. Epidemiol, 140, 256 (1994). Estrogen treatment of cell culture reportedly promotes non-amyloidogenic APP processing and soluble APP (APPs) secretion. Jaffe et al., J. Biol. Chem. 269, 13065 (1994). Web site: http://www.delphion.com/details?pn=US06333317__

Patent Applications on Estrogen Therapy As of December 2000, U.S. patent applications are open to public viewing.6 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 estrogen therapy: •

Combination preparation with a erbeta selective estrogen and serm or antiestorgen Inventor(s): Fritzemeier, Karl-Heinrich; (Berlin, DE), Hegele-Hartung, (Muelheim a.d. Ruhr, DE), Kollenkirchen, Uwe; (Berlin, DE)

Christa;

Correspondence: Millen, White, Zelano & Branigan, P.C.; 2200 Clarendon BLVD.; Suite 1400; Arlington; VA; 22201; US Patent Application Number: 20040053898 Date filed: September 26, 2003 Abstract: A novel medicament for the treatment of estrogen-deficient disease states is disclosed. Said medicament is a combination preparation comprising an ER.beta.selective estrogen and an ER.alpha.-selective antiestrogen or SERM (Selective Estrogen Receptor Modulator). The antiestrogen or SERM which is a component of the combination preparation is preferably selective for the periphery. The preparation is suitable for an organ-specific estrogen therapy and has clear advantages over conventional therapies. Due to the combination of ER.alpha.-selective SERM and ER.beta.-estrogen the preparation permits a complete protection against bone loss caused by estrogen deficiency. The components of the medicament also have a synergistic effect with respect to the inhibition of inflammation inducing genes, in particular in inflammatory disorders such as atherosclerosis and arthritis, or neurodegenerative diseases such as Alzheimers and multiple sclerosis. Furthermore, positive effects on cognition and mood may be expected. The protective estrogen-like effects are achieved, with no expectation of proliferation effects on breasts or uterus. Excerpt(s): This invention relates to a combination preparation that comprises an ER.beta.-specific agonist and an antiestrogen or SERM, preferably an ER.alpha.-selective antiestrogen, in particular a peripherally selective ER.alpha.-selective antiestrogen and/or an ER.alpha.-selective SERM. The efficiency of estrogens for treatment of hormone-deficiency-induced symptoms such as hot flashes and atrophy of estrogen target organs, as well as for preventing bone mass loss in perimenopausal women and postmenopausal women is readily confirmed and generally accepted. It is also well6

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

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documented that the estrogen replacement therapy in postmenopausal women or in women with ovarian dysfunction that is caused in some other way reduces the risk of cardiovascular diseases compared to non-estrogen-treated women (Grady et al. (1992), Ann Intern Med 117, 1016-1037). More recent studies confirm, moreover, a protective action of estrogens against neurodegenerative diseases, such as, e.g., Alzheimer's disease (Henderson (1997), Neurology 48 (Suppl 7), p. 27-p. 35; Birge (1997), Neurology 48 (Suppl 7), p. 36-p. 41), a protective action with respect to brain functions, such as memory and learning capacity (McEwen et al. (1997), Neurology 48 (Suppl 7), p. 8-p. 15; Sherwin (1997), Neurology 48 (Suppl 7), p. 21-p. 26), as well as against hormonedeficiency-induced mood swings (Halbreich (1997), Neurology 48 (Suppl 7), p. 16-p. 20). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Treatment of conditions relating to hormone deficiencies by administration of progestins Inventor(s): Leonard, Thomas W.; (Wilmington, NC) Correspondence: Myers Bigel Sibley & Sajovec; PO Box 37428; Raleigh; NC; 27627; US Patent Application Number: 20030004145 Date filed: May 16, 2002 Abstract: The present invention includes methods for preventing endometrial hyperplasia associated with estrogen therapy through the administration of a progestin agent. The methods presented may include starting the administration of a progestin agent at a high dose, and then lowering the dose. Excerpt(s): The present application claims priority to U.S. Provisional Application No. 60/291,488, filed May 16, 2001, the disclosure of which is incorporated herein by reference in its entirety. The invention relates to a method for administering agents that treat symptoms and conditions related to hormonal deficiencies. In particular, the present invention relates to the administration of estrogens and progestins such that an acceptable bleeding pattern is achieved and maintained during the treatment period. Natural menopause typically occurs in women during middle age and is often described as an ovarian shutdown. Menopause is associated with a profound decrease in circulating levels of estrogens. Currently, there are a large variety of disorders and conditions that are attributed to the reduction of estrogen levels. These disorders and conditions include hot flashes, dryness and atrophy of the vagina, parathesia, dyspareunia, osteoporosis, female sexual dysfunction, and an increase in cardiovascular disease. In an effort to reduce these disorders and conditions, estrogens are administered to women in a so-called "estrogen replacement therapy". Estrogen replacement therapy continues to be the primary treatment of such disorders and conditions associated with menopause. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with estrogen therapy, 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

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Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “estrogen therapy” (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 estrogen therapy. You can also use this procedure to view pending patent applications concerning estrogen therapy. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON ESTROGEN THERAPY Overview This chapter provides bibliographic book references relating to estrogen therapy. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on estrogen therapy 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 “estrogen therapy” (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 estrogen therapy: •

Vascular Dementia Source: Armonk, NY: Futura Publishing Company, Inc. 2001. 310 p. Contact: Available from Blackwell Publishing. P.O. Box 20, Williston, VT 05495-9957. (800) 216-2522; FAX: (802) 864-7626. E-mail: [email protected]. Website: www.blackwellpublishing.com. PRICE: $92.95. ISBN: 0879934255. Summary: This book summarizes information on the diagnosis and treatment of vascular dementia (VAD). Topics include: (1) the epidemiology of VAD; (2) cardiovascular risk factors contributing to degenerative changes, cognitive decline, and dementia; (3) risk factors for VAD; (4) neuropathological correlates of VAD; (5) microvascular pathology in VAD and related dementias; (6) recent advances in VAD research; (7) clinical features of VAD versus Alzheimer's disease (AD); (8) neuropsychological assessments for cognitive decline; (9) subcortical arteriosclerotic

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encephalopathy Binswanger type or chronic microvascular leukoencephalopathy syndrome; (10) criteria for diagnosis of VAD; (11) classification of subtypes of VAD including subcortical versus cortical dementias; (12) neuroimaging in VAD; (13) clinical observation during long-term follow-up in VAD; (14) prevention and treatment of VAD; (15) scientific basis for plasmapheresis in VAD; (16) estrogen therapy for prevention of dementia in postmenopausal women; and (17) factors influencing long-term survival among patients with VAD versus AD.

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

Estrogen therapy: The benefits and risks : 3rd International Workshop on Estrogen Therapy in Geneva (Frontiers of hormone research); ISBN: 3805528795; http://www.amazon.com/exec/obidos/ASIN/3805528795/icongroupinterna

•

Estrogen: The Facts Can Change Your Life, the Latest Word on What the New, Safe Estrogen Therapy Can Do for You : Great Sex, Strong Bones, Good Looks by Lila Nachtigall, Joan Rattner Heilman; ISBN: 006015621X; http://www.amazon.com/exec/obidos/ASIN/006015621X/icongroupinterna

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

Menopause Source: in Charles, M.A. Diabetes Management: Complications Risk Assessment, Diagnosis, and Therapeutic Options. Larchmont, NY: Mary Ann Liebert, Inc. 2000. p. 93101. Contact: Available from Mary Ann Liebert, Inc. 2 Madison Avenue, Larchmont, NY 10538. (914) 834-3100 or (800) 654-3237. Fax: (914) 834-3688. Email: [email protected]. Website: www.liebertpub.com. PRICE: $106.95. ISBN: 913113883.

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Summary: Diabetes is a severe disease, as determined by morbidity and mortality; however, these can be deferred by aggressively identifying and treating the risk factors driving cardiovascular death. This chapter on menopause is from a textbook that focuses on risk assessment, diagnosis, and treatment options for cardiovascular disease in diabetes. The author emphasizes the practical clinical management of patients with diabetes. In this chapter, the author outlines the rationale for estrogen therapy among post-menopausal women with diabetes and especially among women who have their other risk factors well controlled. The author describes the benefits, risks, and mechanisms of action of estrogen use. One final section discusses the administration and dosage of specific estrogen use. 21 references. •

Treatment of the Sphincter: Medical Therapy Source: in Corcos, J.; Schick, E., eds. Urinary Sphincter. New York, NY: Marcel Dekker, Inc. 2001. p. 483-496. Contact: Available from Marcel Dekker, Inc. Cimarron Road, P.O. Box 5005, Monticello, NY 12701. (800) 228-1160 or (845) 796-1919. Fax (845) 796-1772. E-mail: [email protected]. International E-mail: [email protected]. Website: www.dekker.com. PRICE: $225.00 plus shipping and handling. ISBN: 0824704770. Summary: Medical treatment for sphincteric (the controlling muscles of the bladder opening) pathology is often pursued as a first line approach for the patient with either incontinence (involuntary loss of urine) or obstructive voiding. The decision to pursue medical therapy may be patient or physician driven and based on the desire to avoid more aggressive invasive procedures. This chapter on medical therapy for treatment of the sphincter is from a textbook that presents a detailed and systematic account of the current knowledge on the anatomy, physiology, functional relationships, and range of dysfunctions that affect the urinary sphincter. The medical approach to the treatment of the dysfunctional sphincter may be divided practically into medications that are used to either enhance sphincteric function (as in stress incontinence) or weaken sphincteric function (as in dyssynergia or voiding dysfunction) and promote bladder emptying. The author reviews medical therapy for the hyperactive sphincter, including the use of alpha adrenergic blockers, benzodiazepines, beta adrenergic agents, dantrolene sodium, botulinum toxin, phenol block, and baclofen; and medical therapy for the incompetent sphincter, including the use of alpha adrenergic agonists, imipramine, and estrogen therapy. The author concludes that for the smooth sphincter, alpha adrenergic agonists and antagonists represent an effective way to modulate sphincteric function. Although many different drugs have been tried to target striated sphincteric dysfunction, few have been selective enough to warrant widespread clinical use. Too commonly, adverse systemic side effects limit their clinical effectiveness. For a select group of patients, however, these drugs allow them to overcome striated sphincteric dysfunction, without resorting to surgery. 2 tables. 107 references.

•

Effect of Medications on Diabetes Source: in Carlisle, B.A.; Kroon, L.A.; Koda-Kimble, M.A. 101 Medication Tips for People with Diabetes. Alexandria, VA: American Diabetes Association. 1999. p. 76-83. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $14.95 plus shipping and handling. ISBN: 1580400329. Order number 483301.

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Summary: This chapter answers questions about the effects of common medications, alcohol, birth control pills, estrogen therapy, beta blockers, hydrochlorothiazide, and niacin on blood glucose levels. Common medications that can increase blood glucose include glucocorticoids, niacin, and protease inhibitors. Glucocorticoids taken as pills or by injection are likely to increase blood glucose levels if they are taken in large doses. If they are inhaled or applied to the skin, they are unlikely to increase blood glucose. The effect of alcohol on blood glucose depends on how much a person drinks during a particular timespan. Birth control pills will not generally make diabetes worse, and estrogen replacement therapy is safe for most women with diabetes. The benefits of beta blockers for people who have diabetes and who have had a heart attack far exceed the risks; currently prescribed doses of hydrochlorothiazide used to control blood pressure have minimal effects on blood glucose level. The amount of niacin in multivitamins is not high enough to increase blood glucose levels. •

Women and Exercise Source: in Devlin, J.T. and Schneider, S.H., eds. Handbook of Exercise in Diabetes. Alexandria, VA: American Diabetes Association. 2002. p.511-531. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $69.95 plus shipping and handling. ISBN: 1580400191. Summary: This chapter on women and exercise is from a book that provides a practical, comprehensive guide to diabetes and exercise for health care professionals involved in patient care. The authors focus on three areas: exercise and pregnancy, amenorrhea (lack of a menstrual period) and exercise, and osteoporosis and exercise. Exercise may not be effective for the pregestational woman with type 1 diabetes who is planning a pregnancy or is currently pregnant. Exercise in the form of arm ergometry has been documented to be safe for a sedentary, unfit pregnant woman and may be a helpful adjunctive therapy to medical nutritional therapy for a woman with gestational diabetes (a type of diabetes that occurs during pregnancy). After childbirth, if glucose control is maintained, the woman with diabetes should be able to return to an exercise program similar to that of a woman without diabetes. The adolescent girl with diabetes who is amenorrheic needs intensive therapy to ensure that she does not develop accelerated retinopathy (eye disease) when glucose control is achieved. If amenorrhea persists beyond the age of 16, treatment with estrogen therapy to protect the bones is advised. Women with diabetes should be offered a weight bearing exercise program along with hormonal replacement therapy when they reach menopause. In addition, smoking cessation programs are recommended to improve bone mass status. Insulin dosing for the exercising menopausal woman who is taking hormonal replacement therapy is complicated; thus, a team that is expert in insulin therapy is needed as part of the exercise program. 3 figures. 2 tables. 59 references.

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

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

Stopping estrogen therapy raises hip fracture risk Source: Reuters Health eLine Date: March 23, 2004

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•

Very low-dose estrogen therapy under investigation Source: Reuters Medical News Date: May 11, 2000

•

Low-dose estrogen therapy is effective Source: Reuters Health eLine Date: May 10, 2000

•

Oral estrogen therapy more readily continued than transdermal estrogen therapy Source: Reuters Medical News Date: July 23, 1999

•

ACOG 1999: Estrogen therapy controls cardiac norepinephrine release in female rats Source: Reuters Medical News Date: May 17, 1999

•

Addition of Progesterone To Estrogen Therapy Reduces Endometrial Cancer Risk Source: Reuters Medical News Date: February 17, 1997

•

Postmenopausal Estrogen Therapy Stimulates Cerebral Blood Flow Source: Reuters Medical News Date: June 14, 1996

•

Initiation Of Estrogen Therapy At Age 65 Or Older Beneficial Source: Reuters Medical News Date: December 29, 1995

•

Procter amp; Gamble To Enter Estrogen Therapy Market Source: Reuters Medical News Date: April 19, 1995 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to

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Market Wire’s home page at http://www.marketwire.com/mw/home, type “estrogen therapy” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “estrogen therapy” (or synonyms). If you know the name of a company that is relevant to estrogen therapy, 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 “estrogen therapy” (or synonyms).

Academic Periodicals covering Estrogen Therapy Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to estrogen therapy. In addition to these sources, you can search for articles covering estrogen therapy 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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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 Institute7: •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

7

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 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:9 •

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

8

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). 9 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 Gateway10 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.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “estrogen therapy” (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 37535 738 603 47 218 39141

HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 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.14 Simply search by “estrogen therapy” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

10

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

11

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). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14

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 Biologists15 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.16 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.17 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/.

15 Adapted 16

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. 17 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 estrogen therapy 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 estrogen therapy. 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 estrogen therapy. 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 “estrogen therapy”:

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Breast Cancer http://www.nlm.nih.gov/medlineplus/breastcancer.html Dementia http://www.nlm.nih.gov/medlineplus/dementia.html Hormone Replacement Therapy http://www.nlm.nih.gov/medlineplus/hormonereplacementtherapy.html Menopause http://www.nlm.nih.gov/medlineplus/menopause.html Osteoporosis http://www.nlm.nih.gov/medlineplus/osteoporosis.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on estrogen therapy. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Coping with Bladder Problems Source: Rockville, MD: Food and Drug Administration. 2000. 12 p. Contact: Food and Drug Administration. 5600 Fishers Lane (HFI-40), Rockville, MD 20857. (888) 463-6332. Website: www.fda.gov. PRICE: Single copy free. Summary: This brochure, written in nontechnical language, explains the problem of urinary incontinence (involuntary loss of urine) and how it can be managed. Readers are reminded that the use of adult diapers or pads is not the only treatment option; indeed, there are many treatment choices, including drug therapy. The brochure first reviews the causes of incontinence, illustrated with simple drawings of the bladder and the muscles that control the bladder opening. Urinary leakage can be caused by a weak bladder, weakening of the muscles around the bladder (common in women who have had children), a blocked urinary passageway, damage to the nerves that control the bladder, and diseases (such as arthritis) that limit movement. The brochure outlines treatment options, including bladder or habit training, bladder exercises (to strengthen the bladder control muscles, also called Kegel exercises), drug therapy, surgery, catheterization, and treatments designed only for women: throw away patch to block the urethral opening, collagen injections, estrogen therapy, and a urinary control insert that blocks the urethral passage. The brochure encourages readers to seek treatment, as

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incontinence can be stopped or decreased in almost everyone, even the very old and frail. The brochure concludes with a list of resources for readers who want additional information. The brochure is illustrated with simple line drawings and graphics. 7 figures. •

Alzheimer's Disease Source: New York, NY: Nidus Information Services, Inc. 1995. 8 p. Contact: Available from Nidus Information Services, Inc. 175 Fifth Avenue, Suite 2338, New York, NY 10010. (800) 334-9355; (212) 260-4268; FAX (212) 529-2349. PRICE: $5.95. Summary: This report provides an overview of Alzheimer's disease (AD) and its causes, diagnosis, and treatment. It explains the nature of AD, abnormalities that are found in the brains of people with the disease, the prevalence of AD, and populations most likely to develop AD. It reviews the possible causes of AD, including genetic factors, an autoinflammatory response, a deficiency of nerve growth factor, environmental or lifestyle factors, viruses, and abnormal zinc metabolism. This report examines the possible protective effects of estrogen therapy, antiinflammatory drugs, continuing education, avoidance of aluminum and zinc, and smoking. It also discusses the differences between dementia symptoms and normal signs of aging, tests under development for predicting or diagnosing AD, the latest pharmacological treatments for AD, caregiving during the early and later stages of AD, the economic effects of AD, and resources for additional information and assistance. 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 estrogen therapy. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

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•

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

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to estrogen therapy. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with estrogen therapy. 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 estrogen therapy. 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 “estrogen therapy” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “estrogen therapy”. 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 “estrogen therapy” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “estrogen therapy” (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.18

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

18

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)19: •

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/

19

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

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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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ESTROGEN THERAPY DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 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] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenergic Agents: Drugs that act on adrenergic receptors or affect the life cycle of adrenergic transmitters. Included here are adrenergic agonists and antagonists and agents that affect the synthesis, storage, uptake, metabolism, or release of adrenergic transmitters. [NIH]

Adrenergic Agonists: Drugs that bind to and activate adrenergic receptors. [NIH] Adverse Effect: An unwanted side effect of treatment. [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] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Ageing: A physiological or morphological change in the life of an organism or its parts, generally irreversible and typically associated with a decline in growth and reproductive vigor. [NIH] Agenesis: Lack of complete or normal development; congenital absence of an organ or part. [NIH]

Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Alendronate: A nonhormonal medication for the treatment of postmenopausal osteoporosis in women. This drug builds healthy bone, restoring some of the bone loss as a result of osteoporosis. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alopecia: Absence of hair from areas where it is normally present. [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] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Alveolar Bone Loss: The resorption of bone in the supporting structures of the maxilla or mandible as a result of periodontal disease. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration.

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Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]

Amyloid: A general term for a variety of different proteins that accumulate as extracellular fibrils of 7-10 nm and have common structural features, including a beta-pleated sheet conformation and the ability to bind such dyes as Congo red and thioflavine (Kandel, Schwartz, and Jessel, Principles of Neural Science, 3rd ed). [NIH] Anabolic: Relating to, characterized by, or promoting anabolism. [EU] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] 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] Angiotensinogen: An alpha-globulin of which a fragment of 14 amino acids is converted by renin to angiotensin I, the inactive precursor of angiotensin II. It is a member of the serpin superfamily. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] 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] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] 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] 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]

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Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apolipoproteins A: Lipoproteins found in human blood serum in the high-density and very-high-density lipoprotein fraction (HDL, VHDL). They consist of several different polypeptides, the most important of which are apolipoprotein A-I and A-II. They maintain the structural integrity of the HDL particles and are activators of lecithin:cholesterol acyltransferase (LCAT). Atherosclerotic patients show low apolipoprotein A levels and these apolipoproteins are either absent or present in extremely low plasma concentration in Tangier disease. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatase: An enzyme which converts androgens to estrogens by desaturating ring A of the steroid. This enzyme complex is located in the endoplasmic reticulum of estrogenproducing cells including ovaries, placenta, testicular Sertoli and Leydig cells, adipose, and brain tissues. The enzyme complex has two components, one of which is the CYP19 gene product, the aromatase cytochrome P-450. The other component is NADPH-cytochrome P450 reductase which transfers reducing equivalents to P-450(arom). EC 1.14.13.-. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Arteriosclerosis: Thickening and loss of elasticity of arterial walls. Atherosclerosis is the most common form of arteriosclerosis and involves lipid deposition and thickening of the intimal cell layers within arteries. Additional forms of arteriosclerosis involve calcification of the media of muscular arteries (Monkeberg medial calcific sclerosis) and thickening of the walls of small arteries or arterioles due to cell proliferation or hyaline deposition (arteriolosclerosis). [NIH] Arteriovenous: Both arterial and venous; pertaining to or affecting an artery and a vein. [EU] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH]

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Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Axillary: Pertaining to the armpit area, including the lymph nodes that are located there. [NIH]

Axillary Artery: The continuation of the subclavian artery; it distributes over the upper limb, axilla, chest and shoulder. [NIH] Baclofen: A GABA derivative that is a specific agonist at GABA-B receptors. It is used in the treatment of spasticity, especially that due to spinal cord damage. Its therapeutic effects result from actions at spinal and supraspinal sites, generally the reduction of excitatory transmission. [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] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Beta blocker: A drug used to slow the heart rate and reduce pressure inside blood vessels. It also can regulate heart rhythm. [NIH] Beta-pleated: Particular three-dimensional pattern of amyloidoses. [NIH] Bezafibrate: Antilipemic agent that lowers cholesterol and triglycerides. It decreases low density lipoproteins and increases high density lipoproteins. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] 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

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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] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [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] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Artery: The continuation of the axillary artery; it branches into the radial and ulnar arteries. [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] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes

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smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] 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] Carcinogen: Any substance that causes cancer. [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] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Castration: Surgical removal or artificial destruction of gonads. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are

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made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Arteries: The arteries supplying the cerebral cortex. [NIH] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromosomal: Pertaining to chromosomes. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] Citalopram: A selective neuronal serotonin reuptake inhibitor and a clinically effective antidepressant with tolerable side effects. The drug is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia (TD) in preference to tricyclic antidepressants, which aggravate this condition. [NIH]

Climacteric: Physiologic period, characterized by endocrine, somatic, and psychic changes with the termination of ovarian function in the female. It may also accompany the normal

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diminution of sexual activity in the male. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]

Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clomiphene: A stilbene derivative that functions both as a partial estrogen agonist and complete estrogen antagonist depending on the target tissue. It antagonizes the estrogen receptor thereby initiating or augmenting ovulation in anovulatory women. [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] Coenzymes: Substances that are necessary for the action or enhancement of action of an enzyme. Many vitamins are coenzymes. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] 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

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alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Confounding: Extraneous variables resulting in outcome effects that obscure or exaggerate the "true" effect of an intervention. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [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] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called

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also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] 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 Disease: Disorder of cardiac function due to an imbalance between myocardial function and the capacity of the coronary vessels to supply sufficient flow for normal function. It is a form of myocardial ischemia (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels. [NIH] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Coronary Vessels: The veins and arteries of the heart. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cystitis: Inflammation of the urinary bladder. [EU]

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Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytotoxic: Cell-killing. [NIH] Dantrolene: Skeletal muscle relaxant that acts by interfering with excitation-contraction coupling in the muscle fiber. It is used in spasticity and other neuromuscular abnormalities. Although the mechanism of action is probably not central, dantrolene is usually grouped with the central muscle relaxants. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphoresis: Perspiration, especially profuse perspiration. Called also sudoresis. [EU] Diastolic: Of or pertaining to the diastole. [EU] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH]

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Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [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] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dyspareunia: Painful sexual intercourse. [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastin: The protein that gives flexibility to tissues. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures

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that are advantageous to the patient but not urgent. [EU] 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] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] 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] Emollient: Softening or soothing; called also malactic. [EU] Encephalopathy: A disorder of the brain that can be caused by disease, injury, drugs, or chemicals. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH]

Endometrium: The layer of tissue that lines the uterus. [NIH] Endopeptidases: A subclass of peptide hydrolases. They are classified primarily by their catalytic mechanism. Specificity is used only for identification of individual enzymes. They comprise the serine endopeptidases, EC 3.4.21; cysteine endopeptidases, EC 3.4.22; aspartic endopeptidases, EC 3.4.23, metalloendopeptidases, EC 3.4.24; and a group of enzymes yet to be assigned to any of the above sub-classes, EC 3.4.99. EC 3.4.-. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] 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]

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Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Ergometer: An instrument for measuring the force of muscular contraction. [NIH] Ergometry: Any method of measuring the amount of work done by an organism, usually during exertion. Ergometry also includes measures of power. Some instruments used in these determinations include the hand crank and the bicycle ergometer. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen receptor: ER. Protein found on some cancer cells to which estrogen will attach. [NIH]

Estrogen Replacement Therapy: The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, dyspareunia, and progressive development of osteoporosis. This may also include the use of progestational agents in combination therapy. [NIH]

Estrone: 3-Hydroxyestra-1,3,5(10)-trien-17-one. A metabolite of estradiol but possessing less biological activity. It is found in the urine of pregnant women and mares, in the human placenta, and in the urine of bulls and stallions. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), estrone may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] 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

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they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Excitotoxicity: Excessive exposure to glutamate or related compounds can kill brain neurons, presumably by overstimulating them. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] 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 Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] 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]

Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Neck Fractures: Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are hip fractures. [NIH] Femur: The longest and largest bone of the skeleton, it is situated between the hip and the knee. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrinolysis: The natural enzymatic dissolution of fibrin. [NIH] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flush: Transient, episodic redness of the face and neck caused by certain diseases, ingestion of certain drugs or other substances, heat, emotional factors, or physical exertion. [EU] Forearm: The part between the elbow and the wrist. [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

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between 0.01 and 10 MeV. They are also called nuclear x-rays. [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] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to 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]

Genital: Pertaining to the genitalia. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ cell tumors: Tumors that begin in the cells that give rise to sperm or eggs. They can occur virtually anywhere in the body and can be either benign or malignant. [NIH] Gestational: Psychosis attributable to or occurring during pregnancy. [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] Glucocorticoids: A group of corticosteroids that affect carbohydrate metabolism (gluconeogenesis, liver glycogen deposition, elevation of blood sugar), inhibit corticotropin secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. [NIH] Gluconeogenesis: The process by which glucose is formed from a non-carbohydrate source. [NIH]

Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [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]

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] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most

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multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonadal Dysgenesis: Any of several developmental anomalies involving the total or partial failure of the indifferent embryonic gonad to differentiate into ovary or testis. This concept includes gonadal agenesis. [NIH] Gonadorelin: A decapeptide hormone released by the hypothalamus. It stimulates the synthesis and secretion of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. [NIH] Goserelin: 6-(O-(1,1-Dimethylethyl)-D-serine)-10-deglycinamideluteinizing hormonereleasing factor (pig) 2-(aminocarbonyl)hydrazide. A long-acting gonadorelin agonist. It is used in the treatment of malignant neoplasms of the prostate, uterine fibromas, and metastatic breast cancer. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanylate Cyclase: An enzyme that catalyzes the conversion of GTP to 3',5'-cyclic GMP and pyrophosphate. It also acts on ITP and dGTP. (From Enzyme Nomenclature, 1992) EC 4.6.1.2. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Hexestrol: A synthetic estrogen that has been used as a hormonal antineoplastic agent. [NIH] Hip Fractures: Fractures of the femur head, the femur neck, the trochanters, or the inter- or subtrochanteric region. Excludes fractures of the acetabulum and fractures of the femoral

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shaft below the subtrochanteric region. For the fractures of the femur neck the specific term femoral neck fractures is available. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydrochlorothiazide: A thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It has been used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism. [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] Hydrogenation: Specific method of reduction in which hydrogen is added to a substance by the direct use of gaseous hydrogen. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] 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] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperlipoproteinemia: Metabolic disease characterized by elevated plasma cholesterol and/or triglyceride levels. The inherited form is attributed to a single gene mechanism. [NIH]

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Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypertriglyceridemia: Condition of elevated triglyceride concentration in the blood; an inherited form occurs in familial hyperlipoproteinemia IIb and hyperlipoproteinemia type IV. It has been linked to higher risk of heart disease and arteriosclerosis. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hysterectomy: Excision of the uterus. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]

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] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Implant radiation: A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near the tumor. Also called [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus,

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or a vascular torsion. [NIH] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Inflammatory bowel disease: A general term that refers to the inflammation of the colon and rectum. Inflammatory bowel disease includes ulcerative colitis and Crohn's disease. [NIH]

Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [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] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] 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

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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] 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] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] 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] Keratoconjunctivitis: Simultaneous inflammation of the cornea and conjunctiva. [NIH] Keratoconjunctivitis Sicca: Drying and inflammation of the conjunctiva as a result of insufficient lacrimal secretion. When found in association with xerostomia and polyarthritis, it is called Sjogren's syndrome. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kinetic: Pertaining to or producing motion. [EU] Lacrimal: Pertaining to the tears. [EU] Latency: The period of apparent inactivity between the time when a stimulus is presented and the moment a response occurs. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Leukoencephalopathy: A condition with spongy holes in the brain's white matter. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] 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] 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] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory,

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and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Lipid: Fat. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lipoprotein(a): A family of lipoprotein particles varying in density and size depending on the protein-lipid ratio and the protein composition. These particles consist of apolipoprotein B-100 covalently linked to apolipoprotein-a by one or two disulfide bonds. There is a correlation between high plasma levels of this lipoprotein and increased risk for atherosclerotic cardiovascular disease. [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] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Luteal Phase: The period of the menstrual cycle that begins with ovulation and ends with menstruation. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH]

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Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medroxyprogesterone: (6 alpha)-17-Hydroxy-6-methylpregn-4-ene-3,20-dione. A synthetic progestational hormone used in veterinary practice as an estrus regulator. [NIH] Medroxyprogesterone Acetate: An injectable contraceptive, generally marketed under the name Depo-Provera. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Metastatic cancer: Cancer that has spread from the place in which it started to other parts of the body. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis

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and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [NIH] Middle Cerebral Artery: The largest and most complex of the cerebral arteries. Branches of the middle cerebral artery supply the insular region, motor and premotor areas, and large regions of the association cortex. [NIH] Milliliter: A measure of volume for a liquid. A milliliter is approximately 950-times smaller than a quart and 30-times smaller than a fluid ounce. A milliliter of liquid and a cubic centimeter (cc) of liquid are the same. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Modulator: A specific inductor that brings out characteristics peculiar to a definite region. [EU]

Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Monotherapy: A therapy which uses only one drug. [EU] 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] Mosaicism: The occurrence in an individual of two or more cell populations of different chromosomal constitutions, derived from a single zygote, as opposed to chimerism in which the different cell populations are derived from more than one zygote. [NIH] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH]

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Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]

Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] 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] Myocardial Reperfusion: Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing myocardial reperfusion injury. [NIH] Myocardial Reperfusion Injury: Functional, metabolic, or structural changes in ischemic heart muscle thought to result from reperfusion to the ischemic areas. Changes can be fatal to muscle cells and may include edema with explosive cell swelling and disintegration, sarcolemma disruption, fragmentation of mitochondria, contraction band necrosis, enzyme washout, and calcium overload. Other damage may include hemorrhage and ventricular arrhythmias. One possible mechanism of damage is thought to be oxygen free radicals. Treatment currently includes the introduction of scavengers of oxygen free radicals, and injury is thought to be prevented by warm blood cardioplegic infusion prior to reperfusion. [NIH]

Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [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] Neocortex: The largest portion of the cerebral cortex. It is composed of neurons arranged in six layers. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nephropathy: Disease of the kidneys. [EU]

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Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nerve Growth Factor: Nerve growth factor is the first of a series of neurotrophic factors that were found to influence the growth and differentiation of sympathetic and sensory neurons. It is comprised of alpha, beta, and gamma subunits. The beta subunit is responsible for its growth stimulating activity. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] 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] Neurotoxic: Poisonous or destructive to nerve tissue. [EU] 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] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a

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widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normotensive: 1. Characterized by normal tone, tension, or pressure, as by normal blood pressure. 2. A person with normal blood pressure. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Oophorectomy: Surgery to remove one or both ovaries. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Orchiectomy: The surgical removal of one or both testicles. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] 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 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] Parenteral: Not through the alimentary canal but rather by injection through some other

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route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Pediatric Gastroenterologist: A doctor who treats children with digestive diseases. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] 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] Perimenopausal: The time of a woman's life when menstrual periods become irregular. Refers to the time near menopause. [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peroral: Performed through or administered through the mouth. [EU] Perspiration: Sweating; the functional secretion of sweat. [EU] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phosphates: Inorganic salts of phosphoric acid. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and

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function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] 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] 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] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Plasmapheresis: Procedure whereby plasma is separated and extracted from anticoagulated whole blood and the red cells retransfused to the donor. Plasmapheresis is also employed for therapeutic use. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] 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]

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Platelet Count: A count of the number of platelets per unit volume in a sample of venous blood. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polyarthritis: An inflammation of several joints together. [EU] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polyethylene: A vinyl polymer made from ethylene. It can be branched or linear. Branched or low-density polyethylene is tough and pliable but not to the same degree as linear polyethylene. Linear or high-density polyethylene has a greater hardness and tensile strength. Polyethylene is used in a variety of products, including implants and prostheses. [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] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postmenopause: The physiological period following the menopause, the permanent cessation of the menstrual life. Since in the United States the age of the menopause ranges between 48 and 55 years, generally conceived as middle age, the postmenopause often refers to women considerably older. [NIH] Postoperative: After surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiate: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] 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] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are

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emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary Biliary Cirrhosis: A chronic liver disease. Slowly destroys the bile ducts in the liver. This prevents release of bile. Long-term irritation of the liver may cause scarring and cirrhosis in later stages of the disease. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progestogen: A term applied to any substance possessing progestational activity. [EU] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] 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] Prophylactic oophorectomy: Surgery intended to reduce the risk of ovarian cancer by removing the ovaries before disease develops. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostate-Specific Antigen: Kallikrein-like serine proteinase produced by epithelial cells of both benign and malignant prostate tissue. It is an important marker for the diagnosis of prostate cancer. EC 3.4.21.77. [NIH] 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 C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein

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C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia. [NIH]

Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

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] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive

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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] 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] Raloxifene: A second generation selective estrogen receptor modulator (SERM) used to prevent osteoporosis in postmenopausal women. It has estrogen agonist effects on bone and cholesterol metabolism but behaves as a complete estrogen antagonist on mammary gland and uterine tissue. [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] Reabsorption: 1. The act or process of absorbing again, as the selective absorption by the kidneys of substances (glucose, proteins, sodium, etc.) already secreted into the renal tubules, and their return to the circulating blood. 2. Resorption. [EU] 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] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relative risk: The ratio of the incidence rate of a disease among individuals exposed to a specific risk factor to the incidence rate among unexposed individuals; synonymous with risk ratio. Alternatively, the ratio of the cumulative incidence rate in the exposed to the cumulative incidence rate in the unexposed (cumulative incidence ratio). The term relative risk has also been used synonymously with odds ratio. This is because the odds ratio and relative risk approach each other if the disease is rare ( 5 percent of population) and the number of subjects is large. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic

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obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] 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] Retinopathy: 1. Retinitis (= inflammation of the retina). 2. Retinosis (= degenerative, noninflammatory condition of the retina). [EU] Ribosome: A granule of protein and RNA, synthesized in the nucleolus and found in the cytoplasm of cells. Ribosomes are the main sites of protein synthesis. Messenger RNA attaches to them and there receives molecules of transfer RNA bearing amino acids. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH]

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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] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Sedentary: 1. Sitting habitually; of inactive habits. 2. Pertaining to a sitting posture. [EU] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] 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] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [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] SERM: Selective estrogen receptor modulator. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [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] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH]

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Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smoking Cessation: Discontinuation of the habit of smoking, the inhaling and exhaling of tobacco smoke. [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] 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] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spatial disorientation: Loss of orientation in space where person does not know which way is up. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] 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] Spondylitis: Inflammation of the vertebrae. [EU] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on

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muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress incontinence: An involuntary loss of urine that occurs at the same time that internal abdominal pressure is increased, such as with laughing, sneezing, coughing, or physical activity. [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] Subcutaneous: Beneath the skin. [NIH] Subiculum: A region of the hippocampus that projects to other areas of the brain. [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]

Subtrochanteric: Below a trochanter. [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] Supraspinal: Above the spinal column or any spine. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] 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] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH]

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Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Testicles: The two egg-shaped glands found inside the scrotum. They produce sperm and male hormones. Also called testes. [NIH] Testicular: Pertaining to a testis. [EU] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombolytic: 1. Dissolving or splitting up a thrombus. 2. A thrombolytic agent. [EU] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] 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] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive

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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] Topical: On the surface of the body. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH]

Dictionary 145

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] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] 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] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vaginal: Of or having to do with the vagina, the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasoactive: Exerting an effect upon the calibre of blood vessels. [EU] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vasogenic: Acute peripheral circulatory failure due to loss of capillary tone associated with a reduced circulating blood volume. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venous blood: Blood that has given up its oxygen to the tissues and carries carbon dioxide back for gas exchange. [NIH] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular Function: The hemodynamic and electrophysiological action of the ventricles. [NIH]

Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body,

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especially in the abdomen. [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] Volition: Voluntary activity without external compulsion. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Womb: A hollow, thick-walled, muscular organ in which the impregnated ovum is developed into a child. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] Xerostomia: Decreased salivary flow. [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] Zygote: The fertilized ovum. [NIH]

147

INDEX A Abdominal, 44, 105, 132, 136, 142, 144 Abdominal Pain, 105, 144 Acetylcholine, 105, 112, 131 Acidosis, 8, 105 Acne, 53, 105 Adenocarcinoma, 21, 28, 37, 105 Adenosine, 105, 111, 134 Adjunctive Therapy, 78, 105 Adjustment, 3, 105 Adrenal Cortex, 105, 106, 119, 136 Adrenal Medulla, 105, 119, 131 Adrenergic, 6, 77, 105, 117, 119, 142 Adrenergic Agents, 77, 105 Adrenergic Agonists, 77, 105 Adverse Effect, 4, 15, 105, 140 Affinity, 105, 106, 108, 127, 141 Age of Onset, 106, 144 Ageing, 33, 106 Agenesis, 106, 122 Agonist, 72, 106, 109, 113, 117, 122, 138 Agoraphobia, 106, 124, 132 Aldosterone, 18, 106 Alendronate, 24, 106 Alertness, 106, 110 Algorithms, 106, 110 Alimentary, 106, 125, 132 Alkaline, 105, 106, 111 Alopecia, 57, 106, 115 Alternative medicine, 80, 106 Aluminum, 93, 106 Alveolar Bone Loss, 21, 106 Alveolar Process, 106, 139 Amenorrhea, 23, 78, 106, 107 Amino acid, 106, 107, 108, 120, 121, 123, 133, 135, 136, 137, 139, 140, 142, 143, 144 Amygdala, 7, 107, 127 Amyloid, 71, 107 Anabolic, 14, 42, 107, 117 Anatomical, 107, 114, 117, 128, 139 Androgens, 52, 58, 105, 107, 108 Aneurysm, 107, 145 Angina, 32, 107 Angiotensinogen, 107, 138 Animal model, 71, 107 Anomalies, 107, 122 Anorexia, 13, 107 Anorexia Nervosa, 13, 107

Antagonism, 107, 111 Antibody, 106, 107, 113, 124, 126, 128, 129, 138, 146 Antigen, 106, 107, 113, 124, 128, 129 Anti-inflammatory, 108, 121 Antineoplastic, 108, 115, 122 Apolipoproteins, 23, 108, 127 Apolipoproteins A, 23, 108 Arginine, 108, 131 Aromatase, 38, 108 Arterial, 25, 26, 45, 62, 108, 112, 115, 121, 124, 137, 143 Arteries, 108, 110, 112, 115, 127, 128, 130 Arterioles, 108, 110, 111, 130 Arteriosclerosis, 108, 124, 130 Arteriovenous, 58, 108 Artery, 14, 27, 34, 107, 108, 109, 115, 118, 129, 130, 137, 139 Astrocytes, 71, 108, 128 Asymptomatic, 5, 108 Atrophy, 42, 58, 72, 73, 108, 131 Attenuated, 6, 11, 108 Attenuation, 12, 108 Atypical, 47, 109 Autoimmune disease, 109, 130 Autonomic, 105, 109, 132, 133 Axillary, 109, 110 Axillary Artery, 109, 110 B Baclofen, 77, 109 Bacteria, 107, 109, 118, 128, 144 Benign, 13, 19, 109, 121, 122, 130, 136, 138 Benzene, 109 Benzodiazepines, 77, 109 Beta blocker, 78, 109 Beta-pleated, 107, 109 Bezafibrate, 22, 109 Bilateral, 17, 19, 47, 53, 109 Bile, 109, 120, 123, 127, 136, 141 Bile duct, 109, 136 Biochemical, 5, 7, 12, 109, 140 Biological therapy, 109, 122 Biological Transport, 109, 116 Biosynthesis, 109, 136, 140 Biotechnology, 16, 80, 87, 109 Biotransformation, 110 Bladder, 77, 92, 110, 114, 115, 124, 130, 136, 144, 145

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Blood Coagulation, 110, 111 Blood Glucose, 78, 110, 125 Blood pressure, 9, 26, 78, 110, 111, 121, 124, 129, 132, 141 Blood vessel, 109, 110, 111, 112, 115, 118, 126, 133, 141, 142, 143, 145 Blood Volume, 110, 145 Body Fluids, 110, 117, 141 Bone Density, 14, 20, 21, 25, 54, 110 Bone Resorption, 8, 14, 110 Bowel, 110, 125, 142, 144 Brachial, 25, 27, 110 Brachial Artery, 27, 110 Brachytherapy, 110, 125, 126, 137, 146 Bradykinin, 110, 131, 134 Bypass, 34, 110, 130 C Caffeine, 38, 110 Calcium, 11, 20, 24, 31, 111, 113, 130, 137 Capillary, 6, 10, 110, 111, 145 Carbohydrate, 111, 121 Carcinogen, 111, 119 Carcinogenic, 109, 111, 125, 141 Carcinoma, 19, 20, 23, 24, 25, 28, 29, 32, 37, 41, 42, 43, 50, 51, 53, 111 Cardiac, 11, 27, 38, 80, 111, 115, 119, 130, 141 Cardiomyopathy, 11, 111 Cardiovascular, 3, 6, 7, 11, 12, 18, 20, 24, 29, 30, 34, 38, 46, 50, 55, 73, 75, 77, 111, 127, 140 Cardiovascular disease, 3, 11, 12, 18, 46, 50, 73, 77, 111, 127 Case report, 40, 111, 113 Case series, 111, 113 Castration, 26, 43, 53, 54, 111 Catheterization, 92, 111, 125, 130 Causal, 18, 111 Cell Division, 109, 112, 122, 129, 134 Cell Survival, 112, 122 Central Nervous System, 105, 109, 110, 112, 117, 121, 122, 129, 130, 140 Cerebral, 5, 8, 10, 12, 80, 112, 119, 129, 130, 143 Cerebral Arteries, 112, 129 Cerebral Cortex, 112, 130 Cerebrovascular, 9, 10, 111, 112 Cerebrum, 112 Cervical, 35, 112 Cervix, 38, 112 Character, 112, 116

Cholesterol, 108, 109, 112, 115, 123, 127, 138, 141 Cholesterol Esters, 112, 127 Cholinergic, 5, 112 Chromosomal, 112, 129 Chronic, 6, 8, 12, 27, 33, 76, 112, 116, 118, 120, 126, 135, 136, 142, 144 Chronic renal, 112, 120, 135 Chylomicrons, 112, 127 Cirrhosis, 112, 136 Citalopram, 28, 112 Climacteric, 16, 17, 21, 24, 26, 27, 35, 36, 45, 49, 51, 58, 62, 112 Clinical Medicine, 113, 135 Clinical study, 7, 113 Clinical trial, 4, 5, 14, 15, 87, 113, 114, 117, 130, 137, 138 Clomiphene, 25, 35, 113 Cloning, 110, 113 Coenzymes, 113, 131 Cognition, 4, 5, 7, 72, 113 Colitis, 113 Collagen, 52, 92, 107, 113, 120, 134, 136 Colon, 113, 125, 144 Complement, 113, 114, 134 Complementary and alternative medicine, 8, 65, 67, 114 Complementary medicine, 65, 114 Compliance, 4, 17, 45, 51, 62, 114 Computational Biology, 87, 114 Conception, 114, 120, 141 Concomitant, 22, 71, 114 Confounding, 13, 114 Conjugated, 4, 21, 22, 42, 43, 50, 114, 116 Conjunctiva, 114, 126 Connective Tissue, 113, 114, 116, 120, 121, 127, 139, 142 Consciousness, 114, 116, 137 Constriction, 114, 126, 145 Constriction, Pathologic, 114, 145 Contraceptive, 13, 114, 128 Contraindications, ii, 114 Controlled study, 27, 39, 44, 48, 55, 114 Coordination, 114, 130 Cor, 114, 121 Cornea, 115, 126 Coronary, 4, 14, 15, 16, 27, 32, 34, 40, 111, 115, 128, 130 Coronary Disease, 14, 115 Coronary heart disease, 15, 16, 32, 111, 115 Coronary Thrombosis, 115, 128, 130

149

Coronary Vessels, 115 Corpus, 115, 136 Corpus Luteum, 115, 136 Cortex, 115, 119, 129 Cortical, 76, 115, 119 Curative, 115, 131, 143 Cutaneous, 6, 115, 127 Cyclic, 111, 115, 122, 131 Cyclophosphamide, 54, 115 Cystitis, 43, 115 Cytochrome, 108, 116 Cytokine, 12, 116 Cytotoxic, 116, 138 D Dantrolene, 77, 116 Degenerative, 75, 116, 122, 139 Dementia, 4, 5, 29, 33, 56, 66, 67, 71, 75, 92, 93, 116 Dendrites, 116, 131 Density, 6, 14, 18, 20, 21, 24, 108, 109, 110, 116, 127, 132, 135 Dentate Gyrus, 116, 123 Dermis, 116, 144 Diabetes Insipidus, 116, 123 Diabetes Mellitus, 3, 116, 121 Diagnostic procedure, 69, 81, 116 Diaphoresis, 70, 116 Diastolic, 116, 124 Diffusion, 70, 109, 116 Digestion, 106, 109, 110, 117, 127, 142 Dihydrotestosterone, 21, 117, 138 Dilatation, Pathologic, 117, 145 Dilation, 110, 117, 145 Direct, iii, 113, 117, 123, 138, 142 Diuresis, 111, 117 Diuretic, 117, 120, 123 Dizziness, 70, 117, 132 Dopamine, 117, 131 Dose-dependent, 7, 9, 117 Double-blind, 7, 11, 27, 29, 117 Drive, ii, vi, 5, 61, 117, 126 Drug Interactions, 117 Duct, 111, 117, 139 Dyes, 107, 117 Dyskinesia, 112, 117 Dyspareunia, 73, 117, 119 E Edema, 10, 117, 120, 123, 130 Efferent, 6, 117 Efficacy, 4, 7, 12, 15, 27, 28, 41, 50, 117 Elastin, 113, 117 Elective, 17, 117

Electrolyte, 19, 106, 118, 135, 141 Electrons, 118, 126, 137, 138 Electrophysiological, 118, 145 Embolus, 118, 124 Emollient, 118, 121 Encephalopathy, 76, 118 Endogenous, 14, 71, 117, 118, 119, 120 Endometrial, 13, 18, 20, 21, 28, 29, 33, 35, 44, 48, 50, 73, 80, 118 Endometrium, 13, 18, 41, 57, 118 Endopeptidases, 118, 136 Endorphins, 118, 131 Endothelium, 8, 11, 25, 118, 131, 134 Endothelium, Lymphatic, 118 Endothelium, Vascular, 118 Endothelium-derived, 11, 118, 131 End-stage renal, 112, 118, 135 Enkephalins, 119, 131 Entorhinal Cortex, 119, 123 Environmental Health, 86, 88, 119 Enzymatic, 107, 111, 113, 119, 120 Enzyme, 108, 113, 119, 122, 130, 134, 136, 137, 138, 143, 146 Epidemiological, 7, 11, 14, 119 Epinephrine, 105, 117, 119, 131 Epithelial, 105, 109, 119, 122, 136 Epithelial Cells, 119, 122, 136 Epithelium, 118, 119 Ergometer, 119 Ergometry, 78, 119 Estradiol, 4, 8, 21, 28, 41, 43, 49, 70, 71, 119 Estrogen receptor, 7, 11, 113, 119 Estrogen Replacement Therapy, 5, 10, 11, 13, 72, 73, 78, 119 Estrone, 71, 119 Ethanol, 112, 119 Excitation, 116, 119, 131 Excitatory, 10, 109, 119, 120, 121 Excitatory Amino Acids, 10, 120 Excitotoxicity, 10, 120 Exogenous, 6, 9, 12, 21, 35, 50, 110, 118, 120, 144 External-beam radiation, 120, 126, 137, 146 Extracellular, 107, 108, 114, 120, 128, 141 Extracellular Space, 120, 128 F Family Planning, 87, 120 Fat, 114, 115, 118, 120, 121, 127, 130, 144 Fatigue, 120, 122 Femoral, 120, 122 Femoral Neck Fractures, 120, 123

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Femur, 120, 122 Fetus, 120, 134, 136, 145 Fibrinogen, 15, 58, 120, 134, 143 Fibrinolysis, 15, 55, 120 Fibroblasts, 120, 125 Fibrosis, 120, 139 Flush, 70, 120 Forearm, 110, 120 Furosemide, 48, 120 G Gallbladder, 105, 120 Gamma Rays, 120, 137, 138 Gas, 116, 121, 123, 131, 145 Gastrin, 121, 123 Gastrointestinal, 9, 31, 58, 110, 119, 121, 140, 142 Gene, 15, 71, 108, 110, 121, 123 Genital, 121, 145 Genotype, 7, 15, 52, 121 Geriatric, 29, 31, 72, 121 Germ cell tumors, 53, 121 Gestational, 78, 121 Gland, 105, 121, 122, 127, 132, 136, 138, 140, 142, 143 Glucocorticoids, 78, 105, 121 Gluconeogenesis, 121 Glucose, 78, 110, 116, 121, 125, 138, 139 Glucose Intolerance, 116, 121 Glutamate, 120, 121 Glutamic Acid, 121, 131, 136 Glycerol, 71, 121, 133 Glycine, 106, 121, 131, 140 Glycogen, 121 Glycoprotein, 120, 121 Gonad, 121, 122 Gonadal, 28, 31, 122, 141 Gonadal Dysgenesis, 28, 31, 122 Gonadorelin, 122 Goserelin, 55, 122 Governing Board, 122, 135 Grafting, 34, 122 Granuloma, 49, 122 Growth factors, 42, 122, 129 Guanylate Cyclase, 122, 131 H Headache, 31, 111, 122, 136 Heart attack, 78, 111, 122 Heart failure, 11, 122 Hemorrhage, 122, 130, 142 Hepatic, 47, 49, 122 Hepatitis, 33, 122 Hepatocytes, 122

Heredity, 121, 122 Heterogeneity, 6, 106, 122 Hexestrol, 41, 122 Hip Fractures, 42, 120, 122 Hippocampus, 7, 116, 123, 127, 142 Homeostasis, 10, 123 Hormonal, 13, 73, 78, 108, 119, 122, 123 Hormone Replacement Therapy, 6, 11, 12, 13, 14, 15, 22, 48, 92, 123 Hormone therapy, 4, 13, 15, 123 Humoral, 26, 123 Humour, 123 Hybridomas, 123, 125 Hydrochlorothiazide, 78, 123 Hydrogen, 105, 111, 123, 129, 131, 133 Hydrogenation, 109, 123 Hydrophobic, 123, 127 Hydroxylysine, 113, 123 Hydroxyproline, 107, 113, 123 Hyperglycemia, 8, 123 Hyperlipoproteinemia, 26, 123, 124 Hyperplasia, 47, 73, 124 Hypertension, 25, 111, 115, 122, 123, 124 Hyperthermia, 6, 124 Hypertriglyceridemia, 42, 124 Hypertrophy, 115, 124 Hypothalamic, 23, 124 Hypothalamus, 122, 124, 127 Hypothyroidism, 38, 124 Hysterectomy, 25, 47, 124 I Imipramine, 77, 124 Immunologic, 124, 138 Immunosuppressive, 115, 124 Implant radiation, 124, 125, 126, 137, 146 In vitro, 11, 124 In vivo, 8, 11, 124, 128 Incision, 124, 125 Incontinence, 33, 77, 92, 124 Induction, 107, 124 Infarction, 10, 124, 139 Inflammation, 72, 105, 108, 113, 115, 120, 122, 125, 126, 135, 139, 141, 142, 144 Inflammatory bowel disease, 9, 125 Ingestion, 120, 125, 135 Initiation, 15, 80, 125 Inorganic, 125, 129, 133 Insomnia, 125, 136 Insulator, 125, 130 Insulin, 3, 17, 38, 41, 54, 78, 125, 144 Insulin-dependent diabetes mellitus, 17, 54, 125

151

Interleukin-6, 21, 125 Internal radiation, 125, 126, 137, 146 Interstitial, 110, 120, 125, 126, 146 Intestines, 105, 121, 125 Intoxication, 125, 146 Intracellular, 8, 11, 111, 125, 131, 135 Intramuscular, 45, 125, 133 Intravascular, 24, 125 Intravenous, 16, 26, 37, 125, 133 Intubation, 111, 125 Invasive, 15, 77, 125 Involuntary, 77, 92, 125, 130, 138, 141, 142 Ion Channels, 108, 125 Ionizing, 126, 138 Ions, 118, 123, 126, 137 Irradiation, 33, 126, 146 Ischemia, 5, 8, 10, 12, 108, 126, 130, 139 K Kb, 86, 126 Keratoconjunctivitis, 33, 126 Keratoconjunctivitis Sicca, 33, 126 Kidney Disease, 47, 86, 126 Kinetic, 31, 126 L Lacrimal, 126 Latency, 13, 126 Lesion, 122, 126, 143 Lethargy, 124, 126 Leukoencephalopathy, 76, 126 Libido, 25, 107, 126 Life cycle, 105, 126 Life Expectancy, 28, 70, 126 Ligament, 126, 136 Ligation, 10, 126 Limbic, 107, 126 Limbic System, 107, 126 Lipid, 9, 27, 41, 51, 57, 108, 121, 125, 127, 130, 144 Lipophilic, 71, 127 Lipoprotein, 5, 18, 44, 51, 108, 127 Lipoprotein(a), 44, 127 Liver, 29, 37, 40, 57, 105, 109, 112, 115, 120, 121, 122, 127, 136 Localized, 53, 127, 134 Low-density lipoprotein, 23, 127 Lupus, 127, 142 Luteal Phase, 13, 127 Lymph, 109, 112, 118, 123, 127 Lymph node, 109, 112, 127 Lymphatic, 118, 127, 135 Lymphocyte, 107, 127, 128

M Malignant, 105, 108, 121, 122, 127, 130, 136, 138, 139 Malnutrition, 108, 127 Mammary, 127, 138 Mandible, 49, 106, 127, 139 Mediator, 12, 128, 140 Medicament, 72, 128 MEDLINE, 5, 87, 128 Medroxyprogesterone, 4, 42, 128 Medroxyprogesterone Acetate, 42, 128 Membrane, 108, 114, 125, 128, 134, 139 Memory, 7, 24, 37, 56, 73, 107, 116, 128 Menstruation, 106, 127, 128 Mental, iv, 5, 86, 88, 112, 113, 116, 120, 124, 128, 137, 139 Mental Health, iv, 5, 86, 88, 128, 137 Meta-Analysis, 33, 128 Metabolite, 110, 119, 128 Metastasis, 128 Metastatic, 26, 37, 49, 54, 122, 128 Metastatic cancer, 26, 128 MI, 17, 18, 39, 103, 128 Microbiology, 109, 128 Microdialysis, 6, 128 Microglia, 108, 128 Middle Cerebral Artery, 10, 129 Milliliter, 110, 129 Mitosis, 129 Mitotic, 13, 129 Modeling, 4, 6, 129 Modification, 71, 107, 129, 137 Modulator, 72, 129 Molecular, 11, 87, 89, 110, 114, 116, 120, 129, 134, 144 Molecule, 12, 107, 113, 118, 119, 129, 138 Monitor, 37, 129, 132 Monoclonal, 123, 126, 129, 138, 146 Monocytes, 125, 129 Mononuclear, 122, 129 Monotherapy, 28, 129 Morphological, 43, 106, 129 Morphology, 18, 129 Mosaicism, 45, 129 Motion Sickness, 129, 130 Mucus, 35, 129, 144 Multicenter study, 20, 130 Multiple sclerosis, 72, 130 Muscle relaxant, 116, 130 Myelin, 130 Myocardial infarction, 14, 36, 39, 43, 115, 128, 130

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Myocardial Ischemia, 115, 130 Myocardial Reperfusion, 130, 139 Myocardial Reperfusion Injury, 130, 139 Myocardium, 11, 128, 130 N Nausea, 70, 130, 132, 136 Necrosis, 124, 128, 130, 139 Neocortex, 7, 130 Neoplasm, 130, 139 Nephropathy, 126, 130 Nerve, 93, 105, 116, 117, 128, 130, 131, 139, 142, 144 Nerve Growth Factor, 93, 131 Nervous System, 112, 128, 131, 133, 142 Neural, 5, 6, 107, 123, 129, 131 Neurodegenerative Diseases, 72, 73, 131 Neuromuscular, 39, 105, 116, 131 Neuronal, 112, 131 Neurons, 71, 116, 119, 120, 130, 131, 142 Neurotoxic, 71, 131 Neurotoxicity, 71, 131 Neurotransmitter, 71, 105, 107, 110, 117, 120, 121, 126, 131, 132, 142 Neutrons, 126, 131, 137 Niacin, 78, 131, 144 Nitric Oxide, 6, 8, 11, 12, 131 Nitrogen, 107, 115, 131, 144 Norepinephrine, 80, 105, 117, 131 Normotensive, 26, 132 Nuclear, 53, 71, 118, 121, 127, 130, 132 Nuclei, 107, 118, 127, 129, 131, 132 O Odds Ratio, 132, 138 Oophorectomy, 17, 25, 47, 132 Opacity, 116, 132 Orchiectomy, 19, 21, 44, 48, 53, 132 Osteoporosis, 7, 14, 19, 22, 23, 28, 30, 31, 32, 33, 34, 35, 41, 48, 56, 57, 66, 73, 78, 92, 106, 119, 132, 138 Ovaries, 50, 108, 132, 136, 140 Ovary, 115, 119, 121, 122, 132 Ovulation, 113, 127, 132 Ovum, 115, 126, 132, 136, 146 P Palliative, 132, 143 Pancreas, 105, 125, 132 Panic, 124, 132 Panic Disorder, 124, 132 Parenteral, 29, 52, 132 Patch, 4, 22, 92, 133, 144 Pathogenesis, 10, 14, 133 Pathologic, 11, 19, 105, 115, 133, 139

Pathophysiology, 10, 133 Patient Education, 92, 98, 100, 103, 133 Pediatric Gastroenterologist, 9, 133 Pelvic, 36, 133, 136 Pelvis, 132, 133, 145 Peptide, 18, 23, 106, 118, 133, 135, 136, 137, 143 Perfusion, 12, 133 Perimenopausal, 28, 34, 38, 72, 133 Periodontal disease, 106, 133 Peripheral blood, 26, 133 Peripheral Nervous System, 119, 131, 133, 142 Peroral, 43, 53, 54, 133 Perspiration, 116, 133 PH, 31, 110, 133 Pharmacokinetic, 133 Pharmacologic, 8, 133, 144 Phosphates, 8, 133 Phospholipids, 120, 127, 133 Phosphorus, 111, 134 Physiologic, 7, 12, 106, 109, 112, 128, 134, 138, 139 Physiology, 6, 10, 11, 14, 26, 77, 118, 134 Pilot study, 52, 57, 58, 134 Placenta, 108, 119, 134, 136 Plants, 121, 129, 132, 134, 139, 144 Plasma, 18, 28, 41, 108, 110, 112, 118, 120, 121, 123, 127, 134, 137, 138, 140 Plasma protein, 118, 134, 137 Plasmapheresis, 76, 134 Plasmin, 134 Plasminogen, 15, 51, 134 Plasminogen Activators, 134 Platelet Activation, 11, 134 Platelet Aggregation, 48, 131, 134 Platelet Count, 11, 135 Platelets, 11, 131, 134, 135, 140, 143 Plexus, 6, 135 Pneumonia, 114, 135 Poisoning, 125, 130, 135 Polyarthritis, 126, 135 Polycystic, 28, 47, 50, 135 Polyethylene, 71, 135 Polypeptide, 107, 113, 120, 134, 135 Postmenopause, 20, 135 Postoperative, 51, 135 Potassium, 106, 123, 135 Potentiate, 24, 135 Practice Guidelines, 88, 135 Precursor, 71, 107, 115, 117, 118, 119, 131, 134, 135, 137, 144

153

Premenopausal, 21, 39, 135 Premenstrual Syndrome, 18, 55, 135 Prenatal, 45, 136 Presynaptic, 131, 136 Prevalence, 93, 132, 136 Primary Biliary Cirrhosis, 50, 136 Probe, 128, 136 Progesterone, 11, 15, 20, 27, 53, 67, 80, 136, 141 Progestogen, 13, 39, 136 Progression, 56, 107, 136 Progressive, 14, 71, 112, 116, 119, 130, 131, 134, 136 Projection, 132, 136 Proline, 113, 123, 136 Prophylactic oophorectomy, 38, 136 Prospective study, 13, 16, 17, 136 Prostate, 19, 24, 26, 29, 32, 37, 43, 45, 50, 52, 53, 55, 66, 122, 136 Prostate-Specific Antigen, 37, 136 Protease, 78, 136 Protease Inhibitors, 78, 136 Protein C, 108, 127, 136 Protein S, 48, 110, 136, 139 Proteins, 27, 52, 106, 107, 108, 113, 129, 131, 133, 134, 137, 138, 140 Proteolytic, 113, 120, 134, 137 Prothrombin, 15, 137, 143 Protocol, 8, 137 Psychiatric, 4, 13, 29, 137 Psychiatry, 4, 28, 29, 137 Psychic, 112, 126, 128, 137 Psychoactive, 137, 146 Puberty, 45, 137 Public Health, 7, 14, 54, 88, 137 Public Policy, 87, 137 Pulmonary, 16, 110, 115, 137, 145 Pulmonary Artery, 110, 137, 145 Pulse, 129, 137 Q Quality of Life, 12, 137 R Race, 13, 137 Radiation, 120, 124, 125, 126, 137, 138, 146 Radiation therapy, 120, 125, 126, 137, 146 Radioactive, 123, 124, 125, 126, 132, 137, 138, 146 Radioimmunotherapy, 138 Radiolabeled, 126, 138, 146 Radiotherapy, 44, 110, 126, 138, 146 Raloxifene, 24, 57, 58, 138, 140

Randomized, 7, 11, 17, 19, 20, 29, 44, 48, 117, 138 Reabsorption, 123, 138 Receptor, 11, 72, 107, 117, 138, 140 Rectum, 113, 121, 124, 125, 136, 138 Reductase, 108, 138 Refer, 1, 113, 117, 118, 131, 138, 144 Reflex, 6, 138 Regimen, 25, 117, 138 Relapse, 21, 138 Relative risk, 3, 15, 138 Renin, 18, 107, 138 Reperfusion, 8, 130, 138, 139 Reperfusion Injury, 8, 139 Resorption, 14, 106, 138, 139 Respiration, 129, 139 Retina, 139 Retinopathy, 78, 139 Ribosome, 139, 144 Risk factor, 4, 10, 13, 75, 77, 136, 138, 139 S Saliva, 139 Salivary, 21, 139, 146 Saponins, 139, 141 Sarcoma, 37, 139 Schizoid, 139, 146 Schizophrenia, 139, 146 Schizotypal Personality Disorder, 139, 146 Sclerosis, 25, 108, 130, 139 Screening, 113, 140 Secretion, 72, 121, 122, 123, 124, 125, 126, 129, 133, 140 Sedative, 124, 140 Sedentary, 78, 140 Selective estrogen receptor modulator, 11, 138, 140 Semen, 136, 140 Senile, 67, 132, 140 Serine, 118, 122, 136, 140 SERM, 72, 138, 140 Serotonin, 112, 131, 140, 144 Serous, 118, 140 Serum, 19, 20, 25, 35, 37, 51, 54, 58, 71, 108, 113, 127, 140 Sex Characteristics, 107, 137, 140, 143 Shock, 57, 140 Side effect, 4, 7, 70, 77, 105, 109, 112, 115, 140, 144 Signs and Symptoms, 4, 29, 138, 140 Skeletal, 17, 42, 52, 107, 116, 140 Skeleton, 120, 140 Small intestine, 112, 123, 125, 141

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Smoking Cessation, 78, 141 Smooth muscle, 11, 111, 141, 142 Sneezing, 141, 142 Social Environment, 137, 141 Sodium, 77, 106, 123, 138, 141 Solvent, 109, 119, 121, 141 Soma, 141 Somatic, 54, 112, 123, 127, 129, 133, 141 Spatial disorientation, 117, 141 Specialist, 94, 117, 141 Species, 119, 129, 137, 141, 145, 146 Sperm, 107, 121, 141, 143 Sphincter, 77, 141 Spinal cord, 108, 109, 110, 112, 131, 133, 138, 141 Spondylitis, 44, 141 Sporadic, 131, 141 Sterility, 16, 18, 23, 24, 27, 35, 38, 39, 43, 51, 58, 115, 141 Steroid, 8, 52, 108, 139, 141 Stimulant, 110, 141 Stimulus, 117, 119, 125, 126, 138, 142, 143 Stomach, 105, 121, 123, 125, 130, 141, 142 Stool, 113, 124, 142 Stress, 32, 77, 130, 142 Stress incontinence, 32, 77, 142 Stroke, 10, 12, 86, 111, 142 Subcutaneous, 117, 133, 142 Subiculum, 123, 142 Substance P, 128, 136, 140, 142 Subtrochanteric, 122, 142 Supplementation, 70, 142 Suppression, 12, 45, 142 Supraspinal, 109, 142 Sympathomimetic, 117, 119, 132, 142 Symphysis, 136, 142 Symptomatic, 27, 142 Synapse, 105, 136, 142, 144 Synaptic, 131, 142 Synergistic, 72, 142 Systemic, 25, 47, 53, 77, 110, 119, 126, 137, 142, 146 Systemic lupus erythematosus, 47, 142 Systolic, 124, 143 T Tardive, 112, 143 Temporal, 107, 123, 143 Temporal Lobe, 107, 143 Testicles, 132, 143 Testicular, 33, 108, 143 Testis, 119, 122, 143 Testosterone, 14, 19, 25, 45, 138, 143

Therapeutics, 12, 143 Threshold, 14, 124, 143 Thrombin, 120, 134, 136, 137, 143 Thrombocytes, 135, 143 Thrombolytic, 134, 143 Thrombosis, 11, 15, 137, 142, 143 Thrombus, 115, 124, 130, 134, 143, 145 Thyroid, 22, 36, 65, 124, 143 Thyroid Gland, 36, 143 Thyroid Hormones, 143 Thyrotropin, 124, 143 Thyroxine, 38, 143 Tomography, 110, 143 Tone, 132, 143, 145 Topical, 16, 43, 57, 119, 144 Torsion, 125, 144 Toxic, iv, 57, 109, 144 Toxicity, 117, 144 Toxicokinetics, 144 Toxicology, 17, 88, 144 Toxin, 77, 144 Trachea, 143, 144 Transdermal, 4, 21, 22, 26, 27, 38, 39, 41, 44, 45, 49, 50, 52, 55, 56, 57, 58, 62, 80, 144 Transfection, 110, 144 Translation, 71, 106, 144 Transmitter, 105, 108, 117, 120, 125, 128, 132, 144 Tricyclic, 112, 124, 144 Triglyceride, 123, 124, 144 Tryptophan, 113, 140, 144 Type 2 diabetes, 30, 144 U Ulcerative colitis, 9, 125, 144 Urethra, 52, 136, 144, 145 Urinary, 33, 77, 92, 115, 124, 144, 145 Urine, 77, 92, 110, 116, 117, 119, 124, 142, 144, 145 Urogenital, 33, 42, 58, 145 Uterus, 20, 72, 112, 115, 118, 124, 128, 132, 136, 145 V Vagina, 21, 73, 112, 128, 145 Vaginal, 16, 26, 40, 58, 145 Vascular, 9, 10, 11, 12, 15, 41, 54, 75, 116, 118, 125, 131, 134, 143, 145 Vasoactive, 11, 12, 26, 145 Vasoconstriction, 6, 11, 119, 145 Vasodilation, 6, 25, 145 Vasodilator, 6, 12, 110, 117, 130, 145 Vasogenic, 10, 145

155

Vasomotor, 27, 28, 50, 70, 119, 145 Vein, 107, 108, 125, 132, 145 Venous, 15, 42, 108, 135, 137, 145 Venous blood, 135, 145 Venous Thrombosis, 42, 145 Ventricle, 107, 115, 123, 124, 137, 143, 145 Ventricular, 12, 115, 130, 145 Ventricular Function, 12, 145 Venules, 110, 111, 118, 145 Vertebrae, 141, 145 Veterinary Medicine, 87, 145 Virulence, 108, 144, 145 Viruses, 93, 128, 145 Viscera, 141, 145 Vitro, 146

Vivo, 146 Volition, 125, 146 W White blood cell, 107, 127, 129, 146 Windpipe, 143, 146 Withdrawal, 4, 27, 146 Womb, 145, 146 X Xenograft, 55, 107, 146 Xerostomia, 126, 146 X-ray, 110, 120, 126, 132, 137, 138, 146 X-ray therapy, 126, 146 Z Zygote, 114, 129, 146

156

Estrogen Therapy

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