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

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

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MEDROXYPROGESTERONE 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., 1960Medroxyprogesterone: 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: 0-497-00710-X 1. Medroxyprogesterone-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 medroxyprogesterone. 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 MEDROXYPROGESTERONE ........................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Medroxyprogesterone.................................................................... 5 E-Journals: PubMed Central ....................................................................................................... 22 The National Library of Medicine: PubMed ................................................................................ 23 CHAPTER 2. NUTRITION AND MEDROXYPROGESTERONE .............................................................. 71 Overview...................................................................................................................................... 71 Finding Nutrition Studies on Medroxyprogesterone .................................................................. 71 Federal Resources on Nutrition ................................................................................................... 72 Additional Web Resources ........................................................................................................... 73 CHAPTER 3. ALTERNATIVE MEDICINE AND MEDROXYPROGESTERONE ........................................ 75 Overview...................................................................................................................................... 75 National Center for Complementary and Alternative Medicine.................................................. 75 Additional Web Resources ........................................................................................................... 80 General References ....................................................................................................................... 81 CHAPTER 4. PATENTS ON MEDROXYPROGESTERONE..................................................................... 83 Overview...................................................................................................................................... 83 Patents on Medroxyprogesterone................................................................................................. 83 Patent Applications on Medroxyprogesterone............................................................................. 85 Keeping Current .......................................................................................................................... 88 CHAPTER 5. BOOKS ON MEDROXYPROGESTERONE ........................................................................ 89 Overview...................................................................................................................................... 89 Book Summaries: Online Booksellers........................................................................................... 89 CHAPTER 6. PERIODICALS AND NEWS ON MEDROXYPROGESTERONE .......................................... 91 Overview...................................................................................................................................... 91 News Services and Press Releases................................................................................................ 91 Academic Periodicals covering Medroxyprogesterone................................................................. 93 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 97 Overview...................................................................................................................................... 97 NIH Guidelines............................................................................................................................ 97 NIH Databases............................................................................................................................. 99 Other Commercial Databases..................................................................................................... 101 APPENDIX B. PATIENT RESOURCES ............................................................................................... 103 Overview.................................................................................................................................... 103 Patient Guideline Sources.......................................................................................................... 103 Finding Associations.................................................................................................................. 105 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 107 Overview.................................................................................................................................... 107 Preparation................................................................................................................................. 107 Finding a Local Medical Library................................................................................................ 107 Medical Libraries in the U.S. and Canada ................................................................................. 107 ONLINE GLOSSARIES................................................................................................................ 113 Online Dictionary Directories ................................................................................................... 113 MEDROXYPROGESTERONE DICTIONARY ........................................................................ 115 INDEX .............................................................................................................................................. 163

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

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

Effects of Postmenopausal Hormone Replacement Therapy on Central Abdominal Fat, Glycemic Control, Lipid Metabolism, and Vascular Factors in Type 2 Diabetes: A Prospective Study Source: Diabetes Care. 22(9): 1401-1407. September 1999. Contact: Available from American Diabetes Association, Inc. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 806-7801. Website: www.diabetes.org. Summary: This article describes a 12-month prospective study that examined the early and longer term effects of hormone replacement therapy (HRT) on lipid metabolism, glycemic control, total body and central abdominal fat, blood pressure, and arterial pulse wave velocity (APWV) in overweight postmenopausal females who had type 2

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diabetes. Participants were 14 women who were randomized to 6 months of observation or open label HRT before crossover. HRT consisted of 2 months of conjugated equine estrogen (CEE) 0.625 milligrams daily, followed by 4 months CEE and medroxyprogesterone 5 milligrams daily. The study found that 6 months of HRT induced significant reductions in waist circumference, waist to hip ratio, glycosylated hemoglobin (HbA1c), total and low density lipoprotein cholesterol, and central abdominal fat. HRT also improved physical functioning. There was a minor increase in resting energy expenditure. Total fat mass, fasting glucose, insulin, triglyceride, apolipoprotein B, nonesterified fatty acids, resting blood pressure, APWV, and physical activity were unchanged. The article concludes that postmenopausal HRT in these overweight women who had type 2 diabetes was associated with a reduction in central adiposity and improvement in lipid metabolism and glycemic control without deterioration in weight status or cardiovascular parameters measured. Further study is needed to determine whether HRT induced improvements in these cardiovascular risk factors result in lower long term cardiovascular morbidity and mortality, as observed in nondiabetic women. 3 tables. 50 references. (AA-M). •

Effect of Estrogen Plus Progestin on Global Cognition Function in Postmenopausal Women. The Women's Health Initiative Memory Study: A Randomized Controlled Trial Source: JAMA. Journal of the American Medical Association. 289(20): 2663-2672. May 28, 2003. Summary: This article reports the effect of estrogen plus progestin on global cognitive function in postmenopausal women, using data from the Women's Health Initiative Memory Study (WHIMS). The WHIMS is a randomized, double-blind, placebocontrolled trial involving postmenopausal, community-dwelling women aged 65 years or older. Of 4,894 eligible women who were free of probable dementia at baseline, 4,532 (92.6 percent) were enrolled in the estrogen plus progestin component of the trial. A total of 4,381 participants (96.7 percent) provided at least 1 valid cognitive function score between June 1995 and July 2002. Participants received one tablet daily containing either 0.625 mg of conjugated equine estrogen with 2.5 mg of medroxyprogesterone acetate (n=2,145) or placebo (2,236). Global cognitive function measured with the Modified Mini-Mental State Examination increased slightly over time in both groups. Women taking estrogen plus progestin had smaller average increases than those taking placebo, but the differences were not clinically important. However, more women in the estrogen plus progestin group had a clinically meaningful cognitive decline compared with the placebo group. Results do not support the use of estrogen plus progestin to protect cognition in older women. 4 figures, 4 tables, 58 references.

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Long-Term Estrogen Replacement Therapy in Female Patients With Dementia of the Alzheimer Type: 7 Case Reports Source: Dementia. 6(2): 99-107. March-April 1995. Summary: This article reports the results of a study of the efficacy of long-term, lowdose estrogen replacement therapy (ERT) among seven female patients with mild to moderate dementia related to Alzheimer's disease (DAT). Five of the patients had previously responded well to short-term ERT. The seven patients were 56 to 77 years of age. Therapeutic efficacy of estrogen was evaluated by psychometric assessments and a behavior rating scale. The psychometric assessments were performed once in 2-4 weeks. In four of the seven patients the psychometric assessment scores were elevated above pretreatment levels during ERT; termination of ERT resulted in a decrease in score.

Studies

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Geriatric rating scale scores and daily activities of the same four patients improved and cognitive functions were markedly improved throughout the treatment period. Two patients responded moderately well and another patient did not respond at all. The authors conclude that long-term, low-dose ERT improves cognitive function, dementia symptoms, and daily activities in women with mild to moderate DAT. However, the supplemental treatment with medroxyprogesterone acetate (a drug commonly used in ERT) seems to have an unfavorable effect on dementia symptoms and daily activities in these patients. 2 figures, 40 references. •

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).

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

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

Project Title: ADOLESCENT CONTRACEPTION

MISCONCEPTIONS

ABOUT

HORMONAL

Principal Investigator & Institution: Clark, Liana R.; Assistant Professor; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 191044399 Timing: Fiscal Year 2002; Project Start 15-JUL-1999; Project End 30-JUN-2004 Summary: PROFESSIONAL GOAL: The overall goal of this patient-oriented research career development award proposal is to contribute to the professional, academic, and research development of Dr. Liana Clark. In addition to the proposed project exploring the concerns and misconceptions about hormonal contraception, Dr. Clark will also pursue research training at the University of Pennsylvania. She will take courses toward the Master's degree in Clinical Epidemiology and Biostatistics, as well as courses in bioethics and financial issues in medicine. Under the mentorship of Dr. Loretta Jemmott, Dr. Clark hopes to use this award to establish herself as an academic leader in the area of adolescent sexual risk behaviors. SPECIFIC AIMS OF CONTRACEPTION PROJECT: This project will use both cross sectional and longitudinal study design to: a) identify the attitudes, concerns and misconceptions of adolescents regarding hormonal methods of contraception (Norplant, Depo-Provera and the oral contraceptive pill); b) determine the gender, racial/ethnic, sexual history, and sociodemographic factors associated with attitudes, concerns and misconceptions about hormonal contraception; and c) determine how strongly these attitudes, concerns and misconceptions predict nonuse of, or noncompliance with hormonal contraception. This study will have two parts: (1) a baseline component that includes three stages designed to identify adolescent attitudes, concerns and misconceptions about hormonal contraception and the gender, racial/ethnic, sexual history, sociodemographic features associated with holding such concerns; and (2) a follow-up component to determine whether hormonal contraceptive use and/or compliance is related to attitudes, concerns and misconceptions about these methods of contraception. HYPOTHESES: 1. The majority of adolescents studied will have concerns and misconceptions about hormonal contraception. 2. Minority adolescents (African-American and Hispanic) will have greater negative attitudes, concerns and misconceptions about hormonal contraception than will white nonHispanic adolescents. 3. Adolescents who have strongly negative attitudes, concerns and misconceptions about hormonal contraception will be less likely to choose to use these methods. 4. Adolescents who have negative attitudes, concerns and misconceptions about hormonal contraception will be less compliant with the use of these methods. CONCLUSIONS: By targeting the negative attitudes, concerns and misconceptions regarding hormonal contraception, we will be better able to encourage use of these highly effective methods by adolescents. Increased usage and improved compliance with Depo-Provera, Norplant and the oral contraceptive pill will result in an overall decrease in the rate of unintended adolescent pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

Studies

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Project Title: CHICAGO CONSORTIUM WOMEN'S INTERAGENCY HIV STUDY LLL Principal Investigator & Institution: Cohen, Mardge H.; Hektoen Institute for Medical Research 2100 W Harrison Chicago, Il 60612 Timing: Fiscal Year 2003; Project Start 01-JAN-1994; Project End 30-NOV-2007 Summary: (provided by applicant) As a multicenter, prospective cohort study The Women's Interagency HIV Study (WIHS) is designed to directly address key hypotheses related to the natural history and clinical manifestation of HIV among women. During WIHS-III (12/02-11/07), WIHS scientific Aims are to 1) develop, refine, and evaluate composite measures of antiretroviral therapy (ART) exposure and relate these measures to markers of HIV disease progression, 2) define the treated history of HIV-1 infection and the individual determinants, including host and viral genetic factors, of clinical, virologic and immunologic response to highly-active antiretroviral therapy (HAART), 3) evaluate adverse events associated with ART, 4) investigate the long term effects of HIV, and use of HMRT, on the incidence/natural history of viral co-infections that cause disease in women with or at risk for HIV, focusing on human papillomavirus infection and cervical neoplasia, and hepatitis C virus infection and liver disease, 5) evaluate the effects of age, ovulatory function, menopause and its treatment on the course of HIV infection and response to ART, 6) describe the epidemiology of HIV- associated cancers in women, and further define the natural history of malignancies in women on HAART , and 7) evaluate the oral manifestations of HIV disease. Chicago WIHS will use its nine years of successful retention strategies to engage and retain 390 participants (295 HIV+, 95 HIV-) at four clinical sites including150 participants at the oral site through six month visit cycles. These will include interviews, exams, blood, gynecologic and oral specimens, medical record abstractions, registry matches, and local and centralized laboratory analysis. Chicago WIHS will contribute the highest quality data, lead and participate in epidemiologic analyses, and disseminate the results and scientific information learned from this research initiative. As our site-specific scientific initiative, we will investigate immune recovery in HIV infected women on HMRT with particular interest in the effects of age, drug use, exogenous hormones and menopause on immune recovery. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COMP TRIAL OF FEMHRT, EVISTA AND PREMPRO IN POSTMENOPAUS Principal Investigator & Institution: Berga, Sarah L.; Professor and Chair; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002 Summary: The purpose of this investigation is to compare the effects of FemHRT, Evista, and PremPro, on vasomotor symptom relief, vaginal bleeding/spotting, lipid profiles, bone mineral density, and biochemical markers of bone metabolism. We hypothesize that FemHRT will :[1] be as effective as Prempro in reducing vasomotor symptoms;[2] provide better control of breakthrough bleeding/spotting; and [3] will have similar effects on lipid profiles, bone mineral density, and bone metabolism in early postmenopausal women. We further hypothesize that FemHRT will be more effective than Evista in; [1] reducing vasomotor symptoms;[2] controlling breakthrough bleeding; and [3] improving bone density, bone metabolism, and lipid profiles in early postmenopausal women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: COMPARISON OF MEDROXYPROGESTERONE ACETATE

NOMEGESTROL

ACETATE

TO

Principal Investigator & Institution: Hermsmeyer, R Kent.; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2003 Summary: Comparison of nomegestrol acetate (NA) to medroxyprogesterone acetate (MPA) for coronary reactivity (cardiac catheterization studies) and brachial artery reactivity hyperemia by ultrasound with collaborators at OHSU. FUNDING Theramex Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CONTRACEPTIVE IN WOMEN WITH PRIOR GESTATIONAL DIABETES Principal Investigator & Institution: Xiang, Anny H.; Preventive Medicine; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033 Timing: Fiscal Year 2004; Project Start 01-JAN-2004; Project End 31-DEC-2005 Summary: (provided by applicant): This application is submitted in response to PA-02077, "Secondary Analyses in Diabetes, Digestive and Kidney Diseases". We propose to analyze data from an existing observational cohort database to assess the impact of different types of contraception on the risk of diabetes and on glucose levels, blood pressure and serum lipids in Latino women with prior gestational diabetes mellitus (GDM). We have previously shown that those women are at high risk of developing type 2 diabetes during their reproductive years. They require effective contraception because a) pregnancy planning is required to minimize the risk of conceiving with undetected hyperglycemia, which imparts a risk of congenital malformations to the baby and (b) additional pregnancies increase their risk of diabetes. Contraception should be safe regarding effects on glycemia and risk of diabetes, as well as on blood pressure and lipid levels, which can be elevated in association with the insulin resistance that is common in women with GDM. Using data from a subset of the current cohort available through 1994, we found that low-dose combination oral contraceptives (OCs) did not increase the risk of diabetes, but that a progestin-only oral preparation did increase that risk. Effects on lipids and blood pressure were not evaluated. Approximately 20% of hormonal contraception users in our patients elect to use an injectable progestin preparation, depomedroxyprogesterone acetate (DMPA) for longterm contraception. The impact of that preparation on the risk of diabetes is unknown. Accordingly, we now propose to use an expanded version of the cohort, including all patients through 1998 when accrual ended, to assess the impact of DMPA as compared to OCs and non-hormonal contraception, on the risk of diabetes and on glucose levels, blood pressure and lipid levels. Survival analysis will be use to compare diabetes rates among forms of contraception. Generalized linear models will be used to compare effects on glucose, blood pressure and lipid levels. Successful completion of these analyses will provide novel and clinically important information about the safety of several forms of hormonal contraception that are crucial for young Latino women at high risk for type 2 diabetes. The observational results will also be important to the design of future direct comparisons of different forms of contraception in this high-risk population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEPO ADOLESCENTS

PROVERA

AND

BONE

MINERAL

Studies

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DENSITY

IN

Principal Investigator & Institution: Cromer, Barbara A.; Frederick C. Robbins Professor of Child; Pediatrics; Case Western Reserve University 10900 Euclid Ave Cleveland, Oh 44106 Timing: Fiscal Year 2002; Project Start 01-SEP-1999; Project End 31-AUG-2004 Summary: (Adapted from Investigator's Abstract) The United States has one of the highest adolescent pregnancy rates among industrialized nations. One of the major contributing factors is inadequate contraception. A very effective contraceptive method is depot-medroxyprogesterone acetate (DMPA) which has become increasingly popular in this age group. Recent research in adults has suggested a negative effect of DMPA on bone mineral density (BMD). With decreased BMD, one's risk increases later for osteoporosis, a major public health problem affecting millions of postmenopausal women every year. Compromised BMD would appear to be a particular concern in adolescents, as they normally accrue up to 40% of their total bone mineral content during this period. In preliminary work, the investigators demonstrated a 3.0% decrease in BMD in adolescent DMPA users over 2 years, compared with a 9.0% increase in untreated controls (p<0.0001). A prospective cohort study of the effects of DMPA on adolescent BMD, which will also include a double-blinded randomized prevention component, is proposed. Bone density in 400 adolescent DMPA initiators will be compared to their baseline values and to that of 300 and 120, oral and barrier contraceptive initiators, respectively, frequency matched on age and race. Bone density will be measured every six months for a maximum of two years. Bone density will also be measured at the time of discontinuation of contraceptive method. To evaluate the protective effects of estrogen on bone density, females in the DMPA treatment arm will be randomly assigned to DMPA with estradiol (n=200) and DMPA without estradiol (n=200). To examine the question of whether age modifies the effect of DMPA on bone density, the investigators will evaluate the age-treatment interaction between DMPA use and bone density among females of varying gynecologic ages. Finally, sex hormone levels and indices of calcium metabolism will be compared among the treatment groups in order to explore the biologic mechanisms underlying BMD changes. The statistical analysis will estimate the effect of DMPA on bone density while taking account of constant treatment discontinuation throughout the study period. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPO-PROVERA AND BONE DENSITY IN PREMENOPAUSAL WOMEN Principal Investigator & Institution: Clark, M Kathleen.; Associate Professor; None; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002; Project Start 01-FEB-2000; Project End 31-JAN-2004 Summary: (Adapted from abstract): Registered nurses (RNs) and advanced practice nurses (APNs) play an important role in providing contraceptive services to women of reproductive age. Education and counseling regarding use, risks, and benefits of contraceptive choices are long-standing nursing interventions. With prescriptive authority, APNs are additionally responsible for providing safe, effective pharmacological interventions for preventing pregnancy. DMPA is a progestin only injectable contraception, approved for use in the US in 1992. Of concern is a potential adverse effect of DMPA on bone mineral density. Because DMPA disrupts the hypothalamic-pituitary-ovarian-axis (HPO), it theoretically will suppress estrogen

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Medroxyprogesterone

production causing a relative estrogen deficiency, and corresponding loss of bone mineral density. The overall goals of this study are to determine the effect of DMPA on bone mineral density in women aged 18 to 30 years and to determine whether the effect can be modified by calcium intake or predicted by, baseline estradiol levels, irregular vaginal bleeding or weight gain. A two-year prospective longitudinal study of 275 women, 160 who are receiving their first DMPA injection, and 115 control subjects who are not using any hormonal method of contraception, will be completed. All participants will receive a baseline evaluation, and follow-up evaluations every three months for two years. At baseline, participants will have their bone mineral density of the femoral neck, lumbar spine and total body measured using dual energy x-ray densitometry (DEXA). Blood will be drawn for estradiol levels and other physical measurements completed. Participants will complete nutritional and physical activity assessments, as well as a comprehensive interview detailing demographic, medical reproductive and lifestyle behaviors that may influence bone mineral density. All participants will be given one 90-day menstrual calendar for the daily recording of vaginal bleeding. At each followup evaluation bone mineral density and body composition will be measured, nutrition and physical activity reassessed and components of the interview updated. The menstrual calendar will be collected, reviewed and new calendars provided. Random coefficient regression (RCR) analysis will be the major analytic strategy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DEPO-PROVERA USE AND BONE MINERAL DENSITY IN YOUNG WOMEN Principal Investigator & Institution: Scholes, Delia; Center for Health Studies Seattle, Wa 98101 Timing: Fiscal Year 2002; Project Start 15-JUL-1994; Project End 31-JAN-2004 Summary: Osteoporosis and related fractures are growing public health problems. Factors affecting bone loss in later life and those affecting peak bone mass attainment are key to prevention of this condition. Several small studies suggest that depot medroxyprogesterone acetate (Depo-Provera, DMPA), an injectable progesterone-based contraceptive, decreases bone density and may thus increase a woman's later risk of osteoporosis. However, our ongoing evaluation of this association in a large study group provides evidence that DMPA's effects may be more complex, varying by age, duration of use, and anatomic site. In particular, effects on bone may be greater in younger age groups. Preliminary studies also suggest that discontinuation may favorably impact bone mass, but whether any effects are completely reversed and what roles age, duration of prior DMPA use, time since discontinuation, and other covariates may play is, as yet, unclear. We propose to continue our prospective epidemiologic evaluation of the effects of DMPA use on bone mineral density (BMD) in reproductiveage women. The primary aims are: to attain longer-term BMD evaluations in women who continue to use this contraceptive method; to assess the effects of discontinuation in women of varying age and durations of use; and to evaluate DMPA's effects on bone density in adolescents. Members of our established cohort of 457 women 18-39 years of age will be followed to evaluate more fully the effects of continued DMPA use on bone density and to assess changes in BMD after discontinuation. We propose to enrich our cohort with an additional group of adolescent participants. This group will be recruited from the same defined HMO population as our ongoing study group, using automated databases to select DMPA users and randomly-selected age-comparable women not using DMPA. Adolescent women will be followed for 24 to 36 months. For all participants the primary outcome, bone mineral density, will be measured every 6

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11

months at various anatomic sites (hip, spine, and whole body) using dual-energy x-ray absorptiometry. This proposal addresses an area designated as a priority for research by the NIH/NICHD and incorporates a group (adolescents) deemed to be in critical need of adequate study. Moreover, DMPA is an increasingly popular contraceptive among young contracepting women. The size, diversity, and range of DMPA exposure in this study group allow for comprehensive evaluation of the possibly complex association between this effective, convenient and economical contraceptive and bone mass. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DOXYCYCLINE CONTRACEPTORS

FOR

BLEEDING

IN

PROGESTIN

ONLY

Principal Investigator & Institution: Archer, David F.; Director, Clinical Research Center; Obstetrics and Gynecology; Eastern Virginia Medical School Norfolk, Va 23507 Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 30-JUN-2007 Summary: (provided by applicant): Clinically, a high percentage of women using progestin-only contraception experience breakthrough bleeding spotting that causes impaired lifestyle and results in decreased compliance with this contraceptive method. There is a need for an effective, low-cost, easily adapted treatment to reduce the bleeding and spotting in progestin only contraceptives. The molecular environment of the endometrium of women with breakthrough bleeding [BTB] and spotting, like many other inflammatory disorders, contains abnormally high levels of pro-inflammatory cytokines (TNF-alpha and IL-1beta)and abnormally high levels of proteases (matrix metalloproteinases [MMPs] and neutrophil elastase), which prevent normal tissue repair. Doxycycline [DOX] is an inexpensive, FDA approved antibiotic that inhibits MMPs, TACE activity, and reduces NO synthesis. The therapeutic benefit of DOX in animal models and clinical studies of periodontal and ulcerative diseases is due to its inhibition of MMPs, not to its antibiotic effect. We do not anticipate any reduction in contraceptive efficacy with the use of DOX. We propose to clinically evaluate DOX treatment of progestin-only contraceptive induced BTB and spotting, and to biochemically characterize the endometrial molecular biologic changes that occur in DOX treated patients. If successful, DOX treatment could become an important adjuvant for treatment of this and possibly other inflammatory disorders effecting reproductive tract tissues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECT OF HORMONAL CONTRACEPTION ON BONE MINERAL DENSITY Principal Investigator & Institution: Berenson, Abbey B.; Obstetrics and Gynecology; University of Texas Medical Br Galveston 301 University Blvd Galveston, Tx 77555 Timing: Fiscal Year 2002; Project Start 11-SEP-2001; Project End 31-AUG-2006 Summary: Recent studies have suggested that use of depot medroxyprogesterone acetate (DMPA) may have an adverse effect on bone mineral density (BMD). In contrast, use of oral contraceptives has been reported to have a beneficial effect or no effect. In a preliminary study, we observed a decrease of 3.0 percent in BMD among users of DMPA as compared with an increase of 0.1 percent-2.9 percent among users of 30-35 mug pills. Questions regarding the specific relationship between BMD and DMPA, however, have not been fully addressed. Furthermore, almost no data are available on the effects of the recently marketed pills containing only 20 mug of estradiol. Considering that over 11 million women in the US use hormonal contraception each

12

Medroxyprogesterone

year, it seems imperative to obtain accurate information on the effects of these medications on skeletal health. To address this important question, we propose to conduct a prospective clinical trial comparing changes in BMD over a 2-year interval experienced by women using DMPA or oral contraceptives containing 20 mug estradiol as compared with women not using hormonal contraception. Each cohort will be comprised of 229 women aged 16 to 33 years of white, black, or Hispanic race/ethnicity. The primary outcomes (ie, BMD and biomarkers of bone metabolism) will be analyzed to assess changes from baseline within each contraceptive group at 6, 12, 18, and 24 months as compared to changes observed among controls. Furthermore, we will be able to assess the reversibility of potential adverse effects of hormonal contraception on BMD among those who discontinue their method by conducting a bone scan and measuring biomarkers at the point of discontinuation and at 6-month intervals from this point. This study will be among the first to investigate the role of race/ethnicity and age in contraceptive-related BMD changes while accounting for behavioral correlates (eg, prior contraceptive use, nutritional intake, exercise habits, alcohol use, smoking) in a multivariate fashion. Ultimately, this study will determine which women, if any, are placed at increased risk of osteopenia or osteoporosis as a result of using these hormonal contraceptives during their reproductive years. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECT OF HORMONE THERAPY AND RALOXIFENE ON SERUM LIPIDS Principal Investigator & Institution: Roddy, Shirley J.; Learning Resource Center; University of Nebraska Medical Center Omaha, Ne 681987835 Timing: Fiscal Year 2002; Project Start 29-MAR-2002 Summary: This is a prospective, randomized, double-blinded clinical trial designed to compare the short-term effect of Raloxifene or Hormone Replacement Therapy (HRT) on serum lipids and lipoproteins of dyslipidemic postmenopausal women over time. Subjects will be randomized to receive either raloxifene 60 mg/d or conjugated equine estrogen 0.625 mg plus consecutive medroxyprogesterone acetate 2.5 mg/day (HRT). Serum lipoprotein(a), low-density lipoproteins, high-density lipoproteins, total cholesterol and triglycerides will be obtained at baseline, 3 months, and 6 months. The beneficial short-term effects of HRT on lipids and lipoproteins of dyslipidemic women has been established via clinical trials; however, the potential adverse effects of breast and endometrial cancer, hot flashes, and vaginal bleeding have been reported. Raloxifene is a selective estrogen receptor modulator that has estrogen-agonist effect on bone and estrogen antagonist effects on breast and uterus. Short term trials have demonstrated raloxifene reduces LDL and Lp(a) in healthy postmenopausal women with normal lipid panels. This study will add to the scientific body of evidence regarding raloxifene as a potential primary prevention alternative for dyslipidemic postmenopausal women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DISPENSING

EFFECTIVENESS

OF

NURSE

HOME

CONTRACEPTIVE

Principal Investigator & Institution: Melnick, Alan L.; Assistant Professor; Family Medicine; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 30-JUN-2005

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13

Summary: (provided by the applicant): The purpose of our study is to determine whether an innovative way of providing contraception, in the home, could reduce the incidence of unintended pregnancy for low income and minority women who have already had one birth. Women with a first-borne infant found to be at high risk for medical and social problems through a community-based screening program who are interested in delaying a subsequent pregnancy will be randomized into two groups. The first group will receive a home visit by a community health nurse, who will provide contraceptive counseling, including a referral to publicly funded family planning clinic. The second group will receive the same services, but will also receive either a threemonth supply of oral contraceptives or a depo-medroxyprogesterone injection. The study has two objectives: to determine whether this practice reduces subsequent unintended pregnancies in this population and whether this practice encourages or discourages utilization of clinic-based preventive services, such as sexually transmitted disease and cervical cancer screening. The results of our study have important implications for public health. Most local public health departments throughout the United States already use community health nurses to deliver many services at home, including case management for families with infants at risk for medical and social problems. If delivery of contraceptives at home is effective in reducing subsequent unintended pregnancies for these families, local health departments across the country could add this service for very little added cost. To the extent that home contraceptive delivery model proves successful at widening the interval between births for lowincome and minority women, and increases the likelihood that subsequent pregnancies are intended, it will increase the likelihood of having babies born healthier. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ESTROGEN AND COGNITION IN POSTMENOPAUSAL WOMEN Principal Investigator & Institution: Dumas, Julie A.; Psychiatry; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2004; Project Start 01-AUG-2004; Project End 31-JUL-2006 Summary: (provided by applicant): The combination of the increasing size of the older adult population and the recent controversy over the administration of estrogen and progesterone to alleviate symptoms of menopause makes it imperative that we learn about the effects of gonadal steroids on cognition. The proposed research is based on a neurobiological model of the interaction of estrogen and the acetylcholine system and the effects of this interaction on normal cognition. Data indicate that estrogen attenuates the impairments on cognitive tests during anticholinergic drug challenge. Thus far, the role of progesterone in this model has not been elucidated. In order to understand the interaction of estrogen and progesterone with the cholinergic system, Study 1 will examine the performance of postmenopausal women who have taken these hormones for three months and then perform cognitive tests during anticholinergic drug challenges. Further, in an effort to learn about the brain circuitry affected by the hormones and anticholinergic drugs, Study 2 will involve drug challenge sessions conducted during functional magnetic resonance imaging. Thus, this research will provide knowledge about the interaction of gonadal steroids and the cholinergic system, the neuroanatomy of such interactions, and their influence on cognition in postmenopausal women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Medroxyprogesterone

Project Title: ESTROGEN MODULATES INJURY-INDUCED INFLAMMATION Principal Investigator & Institution: Oparil, Suzanne; Professor; Medicine; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2004; Project Start 01-JUL-2004; Project End 30-JUN-2008 Summary: (provided by applicant): Inflammation plays an important role in the pathogenesis of many forms of vascular disease, and menopausal hormone therapy has been shown to modulate the expression of inflammatory biomarkers in women. This proposal will utilize a well-characterized rodent model to elucidate the fundamental cellular/molecular mechanisms by which ovarian hormones, particularly estrogen (E2), modulate the inflammatory response to acute endoluminal vascular injury. Our preliminary studies have demonstrated extensive inflammatory cell infiltration and increased expression of a variety of proinflammatory mediators in carotid arteries of ovariectomized rats within hours after balloon injury. We have made the novel and provocative preliminary observation that E2 inhibits granulocyte and monocyte/macrophage infiltration, as well as proinflammatory mediator expression in injured arteries. The synthetic progestin medroxyprogesterone acetate (MPA) blocks this anti-inflammatory effect. We have also observed that E2 inhibits expression of chemokines known to be chemoattractant for leukocytes in vascular smooth muscle cells (VSMCs) in vitro. The proposed research, based on these exciting and provocative preliminary observations, as well as our extensive experience in studying ovarian hormone-induced modulation of the vascular injury response, will identify the inflammatory cell types whose activation/migration can be modulated by ovarian hormones and will define the signaling cascade by which these cells direct the response to endoluminal arterial injury in the presence and absence of ovarian hormones. Novel highly selective (subtype specific) and potent agonists and antagonists of estrogen receptors (ERalpha and ERbeta), RNA interference technology and microarray analyses will be used to provide a rigorous assessment of the functional role of anti-inflammatory mechanisms in mediating the vasoprotective effects of E2 in this model. Upon successful completion of the proposed research, the cellular/molecular mechanisms responsible for the anti-inflammatory effects of E2 on injured arteries and their inhibition by MPA will be elucidated and related to the extent of the injury response (i.e. neointima formation). These fundamental mechanistic studies will enhance our understanding of the pathobiology of vascular disease, particularly as it occurs in aging women, and will provide the basis for development of novel therapeutic strategies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HORMONE CARDIOVASCULAR RISK

REPLACEMENT

AND

METABOLIC

Principal Investigator & Institution: Sites, Cynthia K.; Obstetrics and Gynecology; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2002; Project Start 02-DEC-1998; Project End 30-NOV-2003 Summary: The menopause transition is associated with a pronounced increase in risk of cardiovascular disease. Hormone replacement therapy in postmenopausal women reduces the risk of cardiovascular disease by approximately 50 percent, although the mechanisms involved are poorly understood. We will examine the impact of hormone replacement therapy on metabolic risk factors affecting cardiovascular disease and future health in aging women. Our overall hypothesis is that hormone replacement therapy in the early postmenopausal period reduces the central accumulation of body fat and improves insulin sensitivity, thereby reducing a metabolic risk factor for

Studies

15

cardiovascular disease. A total of 88 women will be recruited for this 2-year randomized double-blinded placebo-controlled longitudinal study. We will measure outcomes of changes in body fat distribution and insulin sensitivity on 4 occasions (baseline, 6 months, 1 year and 2 years) in women taking continuous conjugated estrogens plus medroxyprogesterone acetate or placebo. Our study will provide new information on the temporal sequence of changes in outcome variables. We will use: 1) computerized tomography (CT) and dual photon x- ray absorptiometry (DEXA) scanning to measure intra-abdominal body fat and total body fat, and 2) euglycemic clamps to measure insulin sensitivity. Analysis of these data will provide an understanding of the impact of hormone replacement on the syndrome of central obesity and insulin resistance, which predisposes women to increased risk for cardiovascular disease. In addition, our study may allow physicians to target hormone replacement to women with specific body compositions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: HORMONE REPLACEMENT IN MENOPAUSAL WOMEN WITH EPILEPSY Principal Investigator & Institution: Harden, Cynthia L.; Neurology and Neuroscience; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 01-JUN-2000; Project End 30-APR-2004 Summary: (Applicant's Abstract): The long-term objective is this study is to determine whether standard hormone replacement therapy is safe for menopausal women with epilepsy. The benefits of hormone replacement therapy for menopausal women are becoming widely appreciated. It is expected that hormone replacement therapy will be increasingly prescribed in a portion of the American population that is also increasing in number. Therefore, the safety of hormone replacement therapy in the settings of specific illnesses must be clear. Estrogen has neuroactive properties that are largely beneficial, that is, it can improve cerebral blood flow, promote axonal sprouting and helps to prevent protein precipitation in the brain pathognomonic of Alzheimer's Disease. However, estrogen and progesterone also have effects on increasing brain excitability which have been demonstrated in animal models of epilepsy, In these settings, estrogen, and to a lesser extent, progesterone, have been proconvulsant. Therefore, an adverse effect of hormone replacement on patients with epilepsy may be postulated. The question posed in this study is, does hormone replacement therapy adversely affect seizures or is it safe for menopausal women with epilepsy? To answer this question, women with epilepsy who are menopausal for at least one year (1 year without menses) and are medically cleared to take hormone replacement therapy will be enrolled. They will be followed for a three month period while taking their usual antiepileptic medications without dosage change. During this prospective baseline period, seizure frequency will be documented. After three months, subjects will be randomized to take either placebo or one of two doses of standard hormone replacement therapy. The hormone replacement therapy used will be Prempro at doses of 1) 0.625 mg conjugated equine estrogens with 2.5 mg medroxyprogesterone and 2) 1.25 mg conjugated equine estrogens with 5 mg medroxyprogesterone. The investigators and the subjects will be blinded as to the study medication given. The subjects will then be followed for a three month prospective treatment phase and again seizure frequency will be documented. Subjects will be monitored for safety concerns regarding hormone replacement therapy and seizure frequency. The outcome of this study will be determined by comparing seizure frequency in the baseline phase with the treated phase between placebo and hormone treated groups.

16

Medroxyprogesterone

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

Project Title: HRT & ATHEROSCLEROSIS AFTER CORONARY BYPASS & MENOPAUSE Principal Investigator & Institution: Ouyang, Pamela C.; Associate Professor of Medicine; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: Coronary atherosclerosis is the major cause of death in postmenopausal women in the USA. While coronary artery bypass surgery decreases symptomatic and clinical evidence of cardiac ischemia it does not alter the underlying artherosclerotic process. Observational studies suggest that postmenopausal estrogen replacement therapy (HRT) reduces cardiac morbidity by up to 50%. However, the HERS study, published in 1998, showed no overall benefit in the clinical outcomes of sudden cardiac death or myocardial infarction in postmenopausal women with known coronary disease randomized to combined conjugated equine estrogen and medroxyprogesterone or placebo over 4 years of follow-up. This study also suggested an increase in these endpoints in the first year of treatment with the active drugs and a subsequent decrease in event rates compared to the placebo arm. The efficacy of HRT to delay the development of saphenous graft atherosclerosis is unknown. The trial of Postmenopausal HRT after CABG is a randomized, double-masked, placebo-controlled trial that tests the hypothesis that HRT started within months of coronary bypass surgery will delay the development of graft atherosclerosis and reduce the occurrence of graft occlusion. Women are randomezed to placebo or HRT with 17 beta-estradiol plus medroxyprogesterone acetate (or 17 beta-estradiol alone if post hysterectomy) within 6 months of surgery. The development of vein graft atherosclerosis will be measured using quantitative coronary angiographic and intravascular ultrasound assessment of disease severity and extent. Studies will be performed 6 months and 3.5 years after randomization. We shall determine the influence of HRT on the primary outcome variables of the change in severity and extent of atherosclerosis in vein grafts over 3.5 years of therapy. We postulate that the pathophysiologic mechanisms of platelet activation, fibrinogen binding to platelets, vascular reactivity, coagulation and fibrinolytic factors and lipoprotein composition predict the occurrence of graft occlusion and graft atherosclerosis. The effect of HRT on these factors will be measured. The proposal also tests the hypothesis that HRT exerts its beneficial effects on these risk factors in addition to more traditional risk factors including lipids and lipoprotein profile. The influence these risk factors and the effect of HRT on the frequency of early graft closure (identified on a 6 month coronary angiogram) will be assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: INJECTABLE CONTRACEPTIVES AND BONE ULTRASOUND MEASURES Principal Investigator & Institution: Rosenberg, Lynn; Professor and Associate Director; Slone Epidemiology Unit; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2002; Project Start 11-APR-2002; Project End 31-MAR-2006 Summary: (provided by applicant): Some studies of largely white populations suggest that users of the injectable progestogen contraceptive (IPC), depotmedroxyprogesterone acetate (DMPA), have lower bone mineral density than nonusers. This has biologic credibility because DMPA use results in decreased levels of estrogen.

Studies

17

In one study, the difference in bone mineral density between users and nonusers was concentrated in women aged 18-21 years, among whom peak bone mineral density would not yet have been achieved, but in another study there was no relation of the bone loss to age. An irreversible effect of IPCs on bone would have serious implications for rates of osteoporotic fractures later in Life, particularly for women who used IPCs at young ages. Black (African) and colored (mixed racial descent) women in South Africa have very high rates of long-term IPC use, about 80 percent of which is DMPA and 20 percent norethisterone enanthate. Ultrasound bone measurements of the heel are strongly predictive of fractures. We will conduct a cross-sectional study of heel bone as measured by ultrasound sonometry in relation to IPC use among black and colored premenopausal women aged 18-44 years in greater Cape Town, South Africa. The aim is to assess whether IPCs are associated with lower ultrasound heel bone measurements. We will also assess whether an adverse effect decreases after cessation of use, whether it is concentrated among younger women, and whether it is related to the duration of use in either current or ex-users. Both DMPA and norethisterone enanthate will be assessed. Information on IPC use and other relevant factors (e.g., oral contraceptive use, cigarette smoking, body mass index, alcohol use, physical activity, lactation, milk intake, and reproductive history) will be obtained through personal interview: height and weight will be measured. The study will assess longer durations of use than any previous study. It should be noted that an effect of IPCs may differ between ethnic groups. Our study will be the first to informatively assess black and colored women whose heel bone measurements differ from each other and/or those of white women. Millions of women worldwide have used IPCs. Given the heavy burden of osteoporotic fractures in elderly women, it is of public health importance to determine whether IPCs have an adverse effect on bone. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISM OF INCREASED PLASMA APO A1 LEVELS BY ESTROGENS Principal Investigator & Institution: Schaefer, Ernst; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MID LUTEAL ESTROGEN AND MEDROXYPROGESTERONE ACETATE IN PCO Principal Investigator & Institution: Marshall, John C.; University of Virginia Charlottesville Box 400195 Charlottesville, Va 22904 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: BLEEDING

MIFEPRISTONE

FOR

PREVENTION

OF

BREAKTHROUGH

Principal Investigator & Institution: Jain, John K.; Assistant Professor; Obstetrics & Gynecology; University of Southern California 2250 Alcazar Street, Csc-219 Los Angeles, Ca 90033

18

Medroxyprogesterone

Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 30-JUN-2005 Summary: (provided by applicant): Progestin-only contraceptives such as depomedroxyprogesterone acetate (DMPA) represent one of the most effective classes of contraceptives but are limited by high discontinuation rates due to breakthrough bleeding especially during the first year of use. Mifepristone is a competitive progesterone receptor antagonist. When Mifepristone was given to normally cycling primates, a near-amenorrheic state was achieved. Mifepristone has been shown to decrease breakthrough bleeding in women using levonorgestrel implants. Although estrogen receptor expression increases after Mifepristone administration, a paradoxical anti-proliferative effect is seen in the endometrium. That has lead some investigators to conclude that mifeprisone can suppress estrogen receptor transcriptional activity through non-competitive means such as sequestration of estrogen receptor transcriptional cofactors. The result being lack of endometrial proliferation and development of an atrophic endometrial state. With less endometrial tissue to shed, bleeding diminishes and amenorrhea ensues. We propose to conduct a 14-month prospective, randomized, double-blind, placebo-controlled study of 50 mg of Mifepristone administered every 2 weeks for 12 cycles to 50 new starters of DMPA in order to determine the incidence of bleeding and ovulation. Bleeding data will be gathered with the use of daily dairies and ovulation monitored by thrice-weekly urine collections. Seven endometrial biopsies obtained pre- and post - treatment will be analyzed using immunohistochemical and quantitative RT-PCR methods to evaluate levels of estrogen and progesterone receptor isoforms. Biopsies will also be evaluated histologically. In order to determine the function of estrogen receptors following DMPA and Mifepristone we will establish primary endometrial cell culture and test estrogen function by measuring markers of proliferation such as SRC, MIB-1 and MMT and correlating results to in vivo biopsy samples. We are currently conducting a pilot study similar to the one proposed to gather preliminary data and to test the feasability of a larger trial. If Mifepristone is shown to safely decrease the incidence of breakthrough bleeding, more women may continue DMPA and not place themselves at risk of an unintended pregnancy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MODULATION OF ESTROGEN-REGULATED GENES BY PR ISOFORMS Principal Investigator & Institution: Harvell, Dijuana M.; Medicine; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2003; Project Start 01-DEC-2003; Project End 30-NOV-2006 Summary: (provided by applicant): Estrogen receptors (ER) and progesterone receptors (PR) are clinical markers that predict breast cancer responsiveness to endocrine therapies. Additionally, PRs alone are independent markers of good prognosis. ER and PR are always co-expressed in normal and malignant cells, and cross talk between estrogen and progesterone signaling is well known. PRs exist as two forms called PR-A and PR-B. The two PRs are present in equal amounts in normal cells, but the A:B ratio is strongly dysregulated in breast cancers. This is important because PR-A and PR-B control different sets of genes and have different functions. We have established solid, estrogen-dependent, tumors in nude mice from 4 human breast cancer cell lines that express: both PRs, neither PR, PR-A or PR-B. The cells are otherwise identical. Invariably, PR-A containing tumors are half the size of PR-B containing tumors. Why? I now plan to study the mechanisms by which the two PRs differentially influence estrogen-mediated signaling in breast cancers. I hypothesize that PR-A and PR-B have

Studies

19

different effects on estrogen,target genes. As a result, the growth promoting and morphologic effects of estrogens are critically influenced by the type of PR present in a tumor. Aim 1. To define estrogen-regulated genes involved in human breast tumor growth, and their differential modulation by PR-A vs. PR-B. Estrogen dependent tumors will be grown in mice from cells expressing no PR, or each PR isoform. Expression profiling studies will define: i. estrogen (+E) regulated genes in the absence of PRs; ii. effects of unliganded PR-A or PR-B on +E gene expression; iii. effects of PR occupancy by medroxyprogesterone acetate (MPA) on +E gene expression. Aim 2. To define mechanisms by which PR-A and PR-B differentially modulate the phenotype of estrogen-dependent tumors, focusing on the estrogen-inhibitory properties of PR-A. These studies use cell lines with stably integrated PRs or cells in which PRs can be switched "on" and "off". I will define the morphology, motility and invasiveness properties of the cells treated with +E, and as modified by each PR with and without MPA. I will analyze specifically, the regulation of four known +E regulated genes involved in breast cancer and ask how unliganded or liganded PRs influence this regulation by +E. Together, these experiments will define how PRs influence +E signaling in breast cancers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OVARIAN STEROID REGULATION OF SEROTONIN NEURAL FUNCTION Principal Investigator & Institution: Bethea, Cynthia L.; Senior Scientist; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2002 Summary: The long-term goal of this research is to define the mechanism(s) by which progesterone (P) increases prolactin secretion in estrogen (E)-primed nonhuman primates. Prolactin secretion is a useful indicator of serotonin function and deficits in prolactin release are reported for patients with major clinical depression. We hypothesize that the serotonin (5HT) neural system transduces the action of ovarian steriods on prolactin secretion and mood. We showed that E and P alter the expression of 3 genes that are pivotal in serotonin neurotransmission, tryptophan hydroxylase, serotonin reuptake transporter and the serotonin 1A autoreceptor. We are now determining the functional consequences of these changes in gene expression. First, TPH protein levels were measured with Western blot and densitometric analysis in monkeys treated with E, P, E+P, modified steroids and the estrogen antagonist tamoxifen. TPH protein levels increased with E and addition of P had no further ef fect. Conjugated equine estrogens significantly increase TPH protein and addition of medroxyprogesterone acetate (MPA) blocks this effect. Hence, there is a marked difference in the action of natural progesterone and MPA on TPH protein levels. Tamoxifen significantly decreased TPH protein levels. These observations have significant implications for hormone replacement therapy and the regulation of mood in postmenopausal women and for the increased incidence of depression in breast cancer patients treated with tamoxifen. Little, if any, change was observed in the expression of 3 postsynaptic receptors for serotonin, 5HT1A, 2A or 2C, in the hypothalamus with E and P. Future studies will examine the functional consequences of the reported changes in expression of SERT and 5HT1A autoreceptor genes, as well as the effect of E+P on mechanisms regulating serotonin degradation. FUNDING NIH HD17269, HD18185 PUBLICATIONS Pecins-Thompson M, Brown NA, Bethea CL. Regulation of serotonin reuptake transporter mRNA expression by ovarian steroids in rhesus macaques. Mol Brain Res 53:120-129, 1998. Pecins-Thompson M, Bethea CL. Ovarian steroid regulation

20

Medroxyprogesterone

of serotonin-1A autoreceptor messenger RNA expression in the dorsal raphe of rhesus macaques. Neuroscience 89:267-277, 1998. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREMARIN POSTMENOPAUSAL WOMEN

AND

MEDROXYPROGESTERONE

IN

Principal Investigator & Institution: Kubik, Carolyn; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002 Summary: A previous Premarin/Medroxyprogesterone (MPA) Acetate study evaluated a daily dose of Premarin 0.625mg combined with various doses of MPA in both continuous combined and cyclic regimens. Following the successful completion of that study it was thought to be appropriate to explore the safety and efficacy of lower doses of Premarin/MPA in continuous combined regimens to determine if the addition of MPA would allow the use of a daily dose of Premarin less than 0.625mg daily which would be effective in preventing bone loss, relieving vasomotor symptoms and maintaining acceptable bleeding and metabolic profiles. The primary endpoints are prevention of endometrial hyperplasia during the first year of the study and prevention of bone loss. It is a prospective double-blind, randomized study. Fischer's exact test will be used for comparison between groups for the incidence of hyperplasia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROGESTOGEN INHIBITION OF OVARIAN CANCER CELL METASTASIS Principal Investigator & Institution: Murdoch, William J.; Animal Science; University of Wyoming Office of Research Laramie, Wy 82071 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2004 Summary: (provided by applicant): Common (surface) epithelial cancer of the ovary is an insidious disease with a high mortality rate. Proteolytic enzymes released from membrane vesicles have been implicated in the metastatic potential of ovarian carcinomas of surface epithelial origin. Novel results of preliminary experiments indicate that high-dose progesterone inhibits, via a receptor-independent mongenomic mechanism, secretion of urokinase plasminogen activator (uPA) by human SKOV-3 ovarian cancer cells; plasma membrane blebbing and in vitro invasive capacity were likewise attenuated. Using SKOV-3 cells as a model for ovarian carcinoma, the specific objectives of the proposed project are to characterize the dose and temporal effects of sterid hormones (progesterone, medroxyprogesterone acetate, testosterone, estradiol) on plasma membrane fluid dynamics (fluorescence polarization), enzymatic (uPA, matrix metalloproteinases) secretions, membrane morphology (to include light and transmission electron microscopic enzyme immunochemistry), in vitro (Matrigel) invasiveness, and in vivo (intraperitoneal transplantation of athymic nude mice) tumorigenes. It is predicted that responses will be selective for the lipophilic progestogens. Results from these fundamental studies may provide a basis for the prophylactic and therapeutic applications of progestogens in individuals at high-risk for the development of ovarian carcinoma and after diagnosis of early-stage disease, respectively. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RCT OF LNG-IUD VS. DMPA FOR YOUNG POSTPARTUM WOMEN Principal Investigator & Institution: Stanwood, Nancy L.; Obstetrics and Gynecology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2004; Project Start 01-SEP-2004; Project End 31-AUG-2006 Summary: (provided by applicant): The U.S. has the highest unintended pregnancy rate of any developed country, mostly in teens and women in their early twenties due to ineffective contraceptive use. Once a young woman has given birth, helping her choose an effective method of postpartum contraception is crucial to preventing an unintended pregnancy. The injectable depomedroxyprogesterone acetate (DMPA) is a highly effective method of contraception, with better compliance and lower pregnancy rates than oral contraceptives. It is commonly recommended to young women for postpartum contraception. However, up to 50% of women stop using it in the first year due to the side effects of irregular bleeding and perceived weight gain. Clinicians also have concerns that DMPA may worsen depression and inhibit maximum bone density in young women. The levonorgestrel intrauterine device (LNG-IUD) is a very effective, well-tolerated contraceptive. It has not been traditionally considered in this population due to a false perception that IUDs lead to a long-term increased risk of pelvic inflammatory disease (PID). Modern evidence counters these fears, suggesting that LNG-IUD may actually decrease the risk of PID. Its performance as a postpartum contraceptive for young women merits evaluation. We aim to perform a pilot randomized trial of 30 women aged 14 to 25 years comparing postpartum DMPA and LNG-IUD with regard to method continuation and side effects. We also aim to assess the recruitment of postpartum young women for randomization between DMPA and LNG-IUD, measuring the number needed to screen to enroll and randomize one subject. We will recruit subjects during the third trimester of prenatal care and will follow them for one year postpartum for the outcomes of method continuation, unintended pregnancy rate, menstrual complaints, patient satisfaction, complications and side effects. The best postpartum method of contraception is one that works well and that women continue to use. The LNG-IUD is highly effective and has high patient satisfaction and continuation rates in older women. Whether younger women find it satisfactory for postpartum contraception and continue to use it is unknown. If this pilot is successful, we plan to perform a larger trial powered to detect a difference in continuation rates between DMPA and LNG-IUD. Such a study could provide evidence for the safe and effective use of LNG-IUD in young postpartum women, leading to fewer unintended pregnancies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SAFETY OF ESTROGENS IN SLE NATIONAL ASSESSMENT (SELENA) Principal Investigator & Institution: Alarcon, Garciela S.; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002 Summary: This study tries to address the effect of exogenous female hormones on disease activity and severity in postmenopausal patients with SLE. Patients will be enrolled and randomized to receive continuous conjugated estrogens pulus 5 mg. medroxiprogesterone for 10 days per month, or placebo for a follow-up of 12 months. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ST.LOUIS-CAPE GIRARDEAU CCOP Principal Investigator & Institution: Henry, Patrick H.; Chairman; St.Louis-Cape Girardeau Ccop 12800 Corporate Hill Dr St. Louis, Mo 63131 Timing: Fiscal Year 2002; Project Start 01-JUN-1987; Project End 31-MAY-2007 Summary: (provided by applicant): The St. Louis-Cape Girardeau CCOP is a consortium of four hospitals in two separate bi-state health service areas serving parts of eastern Missouri and western Illinois. The Investigators from the St. Louis Metropolitan area are affiliated with one or both of the two hospitals in the consortium and have worked together for the past eighteen years in cancer treatment research protocols and more recently, in cancer control research studies. The Cape Girardeau Investigators have worked with CCOP for the past nine years and are affiliated with two hospitals in that city. During the next five years we expect to accrue at least sixty credits per year for cancer treatment research protocols of the NSABP and SWOG and at least seventy five credits (new participants and follow-up) per year for cancer control and prevention studies. These cancer control credits will be derived primarily from our participation in the Breast Cancer Prevention Trial-1, Prostate Cancer Prevention Trial-1 and the Breast Cancer Prevention Trial-2. We will continue to provide high quality data to the Southwest Oncology Group and the National Surgical Adjuvant Breast and Bowel Project which are our research bases, utilizing the data management system developed during the past eighteen years. In summary, we will continue our excellent performance of the past eighteen years in cancer treatment research studies and extend our more recent participation in cancer control and prevention trials. The past experience and capabilities of the Investigators and Clinical Research Associates provides a strong base for continuing development of this Community Clinical Oncology Program. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: VASCULAR EFFECTS & MECHANISM OF ACTION OF ESTROGEN & ESTROGEN-ANDROGEN Principal Investigator & Institution: Fitzpatrick, Lorraine A.; Mayo Clinic Coll of Medicine, Rochester D/B/A/ Mayo Clinic College of Medicine Rochester, Mn 55905 Timing: Fiscal Year 2002 Summary: This clinical study distinguishes itself by being the first to evaluate the vascular changes induced by esterified estrogens 0.625 mg/day alone and with the addition of methyltestosterone or medroxyprogesterone acetate, as opposed to conventional-dose conjugated estrogens 0.625 mg/day or equivalent. This study will specifically evaluate changes in nitric oxide physiology induced by estrogen replacement therapy (ERT) and combination therapy (esterogen-progesterone and estrogen-androgen) at conventional doses, as opposed to acute, high-dose regimens, which are likely to be less representative of the clinical setting. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National

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

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Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “medroxyprogesterone” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for medroxyprogesterone in the PubMed Central database: •

Counting the costs: Comparing depot medroxyprogesterone acetate and norethisterone oenanthate utilisation patterns in South Africa. by Smit J, Gray A, McFadyen L, Zuma K.; 2001; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=32302

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Divergent impact of progesterone and medroxyprogesterone acetate (Provera) on nuclear mitogen-activated protein kinase signaling. by Nilsen J, Brinton RD.; 2003 Sep 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=193591

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Protective effect of medroxyprogesterone acetate plus testosterone against radiationinduced damage to the reproductive function of male rats and their offspring. by Jegou B, Velez de la Calle JF, Bauche F.; 1991 Oct 1; http://www.pubmedcentral.gov/picrender.fcgi?tool=pmcentrez&action=stream&blobt ype=pdf&artid=52579

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

4

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text 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 3-year study of prevention of postmenopausal bone loss: conjugated equine estrogens plus medroxyprogesterone acetate versus tibolone. Author(s): Thiebaud D, Bigler JM, Renteria S, Pache T, Welti HJ, Landry M, Burckhardt P. Source: Climacteric : the Journal of the International Menopause Society. 1998 September; 1(3): 202-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11907945

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A double-blind, randomized, comparative study evaluating clinical effects of two sequential estradiol-progestogen combinations containing either desogestrel or medroxyprogesterone acetate in climacteric women. Author(s): Saure A, Planellas J, Poulsen HK, Jaszczak P. Source: Maturitas. 2000 February 15; 34(2): 133-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10714908

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A prospective study on the effects of depot medroxyprogesterone acetate on trabecular and cortical bone after attainment of peak bone mass. Author(s): Merki-Feld GS, Neff M, Keller PJ. Source: Bjog : an International Journal of Obstetrics and Gynaecology. 2000 July; 107(7): 863-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10901557

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A randomized controlled comparative study of oral medroxyprogesterone acetate 1,200 and 600 mg in patients with advanced or recurrent breast cancer. Author(s): Koyama H, Tominaga T, Asaishi K, Abe R, Iino Y, Enomoto K, Miura S, Nomura Y, Nakazato H, Abe O. Source: Oncology. 1999; 56(4): 283-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10343191

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A randomized controlled trial of estrogen replacement therapy in long-term users of depot medroxyprogesterone acetate. Author(s): Cundy T, Ames R, Horne A, Clearwater J, Roberts H, Gamble G, Reid IR. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 January; 88(1): 7881. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12519833

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A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion. Author(s): Soysal ME, Soysal S, Vicdan K, Ozer S. Source: Human Reproduction (Oxford, England). 2001 May; 16(5): 931-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11331640

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A randomized, open-label study of conjugated equine estrogens plus medroxyprogesterone acetate versus tibolone: effects on symptom control, bleeding pattern, lipid profile and tolerability. Author(s): Baracat EC, Barbosa IC, Giordano MG, Haidar MA, Marinho RM, Menegocci JC, Morais KM, Tomaz G, Wehba S. Source: Climacteric : the Journal of the International Menopause Society. 2002 March; 5(1): 60-9. Erratum In: Climacteric 2002 June; 5(2): Vi. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11974560

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Additional effects of medroxyprogesterone acetate on mammary tumors in oophorectomized, estrogenized, DMBA-treated rats. Author(s): Sakamoto S, Kudo H, Suzuki S, Mitamura T, Sassa S, Kuwa K, Chun Z, Yoshimura S, Maemura M, Nakayama T, Shinoda H. Source: Anticancer Res. 1997 November-December; 17(6D): 4583-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9494572

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Adjuvant endocrine treatment with medroxyprogesterone acetate or tamoxifen in stage I and II endometrial cancer--a multicentre, open, controlled, prospectively randomised trial. Author(s): von Minckwitz G, Loibl S, Brunnert K, Kreienberg R, Melchert F, Mosch R, Neises M, Schermann J, Seufert R, Stiglmayer R, Stosiek U, Kaufmann M. Source: European Journal of Cancer (Oxford, England : 1990). 2002 November; 38(17): 2265-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12441263

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Adjuvant high-dose medroxyprogesterone acetate for early breast cancer: 13 years update in a multicentre randomized trial. Author(s): Focan C, Beauduin M, Salamon E, de Greve J, de Wasch G, Lobelle JP, Majois F, Tagnon A, Tytgat J, van Belle S, Vandervellen R, Vindevoghel A; Adjuvant Breast Cancer Project Belgium. Source: British Journal of Cancer. 2001 July 6; 85(1): 1-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11437394

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Adolescents' compliance with return visits for depot medroxyprogesterone initiation. Author(s): Ohlemeyer CL. Source: Journal of Pediatric and Adolescent Gynecology. 2003 October; 16(5): 297-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14597018

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An analysis of serum interleukin-6 levels to predict benefits of medroxyprogesterone acetate in advanced or recurrent breast cancer. Author(s): Nishimura R, Nagao K, Miyayama H, Matsuda M, Baba K, Matsuoka Y, Yamashita H, Fukuda M, Mizumoto T, Hamamoto R. Source: Oncology. 2000 August; 59(2): 166-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10971177

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Anaphylaxis from medroxyprogesterone acetate. Author(s): Selo-Ojeme DO, Tillisi A, Welch CC. Source: Obstetrics and Gynecology. 2004 May; 103(5 Pt 2): 1045-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15121602

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Androgen receptor agonist activity of the synthetic progestin, medroxyprogesterone acetate, in human breast cancer cells. Author(s): Bentel JM, Birrell SN, Pickering MA, Holds DJ, Horsfall DJ, Tilley WD. Source: Molecular and Cellular Endocrinology. 1999 August 20; 154(1-2): 11-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10509795

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Anti-ischemic effect of chronic oestrogen replacement therapy alone or in combination with medroxyprogesterone acetate in different replacement schemes. Author(s): Cerquetani E, Leonardo F, Pagnotta P, Galetta P, Onorati D, Fini M, Rosano GM. Source: Maturitas. 2001 September 28; 39(3): 245-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11574184

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Apoptosis inhibition mediated by medroxyprogesterone acetate treatment of breast cancer cell lines. Author(s): Ory K, Lebeau J, Levalois C, Bishay K, Fouchet P, Allemand I, Therwath A, Chevillard S. Source: Breast Cancer Research and Treatment. 2001 August; 68(3): 187-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11727956

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Association of oral almitrine and medroxyprogesterone acetate: effect on arterial blood gases in chronic obstructive pulmonary disease. Author(s): Pinet C, Tessonnier F, Ravel T, Orehek J. Source: Respiratory Medicine. 2001 July; 95(7): 602-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11453318

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Autophagy and nuclear changes in FM3A breast tumor cells after epirubicin, medroxyprogesterone and tamoxifen treatment in vitro. Author(s): Bilir A, Altinoz MA, Erkan M, Ozmen V, Aydiner A. Source: Pathobiology : Journal of Immunopathology, Molecular and Cellular Biology. 2001; 69(3): 120-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11872957

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Bhathena RK, Anklesaria BS, Ganatra AM, Pinto R. The influence of transdermal oestradiol replacement therapy and medroxyprogesterone acetate on serum lipids and lipoproteins. Br J Clin Pharmacol 1998 Feb; 45 (2): 170-172. Author(s): Kneer-Aronoff C. Source: Journal of Women's Health / the Official Publication of the Society for the Advancement of Women's Health Research. 1998 October; 7(8): 1054-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10026007

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Biphasic effect of medroxyprogesterone-acetate (MPA) treatment on proliferation and cyclin D1 gene transcription in T47D breast cancer cells. Author(s): Thuneke I, Schulte HM, Bamberger AM. Source: Breast Cancer Research and Treatment. 2000 October; 63(3): 243-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11110058

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Bleeding patterns in postmenopausal women taking continuous combined or sequential regimens of conjugated estrogens with medroxyprogesterone acetate. Menopause Study Group. Author(s): Archer DF, Pickar JH, Bottiglioni F. Source: Obstetrics and Gynecology. 1994 May; 83(5 Pt 1): 686-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8164926

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Bleeding patterns in postmenopausal women using continuous combination hormone replacement therapy with conjugated estrogen and medroxyprogesterone acetate or with 17beta-estradiol and norethindrone acetate. Author(s): Odmark IS, Jonsson B, Backstrom T. Source: American Journal of Obstetrics and Gynecology. 2001 May; 184(6): 1131-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11349178

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Bleeding patterns of women using Lunelle monthly contraceptive injections (medroxyprogesterone acetate and estradiol cypionate injectable suspension) compared with those of women using Ortho-Novum 7/7/7 (norethindrone/ethinyl estradiol triphasic) or other oral contraceptives. Author(s): Garceau RJ, Wajszczuk CJ, Kaunitz AM; Lunelle Study Group. Source: Contraception. 2000 December; 62(6): 289-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11239615

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Body mass index does not influence response to treatment, nor does body weight change with lower doses of conjugated estrogens and medroxyprogesterone acetate in early postmenopausal women. Author(s): Utian WH, Gass ML, Pickar JH. Source: Menopause (New York, N.Y.). 2004 May-June; 11(3): 306-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15167310

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Bone age at discontinuation of medroxyprogesterone acetate therapy in girls with precocious puberty: effect on final height. Author(s): Boulgourdjian E, Escobar ME, Martinez A, Heinrich JJ, Bergada C. Source: Hormone Research. 1995; 44(1): 12-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7649521

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Bone density among long-term users of medroxyprogesterone acetate as a contraceptive. Author(s): Paiva LC, Pinto-Neto AM, Faundes A. Source: Contraception. 1998 December; 58(6): 351-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10095971

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Bone density effects of continuous estrone sulfate and varying doses of medroxyprogesterone acetate. Ogen/Provera Study Group. Author(s): Nand SL, Wren BG, Gross BA, Heller GZ. Source: Obstetrics and Gynecology. 1999 June; 93(6): 1009-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10362172

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Bone density in long term users of depot medroxyprogesterone acetate. Author(s): Gbolade B, Ellis S, Murby B, Randall S, Kirkman R. Source: British Journal of Obstetrics and Gynaecology. 1998 July; 105(7): 790-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9692421

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Bone loss and depot medroxyprogesterone. Author(s): Cundy T, Reid IR. Source: American Journal of Obstetrics and Gynecology. 1997 May; 176(5): 1116-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9166180

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Bone mineral changes in young women with hypothalamic amenorrhea treated with oral contraceptives, medroxyprogesterone, or placebo over 12 months. Author(s): Hergenroeder AC, Smith EO, Shypailo R, Jones LA, Klish WJ, Ellis K. Source: American Journal of Obstetrics and Gynecology. 1997 May; 176(5): 1017-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9166162

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Bone mineral density at various anatomic bone sites in women receiving combined oral contraceptives and depot-medroxyprogesterone acetate for contraception. Author(s): Wanichsetakul P, Kamudhamas A, Watanaruangkovit P, Siripakarn Y, Visutakul P. Source: Contraception. 2002 June; 65(6): 407-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12127638

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Bone mineral density during long-term treatment with Norplant implants and depot medroxyprogesterone acetate. A cross-sectional study of Thai women. Author(s): Taneepanichskul S, Intaraprasert S, Theppisai U, Chaturachinda K. Source: Contraception. 1997 September; 56(3): 153-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9347205

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Bone mineral density in a cohort of adolescent women using depot medroxyprogesterone acetate for one to two years. Author(s): Busen NH, Britt RB, Rianon N. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 2003 April; 32(4): 257-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12667729

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Bone mineral density in adolescent and young Thai girls receiving oral contraceptives compared with depot medroxyprogesterone acetate: a cross-sectional study in young Thai women. Author(s): Tharnprisarn W, Taneepanichskul S. Source: Contraception. 2002 August; 66(2): 101-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12204782

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Bone mineral density in adolescent females using depot medroxyprogesterone acetate. Author(s): Lara-Torre E, Edwards CP, Perlman S, Hertweck SP. Source: Journal of Pediatric and Adolescent Gynecology. 2004 February; 17(1): 17-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15010034

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Bone mineral density in adolescent women using depot medroxyprogesterone acetate. Author(s): Busen NH. Source: Journal of the American Academy of Nurse Practitioners. 2004 February; 16(2): 57-62. Review. Erratum In: J Am Acad Nurse Pract. 2004 May; 16(5): 186. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15055422

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Bone mineral density in long-term depot medroxyprogesterone acetate acceptors. Author(s): Taneepanichskul S, Intaraprasert S, Theppisai U, Chaturachinda K. Source: Contraception. 1997 July; 56(1): 1-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9306024

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Bone mineral density in women using depot medroxyprogesterone acetate for contraception. Author(s): Scholes D, Lacroix AZ, Ott SM, Ichikawa LE, Barlow WE. Source: Obstetrics and Gynecology. 1999 February; 93(2): 233-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9932562

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Carbon dioxide production during acetazolamide and medroxyprogesterone treatment. Author(s): Cole RP. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 2003 April; 21(4): 733; Author Reply 734. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12762366

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Carboplatin, methotrexate and 5-fluorouracil in combination with medroxyprogesterone acetate (JMF-M) in the treatment of advanced or recurrent endometrial carcinoma: A Hellenic cooperative oncology group study. Author(s): Bafaloukos D, Aravantinos G, Samonis G, Katsifis G, Bakoyiannis C, Skarlos D, Kosmidis P. Source: Oncology. 1999 April; 56(3): 198-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10202274

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Changes in normal lipid profile of menopausal women with combined hormone replacement therapy. Comparative clinical trial of two hormonal combinations (conjugated estrogens/medroxyprogesterone acetate versus estradiol valerate/cyproterone acetate). Author(s): Alwers R, Urdinola J, Onatra W, Sanchez F, Posso H. Source: Maturitas. 1999 May 31; 32(1): 41-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10423715

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Combination therapy of low-dose medroxyprogesterone acetate and oral estrogen does not affect endothelial function in the forearms of postmenopausal women. Author(s): Sanada M, Higashi Y, Nakagawa K, Tsuda M, Kodama I, Nagai N, Chayama K, Ohama K. Source: Menopause (New York, N.Y.). 2002 September-October; 9(5): 360-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12218725

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Combined treatment with acetazolamide and medroxyprogesterone in chronic obstructive pulmonary disease patients. Author(s): Wagenaar M, Vos PJ, Heijdra YF, Teppema LJ, Folgering HT. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 2002 November; 20(5): 1130-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12449165

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Comparative effects of Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension) and ortho-Novum 7/7/7 oral contraceptive (norethindrone/ethinyl estradiol triphasic) on lipid profiles. Investigators from the Lunelle Study Group. Author(s): Cromie MA, Maile MH, Wajszczuk CP. Source: Contraception. 2000 January; 61(1): 51-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10745070

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Comparative safety, efficacy, and cycle control of Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension) and Ortho-Novum 7/7/7 oral contraceptive (norethindrone/ethinyl estradiol triphasic). Lunelle Study Group. Author(s): Kaunitz AM, Garceau RJ, Cromie MA. Source: Contraception. 1999 October; 60(4): 179-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10640164

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Comparison of acetazolamide and medroxyprogesterone as respiratory stimulants in hypercapnic patients with COPD. Author(s): Wagenaar M, Vos P, Heijdra Y, Teppema L, Folgering H. Source: Chest. 2003 May; 123(5): 1450-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12740260

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Comparison of physical and emotional side effects of progesterone or medroxyprogesterone in early postmenopausal women. Author(s): Cummings JA, Brizendine L. Source: Menopause (New York, N.Y.). 2002 July-August; 9(4): 253-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12082361

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Comparison of regimens containing oral micronized progesterone or medroxyprogesterone acetate on quality of life in postmenopausal women: a crosssectional survey. Author(s): Fitzpatrick LA, Pace C, Wiita B. Source: Journal of Women's Health & Gender-Based Medicine. 2000 May; 9(4): 381-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10868610

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Comparison of the effect of progesterone, medroxyprogesterone acetate and norethisterone on the proliferation of human breast cancer cells. Author(s): Seeger H, Wallwiener D, Mueck AO. Source: The Journal of the British Menopause Society. 2003 March; 9(1): 36-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12804312

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Comparison of the effects of continuous combined and sequential combined medroxyprogesterone acetate-estradiol treatment on the proliferation of MCF-7 cells. Author(s): Lippert C, Seeger H, Wallwiener D, Mueck AO. Source: Climacteric : the Journal of the International Menopause Society. 2000 December; 3(4): 271-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11910587

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Comparison of weight increase in users of depot medroxyprogesterone acetate and copper IUD up to 5 years. Author(s): Bahamondes L, Del Castillo S, Tabares G, Arce XE, Perrotti M, Petta C. Source: Contraception. 2001 October; 64(4): 223-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11747871

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Conditions in rural Nepal for which depot-medroxyprogesterone acetate initiation is not recommended: implications for community-based service delivery. Author(s): Rai C, Thapa S, Day J, Bhattarai L, McMullen S, Jha R, Shrestha S, Bastola S, Rivera R. Source: Contraception. 1999 July; 60(1): 31-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10549450

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Contraception in diabetic women: comparative metabolic study of Norplant, depot medroxyprogesterone acetate, low dose oral contraceptive pill and CuT380A. Author(s): Diab KM, Zaki MM. Source: The Journal of Obstetrics and Gynaecology Research. 2000 February; 26(1): 1726. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10761326

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Counting the costs: comparing depot medroxyprogesterone acetate and norethisterone oenanthate utilisation patterns in South Africa. Author(s): Smit J, Gray A, McFadyen L, Zuma K. Source: Bmc Health Services Research [electronic Resource]. 2001; 1(1): 4. Epub 2001 June 04. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11401729

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Cyproterone, norethindrone, medroxyprogesterone and levonorgestrel are less potent local human growth hormone and insulin-like growth factor I secretion stimulators than progesterone in human breast cancer explants expressing the estrogen receptor. Author(s): Milewicz T, Kolodziejczyk J, Krzysiek J, Basta A, Sztefko K, Kurek S, Stachura J, Gregoraszczuk EL. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 2002 August; 16(4): 319-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12396561

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Cytokine involvement in cancer anorexia/cachexia: role of megestrol acetate and medroxyprogesterone acetate on cytokine downregulation and improvement of clinical symptoms. Author(s): Mantovani G, Maccio A, Lai P, Massa E, Ghiani M, Santona MC. Source: Crit Rev Oncog. 1998; 9(2): 99-106. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9973244

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Cytologic changes in cervical smears associated with prolonged use of depotmedroxyprogesterone acetate. Author(s): Valente PT, Schantz HD, Trabal JF. Source: Cancer. 1998 December 25; 84(6): 328-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9915133

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Cytologic findings in cervical smears in patients using intramuscular medroxyprogesterone acetate (Depo-provera) for contraception. Author(s): Volk EE, Jax JM, Kuntzman TJ. Source: Diagnostic Cytopathology. 2000 September; 23(3): 161-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10945902

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Decline in bone mineral density with stress fractures in a woman on depot medroxyprogesterone acetate. A case report. Author(s): Harkins GJ, Davis GD, Dettori J, Hibbert ML, Hoyt RA. Source: J Reprod Med. 1999 March; 44(3): 309-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10202754

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Decreased tissue inhibitor of metalloproteinase in the endometrium of women using depot medroxyprogesterone acetate: a role for altered endometrial matrix metalloproteinase/tissue inhibitor of metalloproteinase balance in the pathogenesis of abnormal uterine bleeding? Author(s): Vincent AJ, Zhang J, Ostor A, Rogers PA, Affandi B, Kovacs G, Salamonsen LA. Source: Human Reproduction (Oxford, England). 2002 May; 17(5): 1189-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11980737

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Delayed first injection of the once-a-month injectable contraceptive containing 25 mg medroxyprogesterone acetate and 5 mg estradiol-cypionate: effects on cervical mucus. Author(s): Petta CA, Hays M, Brache V, Massai R, Hua Y, Alvarez-Sanchez F, Salvatierra A, d'Arcangues C, Cook LA, Bahamondes L. Source: Contraception. 2001 December; 64(6): 363-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11834235

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Delayed first injection of the once-a-month injectable contraceptive containing 25 mg of medroxyprogesterone acetate and 5 mg of E(2)-cypionate: effects on ovarian function. Author(s): Petta CA, Hays M, Brache V, Massai R, Hua Y, Alvarez-Sanchez F, Croxatto H, d'Arcangues C, Cook LA, Bahamondes L. Source: Fertility and Sterility. 2001 April; 75(4): 744-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11287029

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Depot medroxyprogesterone acetate (Depo-Provera) and levonorgestrel (Norplant) use in adolescents among clinicians in Northern Europe and the United States. Author(s): Cromer BA, Berg-Kelly KS, Van Groningen JP, Seimer BS, Ruusuvaara L. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 1998 August; 23(2): 74-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9714169

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Depot medroxyprogesterone acetate and basal serum prolactin levels in lactating women. Author(s): Ratchanon S, Taneepanichskul S. Source: Obstetrics and Gynecology. 2000 December; 96(6): 926-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11084179

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Depot medroxyprogesterone acetate galactorrhea. Author(s): Cromwell P, Anyan W. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 1998 August; 23(2): 61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9714166

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Depot medroxyprogesterone acetate in teens: A risk for bone health? Author(s): Bachrach LK, Cundy T, Ott SM. Source: Pediatrics. 2000 November; 106(5): 1137-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11061788

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Depot medroxyprogesterone acetate or oral contraception in postpartum adolescents. Author(s): O'Dell CM, Forke CM, Polaneczky MM, Sondheimer SJ, Slap GB. Source: Obstetrics and Gynecology. 1998 April; 91(4): 609-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9540951

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Depot medroxyprogesterone acetate pioneers. A retrospective study at a North Carolina Health Department. Author(s): Potter LS, Dalberth BT, Canamar R, Betz M. Source: Contraception. 1997 November; 56(5): 305-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9437559

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Depot medroxyprogesterone acetate use in inner-city, minority adolescents: continuation rates and characteristics of long-term users. Author(s): Lim SW, Rieder J, Coupey SM, Bijur PE. Source: Archives of Pediatrics & Adolescent Medicine. 1999 October; 153(10): 1068-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10520615

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Depot medroxyprogesterone acetate. Patterns of use and reasons for discontinuation. Author(s): Paul C, Skegg DC, Williams S. Source: Contraception. 1997 October; 56(4): 209-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9408701

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Depot-medroxyprogesterone acetate injection (Depo-Provera): a highly effective contraceptive option with proven long-term safety. Author(s): Westhoff C. Source: Contraception. 2003 August; 68(2): 75-87. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12954518

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Depressive symptoms in users and non-users of depot medroxyprogesterone acetate. Author(s): Civic D, Scholes D, Ichikawa L, LaCroix AZ, Yoshida CK, Ott SM, Barlow WE. Source: Contraception. 2000 June; 61(6): 385-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10958882

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Dexamethasone and medroxyprogesterone acetate elevate Nm23-H1 metastasis suppressor gene expression in metastatic human breast carcinoma cells: new uses for old compounds. Author(s): Ouatas T, Halverson D, Steeg PS. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 2003 September 1; 9(10 Pt 1): 3763-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14506169

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Diabetes and depot medroxyprogesterone contraception in Navajo women. Author(s): Kim C, Seidel KW, Begier EA, Kwok YS. Source: Archives of Internal Medicine. 2001 July 23; 161(14): 1766-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11485510

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Differential effects of estrogen and medroxyprogesterone on basal and stress-induced growth hormone release, IGF-1 levels, and cellular immunity in postmenopausal women. Author(s): Malarkey WB, Burleson M, Cacioppo JT, Poehlmann K, Glaser R, KiecoltGlaser JK. Source: Endocrine. 1997 October; 7(2): 227-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9549049

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Dissociative glucocorticoid activity of medroxyprogesterone acetate in normal human lymphocytes. Author(s): Bamberger CM, Else T, Bamberger AM, Beil FU, Schulte HM. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 November; 84(11): 4055-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10566649

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Dose response effect of cyclical medroxyprogesterone on blood pressure in postmenopausal women. Author(s): Harvey PJ, Molloy D, Upton J, Wing LM. Source: Journal of Human Hypertension. 2001 May; 15(5): 313-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11378833

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Dose-intense phase II study of weekly cisplatin and epidoxorubicin plus medroxyprogesterone acetate and recombinant interleukin 2 in stage IIIB-IV nonsmall cell lung cancer. Author(s): Mantovani G, Maccio A, Mulas C, Massa E, Madeddu C, Mura L, Contu P, Versace R. Source: Oncol Rep. 2002 May-June; 9(3): 661-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11956647

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Effect of gonadotropin-releasing hormone agonist and medroxyprogesterone acetate on calcium metabolism: a prospective, randomized, double-blind, placebo-controlled, crossover trial. Author(s): Carr BR, Breslau NA, Peng N, Adams-Huet B, Bradshaw KD, Steinkampf MP. Source: Fertility and Sterility. 2003 November; 80(5): 1216-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14607578

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Effect of lower doses of conjugated equine estrogens with and without medroxyprogesterone acetate on bone in early postmenopausal women. Author(s): Lindsay R, Gallagher JC, Kleerekoper M, Pickar JH. Source: Jama : the Journal of the American Medical Association. 2002 May 22-29; 287(20): 2668-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12020302

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Effect of medroxyprogesterone acetate on endothelium-dependent vasodilation in postmenopausal women receiving estrogen. Author(s): Wakatsuki A, Okatani Y, Ikenoue N, Fukaya T. Source: Circulation. 2001 October 9; 104(15): 1773-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11591613

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Effect of medroxyprogesterone acetate on the efficiency of an oral protein-rich nutritional support in HIV-infected patients. Author(s): Rochon C, Prod'homme M, Laurichesse H, Tauveron I, Balage M, Gourdon F, Baud O, Jacomet C, Jouvency S, Bayle G, Champredon C, Thieblot P, Beytout J, Grizard J. Source: Reproduction, Nutrition, Development. 2003 March-April; 43(2): 203-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12956319

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Effect of medroxyprogesterone acetate on vascular inflammatory markers in postmenopausal women receiving estrogen. Author(s): Wakatsuki A, Okatani Y, Ikenoue N, Fukaya T. Source: Circulation. 2002 March 26; 105(12): 1436-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11914251

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Effect of medroxyprogesterone on arterial blood gases, leptin and neuropeptide Y in postmenopausal females. Author(s): Saaresranta T, Irjala K, Polo O. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 2002 December; 20(6): 1413-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12503697

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Effect of medroxyprogesterone on inspiratory flow shapes during sleep in postmenopausal women. Author(s): Saaresranta T, Aittokallio T, Polo-Kantola P, Helenius H, Polo O. Source: Respiratory Physiology & Neurobiology. 2003 March 3; 134(2): 131-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12609480

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Effect of medroxyprogesterone on pulmonary arterial pressure, exhaled nitric oxide, ECG and arterial blood gases. Author(s): Saaresranta T, Uotila P, Saraste M, Irjala K, Hartiala J, Polo O. Source: Journal of Internal Medicine. 2002 May; 251(5): 421-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11982742

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Effects of celecoxib, medroxyprogesterone, and dietary intervention on systemic syndromes in patients with advanced lung adenocarcinoma: a pilot study. Author(s): Cerchietti LC, Navigante AH, Peluffo GD, Diament MJ, Stillitani I, Klein SA, Cabalar ME. Source: Journal of Pain and Symptom Management. 2004 January; 27(1): 85-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14711473

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Effects of estrogen and medroxyprogesterone acetate on subpopulations of triglyceride-rich lipoproteins and high-density lipoproteins. Author(s): Lamon-Fava S, Posfai B, Asztalos BF, Horvath KV, Dallal GE, Schaefer EJ. Source: Metabolism: Clinical and Experimental. 2003 October; 52(10): 1330-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14564686

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Effects of levonorgestrel, medroxyprogesterone acetate, norethindrone, and 17betaestradiol on vascular endothelial growth factor isomers 121 and 165 in Ishikawa cells. Author(s): Archer DF, Navarro FJ, Leslie S, Mirkin S. Source: Fertility and Sterility. 2004 January; 81(1): 165-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14711561

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Effects of levonorgestrel, medroxyprogesterone acetate, norethindrone, progesterone, and 17beta-estradiol on thrombospondin-1 mRNA in Ishikawa cells. Author(s): Mirkin S, Archer DF. Source: Fertility and Sterility. 2004 July; 82(1): 220-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15237017

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Effects of low-dose continuous combined conjugated estrogens and medroxyprogesterone acetate on menopausal symptoms, body weight, bone density, and metabolism in postmenopausal women. Author(s): Gambacciani M, Ciaponi M, Cappagli B, Genazzani AR. Source: American Journal of Obstetrics and Gynecology. 2001 November; 185(5): 1180-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11717654

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Effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate on endometrial bleeding. Author(s): Archer DF, Dorin M, Lewis V, Schneider DL, Pickar JH. Source: Fertility and Sterility. 2001 June; 75(6): 1080-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11384630

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Effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate on plasma lipids and lipoproteins, coagulation factors, and carbohydrate metabolism. Author(s): Lobo RA, Bush T, Carr BR, Pickar JH. Source: Fertility and Sterility. 2001 July; 76(1): 13-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11438314

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Effects of testosterone plus medroxyprogesterone acetate on semen quality, reproductive hormones, and germ cell populations in normal young men. Author(s): McLachlan RI, O'Donnell L, Stanton PG, Balourdos G, Frydenberg M, de Kretser DM, Robertson DM. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 February; 87(2): 546-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11836283

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Efficacy and acceptability of depo-medroxyprogesterone acetate injection. As a method of contraception in Saudi Arabia. Author(s): Sobande AA, Al-Bar HM, Archibong EI, Sadek AA. Source: Saudi Med J. 2000 April; 21(4): 348-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11533816

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Efficacy of every-other-day administration of conjugated equine estrogen and medroxyprogesterone acetate on gonadotropin-releasing hormone agonists treatment in women with endometriosis. Author(s): Irahara M, Uemura H, Yasui T, Kinoshita H, Yamada M, Tezuka M, Kiyokawa M, Kamada M, Aono T. Source: Gynecologic and Obstetric Investigation. 2001; 52(4): 217-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11729332

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Endometrial effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate. Author(s): Pickar JH, Yeh I, Wheeler JE, Cunnane MF, Speroff L. Source: Fertility and Sterility. 2001 July; 76(1): 25-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11438315

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Endometrial effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate: two-year substudy results. Author(s): Pickar JH, Yeh IT, Wheeler JE, Cunnane MF, Speroff L. Source: Fertility and Sterility. 2003 November; 80(5): 1234-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14607581

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Factors associated with withdrawal bleeding after administration of oral dydrogesterone or medroxyprogesterone acetate in women with secondary amenorrhea. Author(s): Battino S, Ben-Ami M, Geslevich Y, Weiner E, Shalev E. Source: Gynecologic and Obstetric Investigation. 1996; 42(2): 113-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8878716

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Factors influencing the absorption of medroxyprogesterone acetate. Author(s): Helmreich ML, Huseby RA. Source: Steroids. 1965; : Suppl 2: 79-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5845180

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Failure of down-regulation of estrogen receptors and progesterone receptors after medroxyprogesterone acetate administration for endometrial hyperplasias. Author(s): Masuzawa H, Badokhon NH, Nakayama K, Konishi I, Nikaido T, Fujii S. Source: Cancer. 1994 October 15; 74(8): 2321-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7922983

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Fatal pulmonary toxicity by the association of radiotherapy and medroxyprogesterone acetate. Author(s): De Greve J, Warson F, Deleu D, Storme G. Source: Cancer. 1985 November 15; 56(10): 2434-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2994878

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Female sex steroid receptors in normal, hyperplastic and carcinomatous endometrium. The relationship to serum steroid hormones and gonadotropins and changes during medroxyprogesterone acetate administration. Author(s): Janne O, Kauppila A, Kontula K, Syrjala P, Vihko R. Source: International Journal of Cancer. Journal International Du Cancer. 1979 November 15; 24(5): 545-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=231013

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Fibrates and medroxyprogesterone acetate induce apoptosis of primary Burkitt's lymphoma cells and cell lines: potential for applying old drugs to a new disease. Author(s): Fenton SL, Luong QT, Sarafeim A, Mustard KJ, Pound J, Desmond JC, Gordon J, Drayson MT, Bunce CM. Source: Leukemia : Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K. 2003 March; 17(3): 568-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12646946

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Fibrinolytic activity of veins during treatment with medroxyprogesterone acetate. Author(s): Astedt B. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1972; 51(3): 283-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4561175

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Fibrinolytic activity of veins during use of depot medroxyprogesterone acetate as a contraceptive. Author(s): Astedt B, Jeppsson S, Pandolfi M. Source: Fertility and Sterility. 1972 July; 23(7): 489-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5036595

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Flare reaction during the initial treatment period with medroxyprogesterone acetate in patients with hormone-resistant prostatic cancer. Author(s): Fossa SD, Urnes T. Source: European Urology. 1986; 12(4): 257-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3743595

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Forearm bone density in long-term users of oral combined contraceptives and depot medroxyprogesterone acetate. Author(s): Perrotti M, Bahamondes L, Petta C, Castro S. Source: Fertility and Sterility. 2001 September; 76(3): 469-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11532466

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Further evaluation on long-term depot-medroxyprogesterone acetate use and bone mineral density: a longitudinal cohort study. Author(s): Tang OS, Tang G, Yip PS, Li B. Source: Contraception. 2000 October; 62(4): 161-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11137068

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Gonadotropin-independent familial sexual precocity with premature Leydig and germinal cell maturation (familial testotoxicosis): effects of a potent luteinizing hormone-releasing factor agonist and medroxyprogesterone acetate therapy in four cases. Author(s): Rosenthal SM, Grumbach MM, Kaplan SL. Source: The Journal of Clinical Endocrinology and Metabolism. 1983 September; 57(3): 571-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6223935

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Growth hormone secretion in idiopathic precocious puberty: effect of medroxyprogesterone. Author(s): Kaplan S, Frasier SD, Costin G. Source: The Journal of Pediatrics. 1969 July; 75(1): 133-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5790396

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Growth inhibition of fibroblasts by progesterone and medroxyprogesterone in vitro. Author(s): Comini Andrada E, Hoschoian JC, Anton E, Lanari A. Source: Int Arch Allergy Appl Immunol. 1985; 76(2): 97-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3967946

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Growth of human aortic smooth muscle cells cultured with human serum is retarded when serum lipids are lowered by medroxyprogesterone. Author(s): Ronnemaa T, Jarvelainen H, Lehtonen A, Gronroos M, Marniemi J, Rautio A. Source: Atherosclerosis. 1987 October; 67(2-3): 223-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2960327

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Health, growth and sexual development of teenagers exposed in utero to medroxyprogesterone acetate. Author(s): Jaffe B, Shye D, Harlap S, Baras M, Belmaker E, Gordon L, Magidor S, Fortney J. Source: Paediatric and Perinatal Epidemiology. 1990 April; 4(2): 184-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2362875

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High dose medroxyprogesterone, rates of bone resorption, and changes in spinal bone density. Author(s): Prior JC. Source: The Journal of Clinical Endocrinology and Metabolism. 1996 December; 81(12): 4500-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8954068

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High dose versus low dose medroxyprogesterone acetate: a randomized trial in advanced breast cancer. Author(s): Gallagher CJ, Cairnduff F, Smith IE. Source: Eur J Cancer Clin Oncol. 1987 December; 23(12): 1895-900. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2963746

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High-dose medroxyprogesterone acetate for the treatment of dysfunctional uterine bleeding in 24 adolescents. Author(s): Aksu F, Madazli R, Budak E, Cepni I, Benian A. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1997 May; 37(2): 228-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9222474

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High-dose medroxyprogesterone acetate in advanced breast cancer. Clinical and pharmacokinetic study with a combined oral and intramuscular regimen. Author(s): Becher R, Miller AA, Hoffken K, Gerhold U, Hirche H, Schmidt CG. Source: Cancer. 1989 May 15; 63(10): 1938-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2522811

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High-dose medroxyprogesterone acetate in patients with renal adenocarcinoma and measurable lung metastases: a phase II study. Author(s): Kjaer M, Frederiksen PL. Source: Cancer Treat Rep. 1986 March; 70(3): 431-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2937534

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High-dose medroxyprogesterone acetate versus estramustine in therapy-resistant prostatic cancer: a randomised study. Author(s): Johansson JE, Andersson SO, Holmberg L. Source: British Journal of Urology. 1991 July; 68(1): 67-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1831397

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High-dose medroxyprogesterone acetate versus oophorectomy as first-line therapy of advanced breast cancer in premenopausal patients. Author(s): Martoni A, Longhi A, Canova N, Pannuti F. Source: Oncology. 1991; 48(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1824798

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High-dose medroxyprogesterone in disseminated breast cancer. Correlation between bioavailability and clinical response. Author(s): Fornasiero A, Morandi P, Daniele O, Ghiotto C, Aversa SM, Battaglia A, Fosser V, Fiorentino MV. Source: Tumori. 1987 December 31; 73(6): 617-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3433369

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High-dose medroxyprogesterone in the treatment of advanced therapy-resistant prostatic carcinoma. Author(s): Johansson JE, Lingardh G. Source: European Urology. 1985; 11(1): 9-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3157573

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High-dose oral medroxyprogesterone acetate in heavily pretreated patients with metastatic breast cancer. Author(s): Goss PE, Ashley S, Powles TJ, Coombes RC. Source: Cancer Treat Rep. 1986 June; 70(6): 777-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2942246

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Hormonal effects of high dose medroxyprogesterone acetate treatment in males with renal or prostatic adenocarcinoma. Author(s): Tomic R, Ljungberg B, Damber JE. Source: Scandinavian Journal of Urology and Nephrology. 1988; 22(1): 15-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2968646

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Hormonal treatment and psychological function during the menopausal transition: an evaluation of the effects of conjugated estrogens/cyclic medroxyprogesterone acetate. Author(s): Khoo SK, Coglan M, Battistutta D, Tippett V, Raphael B. Source: Climacteric : the Journal of the International Menopause Society. 1998 March; 1(1): 55-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11907928

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Hormone replacement therapy with estrogen or estrogen plus medroxyprogesterone acetate is associated with increased epithelial proliferation in the normal postmenopausal breast. Author(s): Hofseth LJ, Raafat AM, Osuch JR, Pathak DR, Slomski CA, Haslam SZ. Source: The Journal of Clinical Endocrinology and Metabolism. 1999 December; 84(12): 4559-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10599719

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Hormone treatment of meningiomas: lack of response to medroxyprogesterone acetate (MPA). A pilot study of five cases. Author(s): Jaaskelainen J, Laasonen E, Karkkainen J, Haltia M, Troupp H. Source: Acta Neurochirurgica. 1986; 80(1-2): 35-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2939693

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Hormonotherapy of meningiomas with medroxyprogesterone acetate. Immunohistochemical demonstration of the effect of medroxyprogesterone acetate on growth fractions of meningioma cells using the monoclonal antibody Ki-67. Author(s): Markwalder TM, Gerber HA, Waelti E, Schaffner T, Markwalder RV. Source: Surgical Neurology. 1988 August; 30(2): 97-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2969629

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Hyperventilation induced by medroxyprogesterone. Author(s): Simpson FG. Source: The Medical Journal of Australia. 1995 July 3; 163(1): 51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7609694

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I have recently started taking Prempro (0.625 mg conjugated estrogens/2.5 mg medroxyprogesterone acetate). There is so much written about the benefits of taking estrogen, but I am wondering about the effects of the progesterone component. Will it counteract the benefits of estrogen? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 1999 January; 6(5): 8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9916577

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Immunoendocrine therapy with interleukin-2 (IL-2) and medroxyprogesterone acetate (MPA): a randomized study with or without MPA in metastatic renal cancer patients during IL-2 maintenance treatment after response or stable disease to IL-2 subcutaneous therapy. Author(s): Lissoni P, Barni S, Tancini G, Brivio F, Cardellini P, Vaghi M, Fossati V, Frigerio F. Source: Tumori. 1993 August 31; 79(4): 246-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8249176

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Immunotherapy (recombinant interleukin 2), hormone therapy (medroxyprogesterone acetate) and antioxidant agents as combined maintenance treatment of responders to previous chemotherapy. Author(s): Mantovani G, Maccio A, Madeddu C, Massa E, Mudu MC, Mulas C, Gramignano G, Massidda S, Murgia V, Lusso MR, Mura L. Source: International Journal of Oncology. 2001 February; 18(2): 383-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11172608

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Improved bioavailability of a new oral preparation of medroxyprogesterone acetate. Author(s): Etienne MC, Milano G, Rene N, Benedetti MS, Efthymiopoulos C, Vo Van ML, Hurteloup P, Montcuquet P, Frenay M, Namer M. Source: Journal of Pharmaceutical Sciences. 1991 December; 80(12): 1130-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1839998

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Improved continuation rate of depot-medroxyprogesterone acetate in adolescent mothers. Author(s): Omar H, Fowler A, D'Angelo S. Source: Int J Adolesc Med Health. 2002 April-June; 14(2): 149-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12467187

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In utero exposure to medroxyprogesterone. Author(s): Brundage SC. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1997 January-February; 10(1): 76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9018670

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In utero exposure to medroxyprogesterone. Author(s): Coutts LC. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1996 November-December; 9(6): 467. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8923411

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In utero medroxyprogesterone exposure after contraceptive failure. Author(s): Brady JE, Brundage SC. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1996 July-August; 9(4): 285-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8829079

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Inability of medroxyprogesterone acetate to down regulate estrogen receptor level in human breast cancer. Author(s): Noguchi S, Yamamoto H, Inaji H, Imaoka S, Koyama H. Source: Cancer. 1990 March 15; 65(6): 1375-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2137722

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Incidence of endometrial hyperplasia in postmenopausal women taking conjugated estrogens (Premarin) with medroxyprogesterone acetate or conjugated estrogens alone. The Menopause Study Group. Author(s): Woodruff JD, Pickar JH. Source: American Journal of Obstetrics and Gynecology. 1994 May; 170(5 Pt 1): 1213-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8178840

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Increased depot medroxyprogesterone acetate use increases family planning program pharmaceutical supply costs. Author(s): Margulies R, Miller L. Source: Contraception. 2001 March; 63(3): 147-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11368987

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Influence of hormone replacement therapy (17 beta-OH estradiol and medroxyprogesterone acetate) on plasma concentration of prothrombin fragment F1+2 and thrombin-antithrombin III complex in postmenopausal woman. Author(s): Cieplluch R, Czestochowska E. Source: Acta Haematol Pol. 1996; 27(1): 21-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8629439

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Influence of progestins on serum hormone levels in postmenopausal women with advanced breast cancer--II. A differential effect of megestrol acetate and medroxyprogesterone acetate on serum estrone sulfate and sex hormone binding globulin. Author(s): Lundgren S, Lonning PE. Source: J Steroid Biochem. 1990 June; 36(1-2): 105-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2141886

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Inhibitory effect of medroxyprogesterone acetate on angiogenesis induced by human endometrial cancer. Author(s): Jikihara H, Terada N, Yamamoto R, Nishikawa Y, Tanizawa O, Matsumoto K, Terakawa N. Source: American Journal of Obstetrics and Gynecology. 1992 July; 167(1): 207-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1279974

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Injectable contraception with depot medroxyprogesterone acetate. Current status. Author(s): Kaunitz AM, Rosenfield A. Source: Drugs. 1993 June; 45(6): 857-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7691495

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Injectable depot medroxyprogesterone acetate contraception: an update for U.S. clinicians. Author(s): Kaunitz AM. Source: Int J Fertil Womens Med. 1998 March-April; 43(2): 73-83. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9609206

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Interleukin-2, interferon-alpha and medroxyprogesterone acetate in metastatic renal cell carcinoma. Author(s): Naglieri E, Lopez M, Lelli G, Morelli F, Amodio A, Di Tonno P, Gebbia N, Di Seri M, Chetri MC, Rizzo P, Abbate I, Casamassima A, Selvaggi FP, Colucci G. Source: Anticancer Res. 2002 September-October; 22(5): 3045-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12530040

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Intramuscular depot medroxyprogesterone versus oral megestrol for the control of postmenopausal hot flashes in breast cancer patients: a randomized study. Author(s): Bertelli G, Venturini M, Del Mastro L, Bergaglio M, Sismondi P, Biglia N, Venturini S, Porcile G, Pronzato P, Costantini M, Rosso R. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2002 June; 13(6): 883-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12123333

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Intramuscular medroxyprogesterone acetate for sexual aggression in elderly men. Author(s): Weiner MF, Denke M, Williams K, Guzman R. Source: Lancet. 1992 May 2; 339(8801): 1121-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1349145

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Lack of correlations between plasma concentration of medroxyprogesterone acetate, hypothalamic-pituitary function, and tumour response in patients with advanced breast cancer. Author(s): Hedley DW, Christie M, Weatherby RP, Caterson ID. Source: Cancer Chemotherapy and Pharmacology. 1985; 14(2): 112-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3156002

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Lack of gonadal protection by medroxyprogesterone acetate-induced transient medical castration during chemotherapy for testicular cancer. Author(s): Fossa SD, Klepp O, Norman N. Source: British Journal of Urology. 1988 November; 62(5): 449-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2850071

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L-histidine/medroxyprogesterone acetate interaction modulates human breast cancer cell growth and progestin receptor expression in vitro. Author(s): Ghezzo F, Racca S, Conti G, Berta GN, D'Avolio A, Abbadessa G, Gambino G, Di Carlo F. Source: Pharmacological Research : the Official Journal of the Italian Pharmacological Society. 1997 February; 35(2): 119-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9175580

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Lipoprotein changes during treatment of pelvic endometriosis with medroxyprogesterone acetate. Author(s): Fahraeus L, Sydsjo A, Wallentin L. Source: Fertility and Sterility. 1986 April; 45(4): 503-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2937657

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Liver function and medroxyprogesterone acetate elimination in man. Author(s): Rautio A. Source: Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie. 1984; 38(4): 199-204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6498308

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Long-acting injectable contraception with depot medroxyprogesterone acetate. Author(s): Kaunitz AM. Source: American Journal of Obstetrics and Gynecology. 1994 May; 170(5 Pt 2): 1543-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8178904

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Long-term depot medroxyprogesterone acetate (Depo-Provera) use in inner-city adolescents. Author(s): Polaneczky M, Liblanc M. Source: The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine. 1998 August; 23(2): 81-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9714170

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Long-term depot-medroxyprogesterone acetate and bone mineral density. Author(s): Tang OS, Tang G, Yip P, Li B, Fan S. Source: Contraception. 1999 January; 59(1): 25-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10342083

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Long-term effects of depot-medroxyprogesterone acetate on lipoprotein metabolism. Author(s): Garza-Flores J, De la Cruz DL, Valles de Bourges V, Sanchez-Nuncio R, Martinez M, Fuziwara JL, Perez-Palacios G. Source: Contraception. 1991 July; 44(1): 61-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1832626

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Long-term effects of transdermal estradiol with and without medroxyprogesterone acetate. Author(s): Pang SC, Greendale GA, Cedars MI, Gambone JC, Lozano K, Eggena P, Judd HL. Source: Fertility and Sterility. 1993 January; 59(1): 76-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8419226

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Long-term follow-up of children breast-fed by mothers receiving depotmedroxyprogesterone acetate. Author(s): Jimenez J, Ochoa M, Soler MP, Portales P. Source: Contraception. 1984 December; 30(6): 523-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6241560

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Long-term treatment with transcutaneous estradiol and oral medroxyprogesterone acetate. Author(s): Pedersen OD, Jensen HK. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1992 December; 71(8): 593-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1336917

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Long-term use of contraceptive depot medroxyprogesterone acetate in young women impairs arterial endothelial function assessed by cardiovascular magnetic resonance. Author(s): Wakatsuki A, Okatani Y, Fukaya T. Source: Circulation. 2003 May 27; 107(20): E197; Author Reply E197. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12777328

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Long-term use of contraceptive depot medroxyprogesterone acetate in young women impairs arterial endothelial function assessed by cardiovascular magnetic resonance. Author(s): Kaunitz AM. Source: Circulation. 2003 March 11; 107(9): E67-8; Author Reply E67-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12628963

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Long-term use of contraceptive depot medroxyprogesterone acetate in young women impairs arterial endothelial function assessed by cardiovascular magnetic resonance. Author(s): Sorensen MB, Collins P, Ong PJ, Webb CM, Hayward CS, Asbury EA, Gatehouse PD, Elkington AG, Yang GZ, Kubba A, Pennell DJ. Source: Circulation. 2002 September 24; 106(13): 1646-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12270857

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Low-dose oral medroxyprogesterone acetate in the management of the paraphilias. Author(s): Gottesman HG, Schubert DS. Source: The Journal of Clinical Psychiatry. 1993 May; 54(5): 182-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8509348

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Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension): a contraceptive method for women in the US and worldwide. Author(s): Kaunitz AM, Mishell DR Jr. Source: Contraception. 1999 October; 60(4): 177-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10640163

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Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension): assessment of return of ovulation after three monthly injections in surgically sterile women. Author(s): Rahimy MH, Ryan KK. Source: Contraception. 1999 October; 60(4): 189-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10640165

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Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension): effects of body weight and injection sites on pharmacokinetics. Author(s): Rahimy MH, Cromie MA, Hopkins NK, Tong DM. Source: Contraception. 1999 October; 60(4): 201-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10640166

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Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension): steady-state pharmacokinetics of MPA and E2 in surgically sterile women. Author(s): Rahimy MH, Ryan KK, Hopkins NK. Source: Contraception. 1999 October; 60(4): 209-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10640167

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Magnitude and variability of sequential estradiol and progesterone concentrations in women using depot medroxyprogesterone acetate for contraception. Author(s): Clark MK, Sowers M, Levy BT, Tenhundfeld P. Source: Fertility and Sterility. 2001 May; 75(5): 871-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11334896

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Male hormonal contraception: effects of injections of testosterone undecanoate and depot medroxyprogesterone acetate at eight-week intervals in chinese men. Author(s): Gu YQ, Tong JS, Ma DZ, Wang XH, Yuan D, Tang WH, Bremner WJ. Source: The Journal of Clinical Endocrinology and Metabolism. 2004 May; 89(5): 2254-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15126550

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Medroxyprogesterone acetate alone or synergistic with chemotherapy suppresses colony formation and DNA synthesis in C6 glioma in vitro. Author(s): Altinoz MA, Bilir A, Ozar E, Onar FD, Sav A. Source: International Journal of Developmental Neuroscience : the Official Journal of the International Society for Developmental Neuroscience. 2001 October; 19(6): 541-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11600316

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Medroxyprogesterone acetate and cancer cachexia: interleukin-6 involvement. Author(s): Yamashita JI, Ogawa M. Source: Breast Cancer. 2000; 7(2): 130-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11029784

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Medroxyprogesterone acetate decreases secretion of interleukin-6 and parathyroid hormone-related protein in a new anaplastic thyroid cancer cell line, KTC-2. Author(s): Kurebayashi J, Otsuki T, Tanaka K, Yamamoto Y, Moriya T, Sonoo H. Source: Thyroid : Official Journal of the American Thyroid Association. 2003 March; 13(3): 249-58. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12729473

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Medroxyprogesterone acetate increases anthracyclines uptake in chronic lymphatic leukemia cells: role of nitric oxide and lipid peroxidation. Author(s): Pagnini U, Pacilio C, Florio S, Crispino A, Claudio PP, Giordano A, Pagnini G. Source: Anticancer Res. 2000 January-February; 20(1A): 33-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10769632

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Medroxyprogesterone acetate inhibits human pancreatic carcinoma cell growth by inducing apoptosis in association with Bcl-2 phosphorylation. Author(s): Abe M, Yamashita J, Ogawa M. Source: Cancer. 2000 May 1; 88(9): 2000-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10813710

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Medroxyprogesterone acetate therapy for patients with adenocarcinoma of the endometrium who wish to preserve the uterus-usefulness and limitations. Author(s): Imai M, Jobo T, Sato R, Kawaguchi M, Kuramoto H. Source: Eur J Gynaecol Oncol. 2001; 22(3): 217-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11501776

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Medroxyprogesterone acetate treatment of abnormal uterine bleeding: factors predicting satisfaction. Author(s): Richter HE, Learman LA, Lin F, Varner RE, Hendrix SL, Summitt RL, Washington AE. Source: American Journal of Obstetrics and Gynecology. 2003 July; 189(1): 37-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12861135

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Medroxyprogesterone acetate versus norethisterone: effect on estradiol-induced changes of markers for endothelial function and atherosclerotic plaque characteristics in human female coronary endothelial cell cultures. Author(s): Mueck AO, Seeger H, Wallwiener D. Source: Menopause (New York, N.Y.). 2002 July-August; 9(4): 273-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12082363

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Medroxyprogesterone at high altitude. The effects on blood gases, cerebral regional oxygenation, and acute mountain sickness. Author(s): Wright AD, Beazley MF, Bradwell AR, Chesner IM, Clayton RN, Forster PJ, Hillenbrand P, Imray CH; Birmingham Medical Research Expeditionary Society. Source: Wilderness Environ Med. 2004 Spring; 15(1): 25-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15040503

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Medroxyprogesterone improves cardiac autonomic control in postmenopausal women with respiratory insufficiency. Author(s): Virtanen I, Polo O, Saaresranta T, Kuusela T, Polo-Kantola P, Ekholm E. Source: Respiratory Medicine. 2004 February; 98(2): 126-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14971875

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Medroxyprogesterone in postmenopausal females with partial upper airway obstruction during sleep. Author(s): Saaresranta T, Polo-Kantola P, Rauhala E, Polo O. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 2001 December; 18(6): 989-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11829107

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Medroxyprogesterone-induced endocrine alterations after menopause. Author(s): Saaresranta T, Irjala K, Polo-Kantola P, Polo O. Source: Menopause (New York, N.Y.). 2002 July-August; 9(4): 288-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12082365

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Melting after keratoprosthesis implantation: the effects of medroxyprogesterone. Author(s): Hicks CR, Crawford GJ. Source: Cornea. 2003 August; 22(6): 497-500. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12883338

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Menopausal bone loss in long-term users of depot medroxyprogesterone acetate contraception. Author(s): Cundy T, Cornish J, Roberts H, Reid IR. Source: American Journal of Obstetrics and Gynecology. 2002 May; 186(5): 978-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12015524

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Menopausal symptom control and side-effects on continuous estrone sulfate and three doses of medroxyprogesterone acetate. Ogen/Provera Study Group. Author(s): Nand SL, Webster MA, Baber R, Heller GZ. Source: Climacteric : the Journal of the International Menopause Society. 1998 September; 1(3): 211-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11913409

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Menstrual pattern and lipid profiles during use of medroxyprogesterone acetate and estradiol cypionate and NET-EN (200 mg) as contraceptive injections. Author(s): Canto de Cetina TE, Luna MO, Cetina Canto JA, Bassol S. Source: Contraception. 2004 February; 69(2): 115-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14759615

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Mifepristone for the prevention of breakthrough bleeding in new starters of depomedroxyprogesterone acetate. Author(s): Jain JK, Nicosia AF, Nucatola DL, Lu JJ, Kuo J, Felix JC. Source: Steroids. 2003 November; 68(10-13): 1115-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14668006

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Mood changes in adolescents using depot-medroxyprogesterone acetate for contraception: a prospective study. Author(s): Gupta N, O'Brien R, Jacobsen LJ, Davis A, Zuckerman A, Supran S, Kulig J. Source: Journal of Pediatric and Adolescent Gynecology. 2001 May; 14(2): 71-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11479103

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Natural progesterone, but not medroxyprogesterone acetate, enhances the beneficial effect of estrogen on exercise-induced myocardial ischemia in postmenopausal women. Author(s): Rosano GM, Webb CM, Chierchia S, Morgani GL, Gabraele M, Sarrel PM, de Ziegler D, Collins P. Source: Journal of the American College of Cardiology. 2000 December; 36(7): 2154-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11127455

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New contraceptive eligibility checklists for provision of combined oral contraceptives and depot-medroxyprogesterone acetate in community-based programmes. Author(s): Stang A, Schwingl P, Rivera R. Source: Bulletin of the World Health Organization. 2000; 78(8): 1015-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10994285

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New trends in the use of medroxyprogesterone acetate as a chemotherapeutic agent in gynecologic malignancies. Author(s): Vanderstappen D, Bonte J. Source: Eur J Gynaecol Oncol. 1992; 13(2): 113-23. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1534051

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No adverse effects of medroxyprogesterone treatment without estrogen in postmenopausal women: double-blind, placebo-controlled, crossover trial. Author(s): Sherwin BB. Source: Obstetrics and Gynecology. 1994 May; 83(5 Pt 1): 798-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8164947

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No adverse effects of medroxyprogesterone treatment without estrogen in postmenopausal women: double-blind, placebo-controlled, crossover trial. Author(s): Prior JC, Alojado N, McKay DW, Vigna YM. Source: Obstetrics and Gynecology. 1994 January; 83(1): 24-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8272302

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No effect of high-dose medroxyprogesterone acetate on the frequency of sister chromatid exchange in lymphocytes of cancer patients. Author(s): Becher R. Source: Oncology. 1988; 45(1): 57-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2963244

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Noncontraceptive benefits and therapeutic uses of depot medroxyprogesterone acetate. Author(s): Cullins VE. Source: J Reprod Med. 1996 May; 41(5 Suppl): 428-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8725706

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Non-oral HRT and lipoprotein metabolism. Which progestin-- dydrogesterone or medroxyprogesterone acetate? Author(s): Bhathena RK, Ganatra AM, Pinto R, Anklesaria BS. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 2000 May; 69(2): 177-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10802094

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Norelgestromin as selective estrogen enzyme modulator in human breast cancer cell lines. Effect on sulfatase activity in comparison to medroxyprogesterone acetate. Author(s): Pasqualini JR, Caubel P, Friedman AJ, Philippe JC, Chetrite GS. Source: The Journal of Steroid Biochemistry and Molecular Biology. 2003 February; 84(23): 193-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12711003

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Nuclear androgen receptor as marker of responsiveness to medroxyprogesterone acetate in human renal cell carcinoma. Author(s): Concolino G, Marocchi A, Toscano V, Di Silverio F. Source: J Steroid Biochem. 1981 December; 15: 397-402. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6461800

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Nuclear morphometric changes and therapy monitoring in patients with endometrial hyperplasia: a study comparing effects of intrauterine levonorgestrel and systemic medroxyprogesterone. Author(s): Vereide AB, Arnes M, Straume B, Maltau JM, Orbo A. Source: Gynecologic Oncology. 2003 December; 91(3): 526-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14675671

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Objective evidence that placebo and oral medroxyprogesterone acetate therapy diminish menopausal vasomotor flushes. Author(s): Albrecht BH, Schiff I, Tulchinsky D, Ryan KJ. Source: American Journal of Obstetrics and Gynecology. 1981 March 15; 139(6): 631-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7211966

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Observations with Depo-Provera (medroxyprogesterone) in the management of renal tumours. Author(s): Romics I, Repassy D. Source: International Urology and Nephrology. 1987; 19(1): 49-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3583612

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On the role of additive hormone monotherapy with tamoxifen, medroxyprogesterone acetate and aminoglutethimide, in advanced breast cancer. Author(s): Petru E, Schmahl D. Source: Klin Wochenschr. 1987 October 15; 65(20): 959-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2963170

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Oral 17beta-estradiol and medroxyprogesterone acetate therapy in postmenopausal women increases HDL particle size. Author(s): Tangney CC, Mosca LJ, Otvos JD, Rosenson RS. Source: Atherosclerosis. 2001 April; 155(2): 425-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11254913

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Oral high-dose medroxyprogesterone acetate (MAP) in treatment of advanced breast cancer. A preliminary report of clinical and experimental studies. Author(s): Izuo M, Iino Y, Endo K. Source: Breast Cancer Research and Treatment. 1981; 1(2): 125-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6216931

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Oral high-dose medroxyprogesterone acetate (MPA) treatment: cortisol/MPA serum profiles in relation to breast cancer regression. Author(s): Mahlke M, Grill HJ, Knapstein P, Wiegand U, Pollow K. Source: Oncology. 1985; 42(3): 144-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4000617

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Oral high-dose medroxyprogesterone acetate causes adrenal suppression in patients with breast cancer. Author(s): Van Veelen H, Houwerzijl J, Roding TJ, Tjabbes T, Vermeer RJ, Sleijfer DT, Pratt JJ, Willemse PH. Source: Eur J Cancer Clin Oncol. 1982 October; 18(10): 1035-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6297915

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Oral high-dose medroxyprogesterone acetate treatment for recurrent breast cancer. Author(s): Iino Y, Takeo T, Sugamata N, Aoyagi H, Takai Y, Takei H, Ando T, Koibuchi Y, Yokoe T, Ohwada S, et al. Source: Anticancer Res. 1995 May-June; 15(3): 1061-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7645926

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Oral high-dose medroxyprogesterone acetate versus tamoxifen. A randomized crossover trial in postmenopausal patients with advanced breast cancer. Author(s): van Veelen H, Willemse PH, Tjabbes T, Schweitzer MJ, Sleijfer DT. Source: Cancer. 1986 July 1; 58(1): 7-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2939943

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Oral medroxyprogesterone acetate in the treatment of advanced or recurrent endometrial carcinoma: a dose-response study by the Gynecologic Oncology Group. Author(s): Thigpen JT, Brady MF, Alvarez RD, Adelson MD, Homesley HD, Manetta A, Soper JT, Given FT. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1999 June; 17(6): 1736-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10561210

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Oral medroxyprogesterone acetate in the treatment of metastatic breast cancer. Author(s): Hortobagyi GN, Buzdar AU, Frye D, Yap HY, Hug V, Pinnamaneni K, Fraschini G, Halvorson HC, Blumenschein GR. Source: Breast Cancer Research and Treatment. 1985; 5(3): 321-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3161565

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Oral medroxyprogesterone in the treatment of metastatic breast cancer. Author(s): Nemoto T, Patel J, Rosner D, Dao TL. Source: Journal of Surgical Oncology. 1986 August; 32(4): 211-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3736062

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Oral medroxyprogesterone in the treatment of postmenopausal symptoms. Author(s): Schiff I, Tulchinsky D, Cramer D, Ryan KJ. Source: Jama : the Journal of the American Medical Association. 1980 September 26; 244(13): 1443-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6775094

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Oral plus intramuscular medroxyprogesterone acetate (high dose Farlutal) in advanced breast cancer. Author(s): Ngelangel CA, Jimenez MV, Villalon AH, Agustin BM. Source: Southeast Asian J Trop Med Public Health. 1985 December; 16(4): 634-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2940689

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Oral route administration of medroxyprogesterone acetate (MAP) at high doses in the treatment of advanced breast cancer: clinical results. Author(s): Guarnieri A, Tucci E, D'Aniello C, Carli A, Mariani L, De Stefano A, Nardi P. Source: Chemioterapia. 1984 October; 3(5): 320-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6241848

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Oral versus im administration of high-dose medroxyprogesterone acetate in pretreated patients with advanced breast cancer. Author(s): Beex L, Burghouts J, van Turnhout J, Breed W, Hillen H, Holdrinet A, Boetius G, Hoogendoorn G, Doesburg W, Verhulst M, et al. Source: Cancer Treat Rep. 1987 December; 71(12): 1151-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3690524

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Ovarian function following a single administration of depo-medroxyprogesterone acetate (DMPA) at different doses. Author(s): Bassol S, Garza-Flores J, Cravioto MC, Diaz-Sanchez V, Fotherby K, Lichtenberg R, Perez-Palacios G. Source: Fertility and Sterility. 1984 August; 42(2): 216-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6235131

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Overweight teens at increased risk for weight gain while using depot medroxyprogesterone acetate. Author(s): Mangan SA, Larsen PG, Hudson S. Source: Journal of Pediatric and Adolescent Gynecology. 2002 April; 15(2): 79-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12057528

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Ovulation after treatment with ethinyl-oestradiol and medroxyprogesterone acetate in a woman approaching premature menopause. Case report. Author(s): Petsos P, Buckler H, Mamtora H, Anderson DC. Source: British Journal of Obstetrics and Gynaecology. 1986 November; 93(11): 1155-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3096369

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Patient acceptability and satisfaction with Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension). Author(s): Shulman LP, Oleen-Burkey M, Willke RJ. Source: Contraception. 1999 October; 60(4): 215-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10640168

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Pharmacodynamic effects of depot-medroxyprogesterone acetate (DMPA) administered to lactating women on their male infants. Author(s): Virutamasen P, Leepipatpaiboon S, Kriengsinyot R, Vichaidith P, Muia PN, Sekadde-Kigondu CB, Mati JK, Forest MG, Dikkeschei LD, Wolthers BG, d'Arcangues C. Source: Contraception. 1996 September; 54(3): 153-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8899256

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Pharmacokinetic study of low- versus high-dose medroxyprogesterone acetate (MPA) in women. Author(s): Ohtsu T, Fujii H, Wakita H, Igarashi T, Itoh K, Imoto S, Kohagura M, Sasaki Y. Source: Cancer Chemotherapy and Pharmacology. 1998; 42(1): 1-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9619751

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Pharmacokinetics of 9alpha-fluoromedroxyprogesterone acetate in rats: comparison with medroxyprogesterone acetate. Author(s): Kozutsumi D, Kawashima A, Sugimoto T, Kotohda Y, Fujimori S, Takami M, Kohno T, Oikawa T, Sugino E, Choshi T, Hibino S. Source: Biopharmaceutics & Drug Disposition. 1999 September; 20(6): 277-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10701698

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Pharmacokinetics of estradiol valerate and medroxyprogesterone acetate in different age groups of postmenopausal women. Author(s): Jarvinen A, Kainulainen P, Nissila M, Nikkanen H, Kela M. Source: Maturitas. 2004 March 15; 47(3): 209-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15036491

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Pharmacokinetics of medroxyprogesterone acetate after single and multiple injection of Cyclofem in Chinese women. Author(s): Zhou XF, Shao QX, Han XJ, Weng LJ, Sang GW. Source: Contraception. 1998 June; 57(6): 405-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9693401

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Pharmacologic doses of medroxyprogesterone may cause bone loss through glucocorticoid activity: an hypothesis. Author(s): Ishida Y, Ishida Y, Heersche JN. Source: Osteoporosis International : a Journal Established As Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the Usa. 2002 August; 13(8): 601-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12181616

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Phase II study of medroxyprogesterone acetate plus tamoxifen in advanced endometrial carcinoma: a Gynecologic Oncology Group study. Author(s): Whitney CW, Brunetto VL, Zaino RJ, Lentz SS, Sorosky J, Armstrong DK, Lee RB; Gynecologic Oncology Group study. Source: Gynecologic Oncology. 2004 January; 92(1): 4-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14751130

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Phase II study of subcutaneously administered interleukin-2 in combination with medroxyprogesterone acetate and antioxidant agents as maintenance treatment in advanced cancer responders to previous chemotherapy. Author(s): Mantovani G, Maccio A, Madeddu C, Mulas C, Massa E, Astara G, Ferreli L, Mudu MC, Gramignano G, Murgia V, Lusso MR, Mocci M, Cardia A, Mura L. Source: Oncol Rep. 2002 July-August; 9(4): 887-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12066227

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Physical findings and symptoms of depot medroxyprogesterone acetate use in adolescent females. Author(s): Matson SC, Henderson KA, McGrath GJ. Source: Journal of Pediatric and Adolescent Gynecology. 1997 February; 10(1): 18-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9061630

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Pigmented purpuric eruption associated with injection medroxyprogesterone acetate. Author(s): Tsao H, Lerner LH. Source: Journal of the American Academy of Dermatology. 2000 August; 43(2 Pt 1): 30810. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10906656

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Plasma leptin in postmenopausal women with coronary artery disease: effect of transdermal 17beta-estradiol and intermittent medroxyprogesterone acetate. Author(s): Os I, Os A, Abdelnoor M, Larsen A, Birkeland K, Westheim A. Source: Climacteric : the Journal of the International Menopause Society. 2003 September; 6(3): 204-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14567768

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Post-abortion depot medroxyprogesterone acetate continuation rates: a randomized trial of cyclic estradiol. Author(s): Goldberg AB, Cardenas LH, Hubbard AE, Darney PD. Source: Contraception. 2002 October; 66(4): 215-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12413614

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Predictive value of serum medroxyprogesterone acetate concentration for response in advanced or recurrent breast cancer. Author(s): Nishimura R, Nagao K, Matsuda M, Baba K, Matsuoka Y, Yamashita H, Fukuda M, Higuchi A, Ikeda K. Source: European Journal of Cancer (Oxford, England : 1990). 1997 August; 33(9): 140712. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9337682

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Premenopausal ovariectomy-related bone loss: a randomized, double-blind, one-year trial of conjugated estrogen or medroxyprogesterone acetate. Author(s): Prior JC, Vigna YM, Wark JD, Eyre DR, Lentle BC, Li DK, Ebeling PR, Atley L. Source: Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research. 1997 November; 12(11): 1851-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9383690

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Progesterone, but not medroxyprogesterone, inhibits vascular cell adhesion molecule1 expression in human vascular endothelial cells. Author(s): Otsuki M, Saito H, Xu X, Sumitani S, Kouhara H, Kishimoto T, Kasayama S. Source: Arteriosclerosis, Thrombosis, and Vascular Biology. 2001 February; 21(2): 243-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11156860

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Prolonged endocrine responses to medroxyprogesterone in postmenopausal women with respiratory insufficiency. Author(s): Saaresranta T, Irjala K, Polo-Kantola P, Helenius H, Polo O. Source: Obstetrics and Gynecology. 2000 August; 96(2): 243-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10908771

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Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case-control study. Author(s): Bassaw K, Gangar K. Source: British Journal of Obstetrics and Gynaecology. 1997 June; 104(6): 758-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9197894

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Protective effect of depot-medroxyprogesterone acetate on surgically treated uterine leiomyomas: a multicentre case-control study. Author(s): Ikomi AA, Singer A. Source: British Journal of Obstetrics and Gynaecology. 1997 March; 104(3): 385-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9091025

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Protocols for the use of cyproterone, medroxyprogesterone, and leuprolide in the treatment of paraphilia. Author(s): Reilly DR, Delva NJ, Hudson RW. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2000 August; 45(6): 559-63. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10986575

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Quality of life and costs associated with micronized progesterone and medroxyprogesterone acetate in hormone replacement therapy for nonhysterectomized, postmenopausal women. Author(s): Ryan N, Rosner A. Source: Clinical Therapeutics. 2001 July; 23(7): 1099-115. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11519773

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Quantitative determination of medroxyprogesterone acetate in plasma by liquid chromatography/electrospray ion trap mass spectrometry. Author(s): Kim SM, Kim DH. Source: Rapid Communications in Mass Spectrometry : Rcm. 2001; 15(21): 2041-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11675672

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Quantitative gas-liquid chromatographic determination of medroxyprogesterone acetate in human plasma. Author(s): Rossi E, De Pascale A, Negrini P, Frigerio A, Castegnaro E, Castegnaro E. Source: Journal of Chromatography. 1979 February 1; 169: 416-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=536431

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Randomized trial comparing aminoglutethimide with high-dose medroxyprogesterone acetate in therapy for advanced breast carcinoma. Author(s): Canney PA, Priestman TJ, Griffiths T, Latief TN, Mould JJ, Spooner D. Source: Journal of the National Cancer Institute. 1988 September 21; 80(14): 1147-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2970555

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Re: Cardiovascular side effects of diethylstilbestrol, cyproterone acetate, medroxyprogesterone acetate and estramustine phosphate used for the treatment of advanced prostatic cancer: results from European Organization for Research on Treatment of Cancer Trials 30761 and 30762. Author(s): deVoogt HJ, Pavone-Macaluso M, Sylvester R, Schroder FH. Source: The Journal of Urology. 1988 December; 140(6): 1557. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2973530

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Recent clinical issues related to the use of depot medroxyprogesterone acetate (DepoProvera). Author(s): Cromer BA. Source: Current Opinion in Obstetrics & Gynecology. 1999 October; 11(5): 467-71. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10526923

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Recombinant leukocyte interferon alpha-2a and medroxyprogesterone in advanced renal cell carcinoma. A randomized trial. Author(s): Steineck G, Strander H, Carbin BE, Borgstrom E, Wallin L, Achtnich U, Arvidsson A, Soderlund V, Naslund I, Esposti PL, et al. Source: Acta Oncologica (Stockholm, Sweden). 1990; 29(2): 155-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2185803

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Recovery of bone density in women who stop using medroxyprogesterone acetate. Author(s): Cundy T, Cornish J, Evans MC, Roberts H, Reid IR. Source: Bmj (Clinical Research Ed.). 1994 January 22; 308(6923): 247-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8111260

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Reduced vaginal bleeding in postmenopausal women who receive combined norethindrone acetate and low-dose ethinyl estradiol therapy versus combined conjugated equine estrogens and medroxyprogesterone acetate therapy. Author(s): Simon JA, Liu JH, Speroff L, Shumel BS, Symons JP. Source: American Journal of Obstetrics and Gynecology. 2003 January; 188(1): 92-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12548201

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Reduction of the intraperitoneal inflammation associated with endometriosis by treatment with medroxyprogesterone acetate. Author(s): Haney AF, Weinberg JB. Source: American Journal of Obstetrics and Gynecology. 1988 August; 159(2): 450-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3407705

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Regulation of human endometrial transforming growth factor beta1 and beta3 isoforms through menstrual cycle and medroxyprogesterone acetate treatment. Author(s): Reis FM, Ribeiro MF, Maia AL, Spritzer PM. Source: Histology and Histopathology. 2002; 17(3): 739-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12168782

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Regulation of platelet aggregation and adenosine triphosphate release in vitro by 17beta-estradiol and medroxyprogesterone acetate in postmenopausal women. Author(s): Bar J, Lahav J, Hod M, Ben-Rafael Z, Weinberger I, Brosens J. Source: Thrombosis and Haemostasis. 2000 October; 84(4): 695-700. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11057872

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Relationship between progesterone receptor level in endometrium and bleeding pattern in depot medroxyprogesterone acetate users. Author(s): Chotnopparatpattara P, Taneepanichskul S, Treratanachat S, Charuruks N. Source: J Med Assoc Thai. 2003 February; 86(2): 172-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12678156

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Relief of vasomotor symptoms and vaginal atrophy with lower doses of conjugated equine estrogens and medroxyprogesterone acetate. Author(s): Utian WH, Shoupe D, Bachmann G, Pinkerton JV, Pickar JH. Source: Fertility and Sterility. 2001 June; 75(6): 1065-79. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11384629

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Respiratory insufficiency in postmenopausal women: sustained improvement of gas exchange with short-term medroxyprogesterone acetate. Author(s): Saaresranta T, Polo-Kantola P, Irjala K, Helenius H, Polo O. Source: Chest. 1999 June; 115(6): 1581-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10378552

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Results of a dose-intense phase 1 study of a combination chemotherapy regimen with cisplatin and epidoxorubicin including medroxyprogesterone acetate and recombinant interleukin-2 in patients with inoperable primary lung cancer. Author(s): Mantovani G, Maccio A, Lai P, Massa E, Massa D, Mulas C, Succu G, Mudu MC, Manca G, Versace R, Pisano A. Source: Journal of Immunotherapy (Hagerstown, Md. : 1997). 2000 March-April; 23(2): 267-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10746553

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Role of human cytochrome P450 3A4 in metabolism of medroxyprogesterone acetate. Author(s): Kobayashi K, Mimura N, Fujii H, Minami H, Sasaki Y, Shimada N, Chiba K. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 2000 August; 6(8): 3297-303. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10955816

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Sequential addition of low dose of medrogestone or medroxyprogesterone acetate to transdermal estradiol: a pilot study on their influence on the endometrium. Author(s): Pansini F, De Paoli D, Albertazzi P, Bonaccorsi G, Campobasso C, Zanotti L, Pisati R, Giulini NA. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1996 September; 68(1-2): 137-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8886696

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Serum immunoglobulin levels during contraceptive use of depotmedroxyprogesterone acetate in Indian women: a preliminary study. Author(s): Lali P, Chandra L, Gupta RP. Source: Contraception. 1996 June; 53(6): 363-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8773424

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Serum medroxyprogesterone acetate levels in new and repeat users of depot medroxyprogesterone acetate at the end of the dosing interval. Author(s): Smit J, Botha J, McFadyen L, Beksinska M. Source: Contraception. 2004 January; 69(1): 3-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14720612

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Serum testosterone, androstenedione and luteinizing hormone levels after short-term medroxyprogesterone acetate treatment in women with polycystic ovarian disease. Author(s): Anttila L, Koskinen P, Erkkola R, Irjala K, Ruutiainen K. Source: Acta Obstetricia Et Gynecologica Scandinavica. 1994 September; 73(8): 634-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7941988

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Spinal bone density in women using depot medroxyprogesterone contraception. Author(s): Szarewski A, Mansour D. Source: Obstetrics and Gynecology. 1999 April; 93(4): 629-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10214848

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Spinal bone density in women using depot medroxyprogesterone contraception. Author(s): Cundy T, Cornish J, Roberts H, Elder H, Reid IR. Source: Obstetrics and Gynecology. 1998 October; 92(4 Pt 1): 569-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9764630

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Spontaneous regression of a solitary cerebral metastases in renal carcinoma followed by meningioma development under medroxyprogesterone acetate therapy. Author(s): Hensiek AE, Kellerman AJ, Hill JT. Source: British Journal of Neurosurgery. 2000 August; 14(4): 354-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11045205

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Subcutaneous interleukin-2 in combination with medroxyprogesterone acetate and antioxidants in advanced cancer responders to previous chemotherapy: phase II study evaluating clinical, quality of life, and laboratory parameters. Author(s): Mantovani G, Madeddu C, Gramignano G, Lusso MR, Mocci M, Massa E, Ferreli L, Astara G, Maccio A, Serpe R. Source: Journal of Experimental Therapeutics & Oncology. 2003 July-August; 3(4): 20519. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14567291

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Successful management of breast cancer with liver metastases with medroxyprogesterone acetate treatment. Author(s): Toyama T, Yamashita H, Hara Y, Hikosaka Y, Kobayashi S, Iwase H. Source: International Journal of Clinical Oncology / Japan Society of Clinical Oncology. 2001 December; 6(6): 306-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11828951

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Suppression of parathyroid hormone-related protein messenger RNA expression by medroxyprogesterone acetate in breast cancer tissues. Author(s): Sugimoto T, Shiba E, Watanabe T, Takai S. Source: Breast Cancer Research and Treatment. 1999 July; 56(1): 11-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10517339

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The antiinflammatory properties of medroxyprogesterone acetate. Author(s): Rachon D. Source: Circulation. 2002 November 26; 106(22): E185; Author Reply E185. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12451020

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The association between depot medroxyprogesterone acetate contraception and bone mineral density in adolescent women. Author(s): Scholes D, LaCroix AZ, Ichikawa LE, Barlow WE, Ott SM. Source: Contraception. 2004 February; 69(2): 99-104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14759613

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The comparison of effects of tibolone and conjugated estrogen-medroxyprogesterone acetate therapy on sexual performance in postmenopausal women. Author(s): Kokcu A, Cetinkaya MB, Yanik F, Alper T, Malatyalioglu E. Source: Maturitas. 2000 July 31; 36(1): 75-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10989245

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The effect of medroxyprogesterone acetate and norethisterone on the estradiol stimulated proliferation in MCF-7 cells: comparison of continuous combined versus sequential combined estradiol/progestin treatment. Author(s): Lippert C, Seeger H, Wallwiener D, Mueck AO. Source: Eur J Gynaecol Oncol. 2001; 22(5): 331-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11766732

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The effect of past use of the injectable contraceptive depot medroxyprogesterone acetate on bone mineral density in normal post-menopausal women. Author(s): Orr-Walker BJ, Evans MC, Ames RW, Clearwater JM, Cundy T, Reid IR. Source: Clinical Endocrinology. 1998 November; 49(5): 615-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10197077

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The effects of Medroxyprogesterone acetate on apoptosis of CD34+ cells. Author(s): Aydin F, Ozdemir F, Kavgaci H, Yilmaz M, Karti S. Source: Chemotherapy. 2003 May; 49(1-2): 66-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12714814

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The effects of short-term medroxyprogesterone acetate and micronized progesterone on glucose metabolism and lipid profiles in patients with polycystic ovary syndrome: a prospective randomized study. Author(s): Bagis T, Gokcel A, Zeyneloglu HB, Tarim E, Kilicdag EB, Haydardedeoglu B. Source: The Journal of Clinical Endocrinology and Metabolism. 2002 October; 87(10): 4536-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12364431

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The impact of different doses of medroxyprogesterone acetate on mood symptoms in sequential hormonal therapy. Author(s): Bjorn I, Bixo M, Nojd KS, Collberg P, Nyberg S, Sundstrom-Poromaa I, Backstrom T. Source: Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology. 2002 February; 16(1): 1-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11915576

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Thrombotic stroke in an otherwise healthy middle-aged female related to the use of continuous-combined conjugated equine estrogens and medroxyprogesterone acetate. Author(s): Feeman WE Jr. Source: J Gend Specif Med. 2000 November-December; 3(8): 62-4; Discussion 64-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11253269

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Treatment of endometriosis with depot medroxyprogesterone acetate: a preliminary experience. Author(s): Arowojolu AO. Source: Afr J Med Med Sci. 2000 March; 29(1): 55-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11379470

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Unscheduled bleeding during initiation of continuous combined hormone replacement therapy: a direct comparison of two combinations of norethindrone acetate and ethinyl estradiol to medroxyprogesterone acetate and conjugated equine estrogens. Author(s): Simon JA, Symons JP; femhrt Study Investigators. Source: Menopause (New York, N.Y.). 2001 September-October; 8(5): 321-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11528357

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Unsuccessful treatment of acromegaly with medroxyprogesterone acetate. Author(s): Atkinson RL Jr, Dimond RC, Howard WJ, Earll JM. Source: Acta Endocrinol (Copenh). 1974 September; 77(1): 19-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4408390

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Unsuspected uterine carcinosarcoma (heterologous) diagnosed following conservative therapies with medroxyprogesterone acetate for presumed early-stage endometrial carcinoma. Author(s): Fujiwara H, Shibahara H, Usui R, Takamizawa S, Kosuge S, Ohwada M, Suzuki M, Sato I. Source: American Journal of Reproductive Immunology (New York, N.Y. : 1989). 2002 March; 47(3): 129-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12069197

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Use of depot medroxyprogesterone acetate contraception in adolescents. Author(s): Davis AJ. Source: J Reprod Med. 1996 May; 41(5 Suppl): 407-13. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8725703

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Use of depot medroxyprogesterone acetate in Thai adolescents. Author(s): Chotnopparatpattara P, Taneepanichskul S. Source: Contraception. 2000 September; 62(3): 137-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11124361

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Use of injectable depot medroxyprogesterone acetate in lactating Indian women. Author(s): Sathyamala C, Shah P, Jain Y, Bhargava A. Source: Lancet. 1994 July 9; 344(8915): 134-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7912374

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Use of injectable progestin (medroxyprogesterone acetate) in adolescent health care. Author(s): Isart F, Weber FT, Merrick CL, Rowe S. Source: Contraception. 1992 July; 46(1): 41-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1424622

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Use of medroxyprogesterone acetate in the treatment of Mullerian adenosarcoma: a case report. Author(s): Hines BJ, Porges RF, Mittal K, Muggia FM, Curtin JP. Source: Gynecologic Oncology. 2002 April; 85(1): 192-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11925144

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Use of medroxyprogesterone acetate to prevent menopausal symptoms. Author(s): Bullock JL, Massey FM, Gambrell RD Jr. Source: Obstetrics and Gynecology. 1975 August; 46(2): 165-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1153148

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Use of menopausal estrogens and medroxyprogesterone in the United States, 19821992. Author(s): Wysowski DK, Golden L, Burke L. Source: Obstetrics and Gynecology. 1995 January; 85(1): 6-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7800326

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Vaginal cytologic evaluation as a practical link between hormone blood levels and tumor hormone dependency in exclusive medroxyprogesterone treatment of recurrent or metastatic endometrial adenocarcinoma. Author(s): Bonte J, Decoster JM, Ide P. Source: Acta Cytol. 1977 March-April; 21(2): 218-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=266331

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Variable response of plasma GH in acromegalic patients treated with medroxyprogesterone acetate. Author(s): Malarkey WB, Daughaday WH. Source: The Journal of Clinical Endocrinology and Metabolism. 1971 September; 33(3): 424-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4936883

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Vascular endothelial growth factor expression is not regulated by estradiol or medroxyprogesterone acetate in endometrial carcinoma. Author(s): Kim YB, Berek JS, Martinez-Maza O, Satyaswaroop PG. Source: Gynecologic Oncology. 1996 April; 61(1): 97-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8626126

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Ventilatory response to medroxyprogesterone acetate in normal subjects: time course and mechanism. Author(s): Skatrud JB, Dempsey JA, Kaiser DG. Source: Journal of Applied Physiology (Bethesda, Md. : 1985). 1978 June; 44(6): 393-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=670006

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Vitamin and trace mineral metabolism in medroxyprogesterone acetate users. Author(s): Amatayakul K, Sivasomboon B, Thanangkul O. Source: Contraception. 1978 September; 18(3): 253-69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=720068

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Weekly doxorubicin with or without high-dose medroxyprogesterone acetate in hormone-resistant advanced breast cancer. A randomised study. The Norwegian Breast Cancer Group. Author(s): Gundersen S, Hannisdal E, Lundgren S, Wist E. Source: European Journal of Cancer (Oxford, England : 1990). 1994; 30A(12): 1775-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7880604

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Weekly low-dose doxorubicin with or without high-dose medroxyprogesterone acetate as secondary treatment in metastatic breast cancer--a randomized trial. Author(s): Elomaa I, Blomqvist C, Rissanen P, Mantyla M. Source: Acta Oncologica (Stockholm, Sweden). 1988; 27(3): 297-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2970862

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Yoshi 864 plus medroxyprogesterone acetate in adenocarcinoma of the kidney: A Southwest Oncology Group Study. Author(s): Altman SJ, Stephens RL, Bonnet JD. Source: Cancer Treat Rep. 1982 September; 66(9): 1781-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6288240

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

Finding Nutrition Studies on Medroxyprogesterone The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “medroxyprogesterone” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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

Combined effect of navelbine with medroxyprogesterone acetate against human breast carcinoma MCF-7 cells in vitro. Author(s): Pharmaceutical Research Laboratories, Kyowa Hakko Kogyo, Shizuoka, Japan. Source: Sugiyama, K Shimizu, M Akiyama, T Ishida, H Okabe, M Tamaoki, T Akinaga, S Br-J-Cancer. 1998 June; 77(11): 1737-43 0007-0920

•

Comparison of the resorbable barrier interceed (TC7) and preoperative use of medroxyprogesterone acetate in postoperative adhesion prevention. Author(s): University of Istanbul, Istanbul Medical School Hospital, Capa, Turkey. Source: Baysal, B Clin-Exp-Obstet-Gynecol. 2001; 28(2): 126-7 0390-6663

•

High-dose medroxyprogesterone acetate plus mitomycin-C or vindesine in the treatment of advanced breast cancer. Author(s): Department of Medical Oncology, University of Pretoria, South Africa. Source: Falkson, C I Falkson, H C Falkson, G Am-J-Clin-Oncol. 1988 August; 11(4): 431-4 0277-3732

•

The clinical effect of medroxyprogesterone (MPA) in elderly patients with lung cancer. Author(s): Department of Pulmonary Medicine, Helsinki University Central Hospital, Finland. Source: Niiranen, A Kajanti, M Tammilehto, L Mattson, K Am-J-Clin-Oncol. 1990 April; 13(2): 113-6 0277-3732

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

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

•

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

•

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

•

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

•

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/

•

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

•

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

Nutrition

•

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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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Vitamins Folic Acid Source: Healthnotes, Inc.; www.healthnotes.com Vitamin A Source: Healthnotes, Inc.; www.healthnotes.com Vitamin D Source: Healthnotes, Inc.; www.healthnotes.com Vitamin E Alternative names: Alpha-Tocopherol, Beta-Tocopherol, D-Alpha-Tocopherol, Delta-Tocopherol, Gamma-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com

•

Minerals Alpha-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com Beta-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com

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D-Alpha-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com Delta-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com Gamma-Tocopherol Source: Integrative Medicine Communications; www.drkoop.com Magnesium Source: Healthnotes, Inc.; www.healthnotes.com Zinc Source: Healthnotes, Inc.; www.healthnotes.com

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

A 2-year prospective study on the effects of depot medroxyprogesterone acetate on bone mass-response to estrogen and calcium therapy in individual users. Author(s): Merki-Feld GS, Neff M, Keller PJ. Source: Contraception. 2003 February; 67(2): 79-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12586317

•

A phase II trial of mitomycin C, 5'-deoxy-5-fluorouridine, etoposide and medroxyprogesterone acetate (McVD-MPA) as a salvage chemotherapy to anthracycline-resistant tumor in relapsed breast cancer and its mechanism(s) of antitumor action. Author(s): Kim R, Osaki A, Tanabe K, Kojima J, Toge T. Source: Oncol Rep. 2001 May-June; 8(3): 597-603. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11295087

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A randomised controlled trial of medroxyprogesterone acetate in mastalgia. Author(s): Serewel A, Haggie JA, Cade D. Source: Annals of the Royal College of Surgeons of England. 1990 July; 72(4): 273. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2143365

•

Actions of medroxyprogesterone acetate on the efficacy of cytotoxic drugs: studies with human breast cancer cells in culture. Author(s): Shaikh N, Owen AM, Ghilchik MW, Braunsberg H. Source: International Journal of Cancer. Journal International Du Cancer. 1989 March 15; 43(3): 458-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2522422

•

Adrenal suppression by oral high-dose medroxyprogesterone acetate in breast cancer patients. Author(s): van Veelen H, Willemse PH, Sleijfer DT, Pratt JJ, Sluiter WJ, Doorenbos H. Source: Cancer Chemotherapy and Pharmacology. 1984; 12(2): 83-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6321047

•

Advanced adenocarcinoma of the kidney: therapy with lomustine, vinblastine, hydroxyurea, and medroxyprogesterone acetate and regression analysis of factors relating to survival. Author(s): Brubaker LH, Troner MB, Birch R. Source: Cancer Treat Rep. 1983 July-August; 67(7-8): 741-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6223695

•

Chemo-hormonal therapy for metastatic renal cell carcinoma with adriamycin, hydroxyurea, vinblastine, and medroxyprogesterone acetate. Author(s): Katakkar SB, Franks CR. Source: Cancer Treat Rep. 1978 September; 62(9): 1379-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=688282

•

Chemotherapy with or without high-dose medroxyprogesterone acetate in oestrogenreceptor-negative advanced breast cancer. Norwegian Breast Cancer Group. Author(s): Gundersen S, Kvinnsland S, Klepp O, Lund E, Hannisdal E, Host H. Source: European Journal of Cancer (Oxford, England : 1990). 1992; 28(2-3): 390-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1534248

•

Cisplatin, adriamycin, etoposide, megestrol acetate versus melphalan, 5-fluorouracil, medroxyprogesterone acetate in the treatment of endometrial carcinoma. Author(s): Cornelison TL, Baker TR, Piver MS, Driscoll DL. Source: Gynecologic Oncology. 1995 November; 59(2): 243-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7590480

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•

Clinical and laboratory evaluation of the myeloprotective effect of medroxyprogesterone acetate in head and neck cancer. Author(s): Amadori D, Frassineti GL, Flamini E, Falcini F, Maltoni M, Nanni O, Riccobon A, Piccinini C. Source: European Journal of Cancer (Oxford, England : 1990). 1992; 28A(8-9): 1331-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1381210

•

Combination chemotherapy of germ cell tumors of the testis with vincristine, adriamycin, cyclophosphamide, actinomycin D and medroxyprogesterone acetate. Author(s): Klepp O, Klepp R, Host H, Asbjornsen G, Talle K, Stenwig AE. Source: Cancer. 1977 August; 40(2): 638-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=70266

•

Combined effect of navelbine with medroxyprogesterone acetate against human breast carcinoma MCF-7 cells in vitro. Author(s): Sugiyama K, Shimizu M, Akiyama T, Ishida H, Okabe M, Tamaoki T, Akinaga S. Source: British Journal of Cancer. 1998 June; 77(11): 1737-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9667641

•

Dexamethasone, medroxyprogesterone acetate, and vindesine modulation of human malignant melanoma growth in soft agar. Author(s): Bojar H, Fabry W. Source: Anticancer Res. 1985 March-April; 5(2): 189-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3994310

•

High-dose depot-medroxyprogesterone acetate--effects on the fatty acid composition of serum lecithin and cholesterol ester. Author(s): Enk L, Crona N, Friberg LG, Samsioe G, Silfverstolpe G. Source: Gynecologic Oncology. 1985 November; 22(3): 317-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2933308

•

High-dose medroxyprogesterone acetate in combination with vindesine in advanced breast cancer. Author(s): Falkson HC, Falkson G. Source: Eur J Cancer Clin Oncol. 1986 December; 22(12): 1511-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2954823

•

High-dose medroxyprogesterone acetate plus mitomycin-C or vindesine in the treatment of advanced breast cancer. Author(s): Falkson CI, Falkson HC, Falkson G.

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Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 1988 August; 11(4): 431-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2970218 •

Interferon alfa and vinblastine versus medroxyprogesterone acetate in the treatment of metastatic renal cell carcinoma. Author(s): Kriegmair M, Oberneder R, Hofstetter A. Source: Urology. 1995 May; 45(5): 758-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7747370

•

Mechanism of adrenal suppression by high-dose medroxyprogesterone acetate in breast cancer patients. Author(s): van Veelen H, Willemse PH, Sleijfer DT, van der Ploeg E, Sluiter WJ, Doorenbos H. Source: Cancer Chemotherapy and Pharmacology. 1985; 15(2): 167-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3160504

•

Medroxyprogesterone acetate supplementation diminishes the hypoestrogenic side effects of gonadotropin-releasing hormone agonist without changing its efficacy in endometriosis. Author(s): Makarainen L, Ronnberg L, Kauppila A. Source: Fertility and Sterility. 1996 January; 65(1): 29-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8557151

•

Mitomycin C, methotrexate, and vincristine with medroxyprogesterone acetate or prednisolone for doxorubicin resistant advanced breast cancer--a randomized control study. Author(s): Tashiro H, Nomura Y. Source: Anticancer Res. 1995 September-October; 15(5B): 2229-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8572630

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Oral versus intramuscular high-dose medroxyprogesterone acetate (HD-MPA) in advanced breast cancer. A randomized study of the Belgian Society of Medical Oncology. Author(s): Paridaens R, Becquart D, Michel J, Vanderlinden B, Longueville J, Majois F, Beauduin M, Focan C, Wildiers J, Bernheim J, et al. Source: Anticancer Res. 1986 September-October; 6(5): 1089-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2948441

•

Phase II study of vinblastine, methyl-CCNU, and medroxyprogesterone in advanced renal cell cancer. Author(s): Hahn RG, Temkin NR, Savlov ED, Perlia C, Wampler GL, Horton J, Marsh J, Carbone PP.

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Source: Cancer Treat Rep. 1978 July; 62(7): 1093-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=356971 •

Placebo-controlled comparison of hormonal and biochemical effects of danazol and high-dose medroxyprogesterone acetate. Author(s): Telimaa S, Apter D, Reinila M, Ronnberg L, Kauppila A. Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology. 1990 July-August; 36(1-2): 97-105. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2142109

•

Possible effect of medroxyprogesterone acetate (MPA) in lymphoid blast crisis of chronic myelogenous leukemia. Author(s): Fink M. Source: Annals of Hematology. 1994 February; 68(2): 89-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8148420

•

The association of depo-medroxyprogesterone acetate and breast cancer. Author(s): Greenspan AR, Hatcher RA, Moore M, Rosenberg MJ, Ory HW. Source: Contraception. 1980 June; 21(6): 563-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7428364

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The clinical effect of medroxyprogesterone (MPA) in elderly patients with lung cancer. Author(s): Niiranen A, Kajanti M, Tammilehto L, Mattson K. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 1990 April; 13(2): 113-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2156416

•

The effect of oestrogens and medroxyprogesterone acetate on the uptake of cytotoxic drugs by MCF-7 breast cancer cells. Author(s): Reed MJ, Ross MS, Ghilchik MW. Source: Anticancer Res. 1992 March-April; 12(2): 533-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1533753

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The effects of feeding an Asian or Western diet on sperm numbers, sperm quality and serum hormone levels in cynomolgus monkeys (Macaca fascicularis) injected with testosterone enanthate (TE) plus depot medroxyprogesterone acetate (DMPA). Author(s): Suhana N, Sutyarso, Moeloek N, Soeradi O, Sri Sukmaniah S, Supriatna J. Source: International Journal of Andrology. 1999 April; 22(2): 102-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10194642

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The effects of low and high dose medroxyprogesterone acetate on sex steroids and sex hormone binding globulin in postmenopausal breast cancer patients. Author(s): Dowsett M, Lal A, Smith IE, Jeffcoate SL. Source: British Journal of Cancer. 1987 March; 55(3): 311-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2952154

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/

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

The following is a specific Web list relating to medroxyprogesterone; 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 Menopause Source: Healthnotes, Inc.; www.healthnotes.com Menopause Source: Integrative Medicine Communications; www.drkoop.com Osteoporosis Source: Healthnotes, Inc.; www.healthnotes.com

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Sleep Apnea Source: Integrative Medicine Communications; www.drkoop.com •

Herbs and Supplements Estrogens (Combined) Source: Healthnotes, Inc.; www.healthnotes.com Medroxyprogesterone Source: Healthnotes, Inc.; www.healthnotes.com Prempro 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 MEDROXYPROGESTERONE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “medroxyprogesterone” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on medroxyprogesterone, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Medroxyprogesterone By performing a patent search focusing on medroxyprogesterone, 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. 8Adapted

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 medroxyprogesterone: •

Medroxyprogesterone acetate compositions Inventor(s): Lamb; Donald J. (Portage, MI) Assignee(s): The Upjohn Company (Kalamazoo, MI) Patent Number: 4,038,389 Date filed: March 29, 1976 Abstract: A pharmaceutical vehicle for parenteral administration of medroxyprogesterone acetate is disclosed comprising an aqueous solution of sodium sulfate, quaternary ammonium wetting agent, and a member selected from glycerin, propylene glycol, polyethylene glycol, and polypropylene glycol. The compositions may contain a non-ionic hydrophilic colloid as a preferred adjuvant. Compositions are useful for suspending large amounts, e.g., from 200 to 600 mg./ml. of medroxyprogesterone acetate and maintaining suitable suspendability and syringeability characteristics and are used for the known therapeutic indications for medroxyprogesterone acetate. Excerpt(s): This invention relates to a pharmaceutical vehicle and compositions utilizing said vehicle and more particularly to an aqueous vehicle suitable for suspending therein large amounts, e.g., from 200 to 600 mg./ml. of medroxyprogesterone acetate, for parenteral administration. The vehicle comprises an aqueous solution of sodium sulfate, a parenterally acceptable quaternary ammonium wetting agent, and a member selected from the group consisting of glycerin, propylene glycol, polyethylene glycol, and polypropylene glycol. Prior to the present invention, the pharmaceutical art, for lack of a suitable vehicle, has had to forego the provision of parenteral dosage forms containing high concentrations, e.g., in excess of 200 ml./ml., of medroxyprogesterone acetate. The development of a satisfactory parenteral vehicle for suspending medroxyprogesterone acetate has been a heretofore unsolved problem due to the many requirements that the vehicle and composition must satisfy. Web site: http://www.delphion.com/details?pn=US04038389__

•

Method of treating inflammatory conditions with progesterone analogs Inventor(s): Schreiber; Alan D. (Philadelphia, PA) Assignee(s): University of Pennsylvania (Philadelphia, PA) Patent Number: 6,610,674 Date filed: September 8, 2000 Abstract: The present invention provides methods for treating inflammatory conditions, including but not limited to, inflammatory bowel disease (ulcerative colitis, Crohn's disease, and proctitis), other noninfectious, inflammatory conditions of the GI tract (microscopic colitis, allergic eosinophilic gastroenteritis, food allergies, pill induced esophagitis, celiac disease, recurrent polyps, and hemorrhoids), and psoriasis, using progesterone or progesterone analogs such as medroxyprogesterone acetate. Excerpt(s): This invention provides methods for treating inflammatory conditions, including but not limited to, inflammatory bowel disease (ulcerative colitis, Crohn's disease, and proctitis), other noninfectious, inflammatory conditions of the GI tract

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(microscopic colitis, allergic eosinophilic gastroenteritis, food allergies, pill induced esophagitis, celiac disease, recurrent polyps, and hemorrhoids), and psoriasis using progesterone and progesterone analogs. Proctitis, inflammation of the rectum, is invariably present in UC and is sometimes present in CD. It may also occur independently from these diseases. Proctitis is another manifestation of IBD with pathology similar to UC. A patient presenting with proctitis may later develop fullblown UC or CD. Physicians and medical researchers have not been successful in identifying a cause for these diseases, although several theories have been postulated. The diseases may be caused by a pathogen or other antigen that initiates the inflammatory response in the bowel, accompanied by a defect in the ability to downregulate the immune response. Once initiated, many of the pathophysiological events in IBD are related to amplification of the inflammatory process. In response to antigens, cytokines and other inflammatory mediators are released. Some cytokines promote T cell activity. The inflammatory cascade continues with IL-2, helper T cells, B-cell proliferation, and antibody synthesis. Stimulated neutrophils and macrophages accumulate and further damage the tissue by releasing reactive oxygen species and other biologically active products. Additional acute inflammatory cells respond to the tissue damage, whether or not the primary initiating stimulus has ceased. Web site: http://www.delphion.com/details?pn=US06610674__

Patent Applications on Medroxyprogesterone As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to medroxyprogesterone: •

Combination preparation for contraception based on naural estrogens Inventor(s): Dittgen, Michael; (Apolda, DE), Fricke, Sabine; (Jena, DE), Hoffmann, Herbert; (Jena, DE), Moore, Claudia; (Jena, DE), Oettel, Michael; (Jena, DE), Ostertag, Monika; (Gottingen, DE) Correspondence: Striker, Striker & Stenby; 103 East Neck Road; Huntington; NY; 11743; US Patent Application Number: 20020107229 Date filed: September 12, 2001 Abstract: The combination preparation for contraception includes from 2 to 4 first stage daily dosage portions each including an effective amount of at least one natural estrogen as sole active ingredient, from 16 to 22 second stage daily dosage portions each including an effective amount of a combination of at least one natural estrogen and at least one natural or synthetic gestogen as active ingredient; from 2 to 4 third stage daily dosage portions each including an effective amount of at least one natural estrogen as sole active ingredient; and from 2 to 4 final stage daily dosage portions containing a pharmaceutically acceptable placebo. The estrogen may be estradiol, an estradiol compound that is metabolized to estradiol when taken into the body, a conjugated equine estrogen or a phytoestrogen. The natural or synthetic gestogen can be natural progesterone or a synthetic gestogens, such as medroxyprogesterone acetate.

9

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

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Excerpt(s): The present invention relates to a multistage contraceptive preparation based on natural estrogens. Oral contraceptives were first marketed 60 years ago. By continuous research it has been possible to reduce the required dosages of hormones in a stepwise manner. Currently low dosage oral contraceptives exist which chiefly comprise an estrogen component and a gestogen component. The hormone dosage of these contraceptives is delivered in different combinations and dosages in the form of combination preparations (one-stage preparation) or multistage combination preparations (staged preparations) and sequenced preparations (two-stage preparations) over time periods of from 21 to 28 days. One-stage preparations (usually designated as combination preparations) are characterized by a constant dosage of certain estrogens and gestogens each day. Because of the uniform delivery of gestogen ingredients with estrogen components from the first application day, the combination preparation is a highly reliable contraceptive. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Hormone replacement therapy Inventor(s): Pickar, James H.; (Springfield, PA) Correspondence: Egon E. Berg; American Home Products Corporation; Patent Law Department; Five Giralda Farms; Madison; NJ; 07940; US Patent Application Number: 20010034340 Date filed: March 15, 2001 Abstract: This invention relates to methods and pharmaceutical compositions for providing hormone replacement therapy in perimenopausal, menopausal, and postmenopausal women through the continuous administration of combinations of conjugated estrogens and medroxyprogesterone acetate. Excerpt(s): This application claims the benefit of U.S. Provisional Application No. 60/268,607, filed Feb. 14, 2001, and U.S. Provisional Application No. 60/190,630, filed Mar. 20, 2000. Menopause is generally defined as the last natural menstrual period and is characterized by the cessation of ovarian function, leading to the substantial diminution of circulating estrogen in the bloodstream. Menopause is usually identified, in retrospect, after 12 months of amenorrhea. It is not a sudden event, but is often preceded by a time of irregular menstrual cycles prior to eventual cessation of menses. Following the cessation of menstruation, the decline in endogenous estrogen concentrations is typically rapid. There is a decrease in serum estrogens from circulating levels ranging from 40-250 pg/mL of estradiol and 40-170 pg/mL of estrone during ovulatory cycles to less than 15 pg/mL of estradiol and 30 pg/mL of estrone in postmenopausal women. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Patents 87

•

Method of treating inflammatory conditions with progesterone or progesterone analogs Inventor(s): Schreiber, Alan D.; (Philadelphia, PA) Correspondence: Finnegan, Henderson, Farabow, Garrett & Dunner; Llp; 1300 I Street, NW; Washington; DC; 20005; US Patent Application Number: 20040038954 Date filed: June 24, 2003 Abstract: The present invention provides methods for treating inflammatory conditions, including but not limited to, inflammatory bowel disease (ulcerative colitis, Crohn's disease, and proctitis), other noninfectious, inflammatory conditions of the GI tract (microscopic colitis, allergic eosinophilic gastroenteritis, food allergies, pill induced esophagitis, celiac disease, recurrent polyps, and hemorrhoids), and psoriasis, using progesterone or progesterone analogs such as medroxyprogesterone acetate. Excerpt(s): This application claims priority to U.S. Provisional Patent Application No. 60/156,434, filed Sep. 28, 1999. This invention provides methods for treating inflammatory conditions, including but not limited to, inflammatory bowel disease (ulcerative colitis, Crohn's disease, and proctitis), other noninfectious, inflammatory conditions of the GI tract (microscopic colitis, allergic eosinophilic gastroenteritis, food allergies, pill induced esophagitis, celiac disease, recurrent polyps, and hemorrhoids), and psoriasis using progesterone and progesterone analogs. "Inflammatory bowel disease" (IBD) encompasses the idiopathic, chronic inflammatory bowel diseases ulcerative colitis (UC), Crohn's disease (CD), and proctitis. Researchers do not know the cause of these diseases, but believe that they involve genetic and immunologic influences on the gastrointestinal tract's ability to distinguish foreign from self-antigens and/or to alter the mucosal immune response. They share many overlapping epidemiological, clinical, and therapeutic features IBD affects up to 1,000,000 Americans and disease symptoms can be so severe as to prevent the patient from carrying on a normal life. The total cost of the disease, including lost productivity, in the US is two billion dollars per year. Ward et al., Clinical economics review: medical management of inflammatory bowel disease; Ailment Pharmacol Ther 13:15-25 (1999). Drug therapies that allow patients to avoid surgical intervention could reduce the cost significantly. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Stabilized aqueous suspensions for parenteral use Inventor(s): Colombo, Giuseppe; (Milan, IT), Fox, Lloyd E.; (Richlands, MI), Martini, Alessandro; (Milan, IT) Correspondence: Oblon Spivak Mcclelland Maier & Neustadt PC; Fourth Floor; 1755 Jefferson Davis Highway; Arlington; VA; 22202; US Patent Application Number: 20020115645 Date filed: May 15, 2000 Abstract: A pharmaceutical aqueous suspension formulation for parenteral administration having substantially stabilized pH, comprising a biologically active compound and a pH controlling effective concentration of L-Methionine.Preferably, the biologically active compound is a steroidal compound, for instance exemestane,

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medroxyprogesterone acetate and estradiol cypionate medroxyprogesterone acetate and estradiol cypionate.

or

a

combination

of

Excerpt(s): The present invention is in the field of galenic preparations. It concerns in particular a pharmaceutical aqueous suspension of a biologically active compound, e.g. a steroidal compound, having stabilized pH, particularly suitable for parenteral administration. The inventors of the present invention have found that the pH of a pharmaceutical aqueous suspension of a biologically active compound can be controlled by adding a pH controlling effective concentration of L-Methionine thereto. Moreover, when a pH controlling effective concentration of L-Methionine is used, it strengthens the buffering capacity of low concentrations of conventional buffering agents with a super-additive (synergistic) effect. In this way the use of conventional buffering agents can be eliminated or limited, thus improving the re-suspendability and controlled flocculation of the pharmaceutical preparation. A pharmaceutical suspension is a coarse dispersion in which insoluble solid particles are dispersed in a liquid medium. 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 medroxyprogesterone, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “medroxyprogesterone” (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 medroxyprogesterone. You can also use this procedure to view pending patent applications concerning medroxyprogesterone. 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 MEDROXYPROGESTERONE Overview This chapter provides bibliographic book references relating to medroxyprogesterone. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on medroxyprogesterone include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “medroxyprogesterone” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “medroxyprogesterone” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “medroxyprogesterone” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Proceedings of the International Symposium on Medroxyprogesterone Acetate, Geneva, Switzerland, February 24-26, 1982 (International congress series); ISBN: 9021995603; http://www.amazon.com/exec/obidos/ASIN/9021995603/icongroupinterna

•

Role of medroxyprogesterone in endocrine-related tumors (Progress in cancer research and therapy); ISBN: 0890045127; http://www.amazon.com/exec/obidos/ASIN/0890045127/icongroupinterna

•

Role of Medroxyprogesterone in Endocrine-Related Tumors (Progress in Cancer Research and Therapy, Vol. 15) by A. Pellegrini; ISBN: 0881670324; http://www.amazon.com/exec/obidos/ASIN/0881670324/icongroupinterna

•

The Role of Medroxyprogesterone in Endocrine-Related Tumors (Role of Medroxyprogesterone in Endocrine-Related Tumors) by L. Campio (Editor); ISBN:

90

Medroxyprogesterone

0890048657; http://www.amazon.com/exec/obidos/ASIN/0890048657/icongroupinterna

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

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

Depot medroxyprogesterone acetate use linked to impaired arterial function Source: Reuters Industry Breifing Date: September 02, 2002

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•

Depot medroxyprogesterone acetate use linked to reversible bone loss Source: Reuters Industry Breifing Date: August 21, 2002

•

Low rate of menopausal bone loss seen after depot medroxyprogesterone use Source: Reuters Medical News Date: June 12, 2002

•

Depot medroxyprogesterone acetate use associated with bone mineral density loss Source: Reuters Industry Breifing Date: May 12, 2004

•

Compliance High With HRT regimen of medroxyprogesterone and estrone E1 sulfate Source: Reuters Medical News Date: May 08, 1998

•

Tamoxifen-Resistant Breast Cancer: Substitute Medroxyprogesterone Acetate Source: Reuters Medical News Date: September 25, 1997

•

Depot Medroxyprogesterone Acetate Effective For Endometriosis Source: Reuters Medical News Date: September 13, 1996 The NIH

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

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Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “medroxyprogesterone” (or synonyms). If you know the name of a company that is relevant to medroxyprogesterone, 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 “medroxyprogesterone” (or synonyms).

Academic Periodicals covering Medroxyprogesterone Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to medroxyprogesterone. In addition to these sources, you can search for articles covering medroxyprogesterone 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 Institute10: •

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/

10

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.11 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:12 •

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

•

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

11

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 12 See http://www.nlm.nih.gov/databases/databases.html.

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•

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

•

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

The NLM Gateway13 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “medroxyprogesterone” (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 6633 741 76 18 15 7483

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.17 Simply search by “medroxyprogesterone” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

13

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

14

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists18 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.19 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.20 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

18 Adapted 19

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on medroxyprogesterone 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 medroxyprogesterone. 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 medroxyprogesterone. 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 “medroxyprogesterone”:

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Breast Cancer http://www.nlm.nih.gov/medlineplus/breastcancer.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 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 medroxyprogesterone. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to medroxyprogesterone. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with medroxyprogesterone. 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 medroxyprogesterone. 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 “medroxyprogesterone” (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 “medroxyprogesterone”. 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 “medroxyprogesterone” (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 “medroxyprogesterone” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.21

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

21

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)22: •

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

•

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/

22

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

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

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

•

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

•

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

•

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

•

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

•

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

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

•

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

•

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

•

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

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MEDROXYPROGESTERONE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal fat: Fat (adipose tissue) that is centrally distributed between the thorax and pelvis and that induces greater health risk. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abortion: 1. The premature expulsion from the uterus of the products of conception - of the embryo, or of a nonviable fetus. The four classic symptoms, usually present in each type of abortion, are uterine contractions, uterine haemorrhage, softening and dilatation of the cervix, and presentation or expulsion of all or part of the products of conception. 2. Premature stoppage of a natural or a pathological process. [EU] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] 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] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Acute leukemia: A rapidly progressing cancer of the blood-forming tissue (bone marrow). [NIH]

Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenosine Triphosphate: Adenosine 5'-(tetrahydrogen triphosphate). An adenine nucleotide containing three phosphate groups esterified to the sugar moiety. In addition to its crucial roles in metabolism adenosine triphosphate is a neurotransmitter. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adipose Tissue: Connective tissue composed of fat cells lodged in the meshes of areolar tissue. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids,

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androgens, and glucocorticoids. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] 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] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [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] Almitrine: A respiratory stimulant that enhances respiration by acting as an agonist of peripheral chemoreceptors located on the carotid bodies. The drug increases arterial oxygen tension while decreasing arterial carbon dioxide tension in patients with chronic obstructive pulmonary disease. It may also prove useful in the treatment of nocturnal oxygen desaturation without impairing the quality of sleep. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy,

Dictionary 117

magnet therapy, spiritual healing, and meditation. [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. 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] Aminoglutethimide: An anticancer drug that belongs to the family of drugs called nonsteroidal aromatase inhibitors. Aminoglutethimide is used to decrease the production of sex hormones (estrogen or testosterone) and suppress the growth of tumors that need sex hormones to grow. [NIH] Amplification: The production of additional copies of a chromosomal DNA sequence, found as either intrachromosomal or extrachromosomal DNA. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaplastic: A term used to describe cancer cells that divide rapidly and bear little or no resemblance to normal cells. [NIH] Androgenic: Producing masculine characteristics. [EU] Androgens: A class of sex hormones associated with the development and maintenance of the secondary male sex characteristics, sperm induction, and sexual differentiation. In addition to increasing virility and libido, they also increase nitrogen and water retention and stimulate skeletal growth. [NIH] Androstenedione: A steroid with androgenic properties that is produced in the testis, ovary, and adrenal cortex. It is a precursor to testosterone and other androgenic hormones. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Angiogenesis: Blood vessel formation. Tumor angiogenesis is the growth of blood vessels from surrounding tissue to a solid tumor. This is caused by the release of chemicals by the tumor. [NIH] Angiogram: An x-ray of blood vessels; the person receives an injection of dye to outline the vessels on the x-ray. [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] Anisotropy: A physical property showing different values in relation to the direction in or along which the measurement is made. The physical property may be with regard to thermal or electric conductivity or light refraction. In crystallography, it describes crystals whose index of refraction varies with the direction of the incident light. It is also called acolotropy and colotropy. The opposite of anisotropy is isotropy wherein the same values characterize the object when measured along axes in all directions. [NIH]

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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] Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Anthracycline: A member of a family of anticancer drugs that are also antibiotics. [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Antiepileptic: An agent that combats epilepsy. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes

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associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Aromatase: An enzyme which converts androgens to estrogens by desaturating ring A of the steroid. This enzyme complex is located in the endoplasmic reticulum of estrogenproducing cells including ovaries, placenta, testicular Sertoli and Leydig cells, adipose, and brain tissues. The enzyme complex has two components, one of which is the CYP19 gene product, the aromatase cytochrome P-450. The other component is NADPH-cytochrome P450 reductase which transfers reducing equivalents to P-450(arom). EC 1.14.13.-. [NIH] 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] Artery: Vessel-carrying blood from the heart to various parts of the body. [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] 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] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU]

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Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biomarkers: Substances sometimes found in an increased amount in the blood, other body fluids, or tissues and that may suggest the presence of some types of cancer. Biomarkers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and GI tract cancers), and PSA (prostate cancer). Also called tumor markers. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Blast Crisis: Rapid increase in the proportion of blast cells in the blood and bone marrow. [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 Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Density: The amount of mineral per square centimeter of bone. This is the definition used in clinical practice. Actual bone density would be expressed in grams per milliliter. It is most frequently measured by photon absorptiometry or x-ray computed tomography. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH]

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Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [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] 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] Breast Feeding: The nursing of an infant at the mother's breast. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Cachexia: General ill health, malnutrition, and weight loss, usually associated with chronic disease. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] 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]

Carcinosarcoma: A malignant tumor that is a mixture of carcinoma (cancer of epithelial tissue, which is skin and tissue that lines or covers the internal organs) and sarcoma (cancer of connective tissue, such as bone, cartilage, and fat). [NIH] Cardiac: Having to do with the heart. [NIH] Cardiac catheterization: A procedure in which a thin, hollow tube is inserted into a blood vessel. The tube is then advanced through the vessel into the heart, enabling a physician to study the heart and its pumping activity. [NIH]

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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] Carotid Arteries: Either of the two principal arteries on both sides of the neck that supply blood to the head and neck; each divides into two branches, the internal carotid artery and the external carotid artery. [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] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Celecoxib: A drug that reduces pain. Celecoxib belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is being studied for cancer prevention. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Adhesion: Adherence of cells to surfaces or to other cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called

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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] Chemokines: Class of pro-inflammatory cytokines that have the ability to attract and activate leukocytes. They can be divided into at least three structural branches: C (chemokines, C), CC (chemokines, CC), and CXC (chemokines, CXC), according to variations in a shared cysteine motif. [NIH] Chemoreceptors: Cells specialized to detect chemical substances and relay that information centrally in the nervous system. Chemoreceptors may monitor external stimuli, as in taste and olfaction, or internal stimuli, such as the concentrations of oxygen and carbon dioxide in the blood. [NIH] Chemotherapeutic agent: A drug used to treat cancer. [NIH] Chemotherapy: Treatment with anticancer drugs. [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] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Chronic granulocytic leukemia: A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myelogenous leukemia or chronic myeloid leukemia. [NIH] Chronic myelogenous leukemia: CML. A slowly progressing disease in which too many white blood cells are made in the bone marrow. Also called chronic myeloid leukemia or chronic granulocytic leukemia. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis,

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it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clear cell carcinoma: A rare type of tumor of the female genital tract in which the inside of the cells looks clear when viewed under a microscope. [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 diminution of sexual activity in the male. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] 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] Combination chemotherapy: Treatment using more than one anticancer drug. [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,

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IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] 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] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Computerized tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized axial tomography (CAT) scan and computed tomography (CT scan). [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of

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separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] Contraceptive Agents: Chemical substances that prevent or reduce the probability of conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [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 Arteriosclerosis: Thickening and loss of elasticity of the coronary arteries. [NIH] 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]

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Corticosteroid: Any of the steroids elaborated by the adrenal cortex (excluding the sex hormones of adrenal origin) in response to the release of corticotrophin (adrenocorticotropic hormone) by the pituitary gland, to any of the synthetic equivalents of these steroids, or to angiotensin II. They are divided, according to their predominant biological activity, into three major groups: glucocorticoids, chiefly influencing carbohydrate, fat, and protein metabolism; mineralocorticoids, affecting the regulation of electrolyte and water balance; and C19 androgens. Some corticosteroids exhibit both types of activity in varying degrees, and others exert only one type of effect. The corticosteroids are used clinically for hormonal replacement therapy, for suppression of ACTH secretion by the anterior pituitary, as antineoplastic, antiallergic, and anti-inflammatory agents, and to suppress the immune response. Called also adrenocortical hormone and corticoid. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Culture Media: Any liquid or solid preparation made specifically for the growth, storage, or transport of microorganisms or other types of cells. The variety of media that exist allow for the culturing of specific microorganisms and cell types, such as differential media, selective media, test media, and defined media. Solid media consist of liquid media that have been solidified with an agent such as agar or gelatin. [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] Cyclin: Molecule that regulates the cell cycle. [NIH] 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] Cyproterone: An anti-androgen that, in the form of its acetate, also has progestational properties. It is used in the treatment of hypersexuality in males, as a palliative in prostatic carcinoma, and, in combination with estrogen, for the therapy of severe acne and hirsutism in females. [NIH] Cyproterone Acetate: An agent with anti-androgen and progestational properties. It shows competitive binding with dihydrotestosterone at androgen receptor sites. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it

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(phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Danazol: A synthetic steroid with antigonadotropic and anti-estrogenic activities that acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins. It possesses some androgenic properties. Danazol has been used in the treatment of endometriosis and some benign breast disorders. [NIH] Daunorubicin: Very toxic anthracycline aminoglycoside antibiotic isolated from Streptomyces peucetius and others, used in treatment of leukemias and other neoplasms. [NIH]

Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Desogestrel: A synthetic progestational hormone used often as the progestogenic component of combined oral contraceptive agents. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Diethylstilbestrol: DES. A synthetic hormone that was prescribed from the early 1940s until 1971 to help women with complications of pregnancy. DES has been linked to an increased risk of clear cell carcinoma of the vagina in daughters of women who used DES. DES may also increase the risk of breast cancer in women who used DES. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] 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

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of subsidiary means. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] 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] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Doxorubicin: Antineoplastic antibiotic obtained from Streptomyces peucetics. It is a hydroxy derivative of daunorubicin and is used in treatment of both leukemia and solid tumors. [NIH] Dydrogesterone: A synthetic progestational hormone with no androgenic or estrogenic properties. Unlike many other progestational compounds, dydrogesterone produces no increase in temperature and does not inhibit ovulation. [NIH] Dyspareunia: Painful sexual intercourse. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Ejaculation: The release of semen through the penis during orgasm. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] 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] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Emulsions: Colloids of two immiscible liquids where either phase may be either fatty or aqueous; lipid-in-water emulsions are usually liquid, like milk or lotion and water-in-lipid emulsions tend to be creams. [NIH] Enanthate: An oily injectable contraceptive given every 8 weeks. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous)

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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] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] Endothelium-derived: Small molecule that diffuses to the adjacent muscle layer and relaxes it. [NIH] 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] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [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] Eosinophilic: A condition found primarily in grinding workers caused by a reaction of the pulmonary tissue, in particular the eosinophilic cells, to dust that has entered the lung. [NIH] Eosinophilic Gastroenteritis: Infection and swelling of the lining of the stomach, small intestine, or large intestine. The infection is caused by white blood cells (eosinophils). [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epirubicin: An anthracycline antibiotic which is the 4'-epi-isomer of doxorubicin. The compound exerts its antitumor effects by interference with the synthesis and function of DNA. Clinical studies indicate activity in breast cancer, non-Hodgkin's lymphomas, ovarian cancer, soft-tissue sarcomas, pancreatic cancer, gastric cancer, small-cell lung cancer and acute leukemia. It is equal in activity to doxorubicin but exhibits less acute toxicities and less cardiotoxicity. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals,

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or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estramustine: A nitrogen mustard linked to estradiol, usually as phosphate; used to treat prostatic neoplasms; also has radiation protective properties. [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] Ethinyl Estradiol: A semisynthetic estrogen with high oral estrogenic potency. It is often used as the estrogenic component in oral contraceptives. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Exemestane: An anticancer drug used to decrease estrogen production and suppress the growth of estrogen-dependent tumors. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extensor: A muscle whose contraction tends to straighten a limb; the antagonist of a flexor. [NIH]

Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extracellular Matrix Proteins: Macromolecular organic compounds that contain carbon, hydrogen, oxygen, nitrogen, and usually, sulfur. These macromolecules (proteins) form an

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intricate meshwork in which cells are embedded to construct tissues. Variations in the relative types of macromolecules and their organization determine the type of extracellular matrix, each adapted to the functional requirements of the tissue. The two main classes of macromolecules that form the extracellular matrix are: glycosaminoglycans, usually linked to proteins (proteoglycans), and fibrous proteins (e.g., collagen, elastin, fibronectins and laminin). [NIH] F Factor: A plasmid whose presence in the cell, either extrachromosomal or integrated into the bacterial chromosome, determines the "sex" of the bacterium, host chromosome mobilization, transfer via conjugation of genetic material, and the formation of sex pili. [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] Femoral: Pertaining to the femur, or to the thigh. [EU] 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] Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to water-electrolyte balance. Fluids may be administered intravenously, orally, by intermittent gavage, or by hypodermoclysis. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorescence Polarization: Measurement of the polarization of fluorescent light from solutions or microscopic specimens. It is used to provide information concerning molecular size, shape, and conformation, molecular anisotropy, electronic energy transfer, molecular interaction, including dye and coenzyme binding, and the antigen-antibody reaction. [NIH] Fluorouracil: A pyrimidine analog that acts as an antineoplastic antimetabolite and also has immunosuppressant. It interferes with DNA synthesis by blocking the thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH]

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Functional magnetic resonance imaging: A noninvasive tool used to observe functioning in the brain or other organs by detecting changes in chemical composition, blood flow, or both. [NIH]

Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma Rays: Very powerful and penetrating, high-energy electromagnetic radiation of shorter wavelength than that of x-rays. They are emitted by a decaying nucleus, usually between 0.01 and 10 MeV. They are also called nuclear x-rays. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] 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] Germ Cells: The reproductive cells in multicellular organisms. [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] Glioma: A cancer of the brain that comes from glial, or supportive, cells. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic

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character. [EU] 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 multicellular animals. [NIH] Gonadal: Pertaining to a gonad. [EU] Gonadorelin: A decapeptide hormone released by the hypothalamus. It stimulates the synthesis and secretion of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Goserelin: 6-(O-(1,1-Dimethylethyl)-D-serine)-10-deglycinamideluteinizing hormonereleasing factor (pig) 2-(aminocarbonyl)hydrazide. A long-acting gonadorelin agonist. It is used in the treatment of malignant neoplasms of the prostate, uterine fibromas, and metastatic breast cancer. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Grafting: The operation of transfer of tissue from one site to another. [NIH] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [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] Haemorrhage: The escape of blood from the vessels; bleeding. Small haemorrhages are classified according to size as petechiae (very small), purpura (up to 1 cm), and ecchymoses (larger). The massive accumulation of blood within a tissue is called a haematoma. [EU] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Hematologic malignancies: Cancers of the blood or bone marrow, including leukemia and lymphoma. Also called hematologic cancers. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH]

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Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

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] High-density lipoproteins: Lipoproteins that contain a small amount of cholesterol and carry cholesterol away from body cells and tissues to the liver for excretion from the body. Low-level HDL increases the risk of heart disease, so the higher the HDL level, the better. The HDL component normally contains 20 to 30 percent of total cholesterol, and HDL levels are inversely correlated with coronary heart disease risk. [NIH] Hirsutism: Excess hair in females and children with an adult male pattern of distribution. The concept does not include hypertrichosis, which is localized or generalized excess hair. [NIH]

Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Homodimer: Protein-binding "activation domains" always combine with identical proteins. [NIH]

Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormonal therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called hormone therapy or endocrine therapy. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency. [NIH] Hormone therapy: Treatment of cancer by removing, blocking, or adding hormones. Also called endocrine therapy. [NIH] Human growth hormone: A protein hormone, secreted by the anterior lobe of the pituitary, which promotes growth of the whole body by stimulating protein synthesis. The human gene has already been cloned and successfully expressed in bacteria. [NIH] Human papillomavirus: HPV. A virus that causes abnormal tissue growth (warts) and is often associated with some types of cancer. [NIH] 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] 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

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isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hydroxyurea: An antineoplastic agent that inhibits DNA synthesis through the inhibition of ribonucleoside diphosphate reductase. [NIH] Hyperglycemia: Abnormally high blood sugar. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [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] Hysterectomy: Excision of the uterus. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileum: The lower end of the small intestine. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunochemistry: Field of chemistry that pertains to immunological phenomena and the study of chemical reactions related to antigen stimulation of tissues. It includes physicochemical interactions between antigens and antibodies. [NIH] Immunodiffusion: Technique involving the diffusion of antigen or antibody through a semisolid medium, usually agar or agarose gel, with the result being a precipitin reaction. [NIH]

Immunoelectrophoresis: A technique that combines protein electrophoresis and double

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immunodiffusion. In this procedure proteins are first separated by gel electrophoresis (usually agarose), then made visible by immunodiffusion of specific antibodies. A distinct elliptical precipitin arc results for each protein detectable by the antisera. [NIH] Immunoglobulin: A protein that acts as an antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

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

Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inoperable: Not suitable to be operated upon. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] 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

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a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] 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] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraperitoneal: IP. Within the peritoneal cavity (the area that contains the abdominal organs). [NIH] Intravascular: Within a vessel or vessels. [EU] Intravenous: IV. Into a vein. [NIH] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

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] 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] Lactation: The period of the secretion of milk. [EU]

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Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leuprolide: A potent and long acting analog of naturally occurring gonadotropin-releasing hormone (gonadorelin). Its action is similar to gonadorelin, which regulates the synthesis and release of pituitary gonadotropins. [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Levonorgestrel: A progestational hormone with actions similar to those of progesterone and about twice as potent as its racemic or (+-)-isomer (norgestrel). It is used for contraception, control of menstrual disorders, and treatment of endometriosis. [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [NIH] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] 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]

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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] Liver metastases: Cancer that has spread from the original (primary) tumor to the liver. [NIH]

Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Lomustine: An alkylating agent of value against both hematologic malignancies and solid tumors. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lung metastases: Cancer that has spread from the original (primary) tumor to the lung. [NIH]

Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH]

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Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammary: Pertaining to the mamma, or breast. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Matrix metalloproteinase: A member of a group of enzymes that can break down proteins, such as collagen, that are normally found in the spaces between cells in tissues (i.e., extracellular matrix proteins). Because these enzymes need zinc or calcium atoms to work properly, they are called metalloproteinases. Matrix metalloproteinases are involved in wound healing, angiogenesis, and tumor cell metastasis. [NIH] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical castration: Refers to the use of drugs to suppress the function of the ovaries or testicles. [NIH] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medrogestone: 6,17-Dimethylpregna-4,6-diene-3,20-dione. A synthetic progestational hormone with actions similar to those of progesterone. It is used in the treatment of menstrual irregularities and has also been employed in the treatment of prostatic hypertrophy and endometrial carcinoma. [NIH] Medroxyprogesterone Acetate: An injectable contraceptive, generally marketed under the name Depo-Provera. [NIH] Megestrol: 17-Hydroxy-6-methylpregna-3,6-diene-3,20-dione. A progestational hormone used most commonly as the acetate ester. As the acetate, it is more potent than progesterone both as a progestagen and as an ovulation inhibitor. It has also been used in the palliative treatment of breast cancer. [NIH] Megestrol Acetate: A drug that belongs to the group of hormones called progestins, used as hormone therapy to block estrogen and to suppress the effects of estrogen and androgens.

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[NIH]

Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Melanoma: A form of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole. [NIH] Melphalan: An alkylating nitrogen mustard that is used as an antineoplastic in the form of the levo isomer - melphalan, the racemic mixture - merphalan, and the dextro isomer medphalan; toxic to bone marrow, but little vesicant action; potential carcinogen. [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] Menarche: The establishment or beginning of the menstrual function. [EU] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningioma: A type of tumor that occurs in the meninges, the membranes that cover and protect the brain and spinal cord. Meningiomas usually grow slowly. [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 Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] 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] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Methyltestosterone: A synthetic hormone used for androgen replacement therapy and as an hormonal antineoplastic agent. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH]

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Midaxillary line: An imaginary vertical line that passes midway between the anterior and posterior axillary (armpit) folds. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [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] Millimeter: A measure of length. A millimeter is approximately 26-times smaller than an inch. [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] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] 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] Monocyte: A type of white blood cell. [NIH] Monotherapy: A therapy which uses only one drug. [EU] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Mutagenic: Inducing genetic mutation. [EU] Myelogenous: Produced by, or originating in, the bone marrow. [NIH] Myelosuppression: A condition in which bone marrow activity is decreased, resulting in fewer red blood cells, white blood cells, and platelets. Myelosuppression is a side effect of some cancer treatments. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the

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blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (coronary arteriosclerosis), to obstruction by a thrombus (coronary thrombosis), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (myocardial infarction). [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] 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] Neoplasia: Abnormal and uncontrolled cell growth. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]

Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] 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]

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Neutrophil: A type of white blood cell. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells. It is synthesized from arginine by a complex reaction, catalyzed by nitric oxide synthase. Nitric oxide is endothelium-derived relaxing factor. It is released by the vascular endothelium and mediates the relaxation induced by some vasodilators such as acetylcholine and bradykinin. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic guanylate cyclase and thus elevates intracellular levels of cyclic GMP. [NIH]

Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Non-small cell lung cancer: A group of lung cancers that includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. [NIH] Norgestrel: (+-)-13-Ethyl-17-hydroxy-18,19-dinorpregn-4-en-20-yn-3-one. A progestational agent with actions similar to those of progesterone. This racemic or (+-)-form has about half the potency of the levo form (levonorgestrel). Norgestrel is used as a contraceptive and ovulation inhibitor and for the control of menstrual disorders and endometriosis. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Oestradiol: Growth hormone. [NIH] Oestrogen: A generic term for oestrus-producing steroid compounds; the female sex hormones. In humans, oestrogen is formed in the ovary, possibly the adrenal cortex, the testis, and the foetoplacental unit; it has various functions in both sexes. It is responsible for the development of the female secondary sex characteristics, and during the menstrual cycle it acts on the female genitalia to produce an environment suitable for the fertilization, implantation, and nutrition of the early embryo. Oestrogen is used in oral contraceptives and as a palliative in cancer of the breast after menopause and cancer of the prostate; other uses include the relief of the discomforts of menopause, inhibition of lactation, and treatment of osteoporosis, threatened abortion, and various functional ovarian disorders. [EU]

Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oligomenorrhea: Abnormally infrequent menstruation. [NIH] Oncology: The study of cancer. [NIH] Oophorectomy: Surgery to remove one or both ovaries. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH]

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Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Oral Manifestations: Disorders of the mouth attendant upon non-oral disease or injury. [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] Ovariectomy: The surgical removal of one or both ovaries. [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] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [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] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic cancer: Cancer of the pancreas, a salivary gland of the abdomen. [NIH] Papillomavirus: A genus of Papovaviridae causing proliferation of the epithelium, which may lead to malignancy. A wide range of animals are infected including humans, chimpanzees, cattle, rabbits, dogs, and horses. [NIH] Paradoxical: Occurring at variance with the normal rule. [EU] Parathyroid: 1. Situated beside the thyroid gland. 2. One of the parathyroid glands. 3. A sterile preparation of the water-soluble principle(s) of the parathyroid glands, ad-ministered parenterally as an antihypocalcaemic, especially in the treatment of acute hypoparathyroidism with tetany. [EU] Parathyroid Glands: Two small paired endocrine glands in the region of the thyroid gland. They secrete parathyroid hormone and are concerned with the metabolism of calcium and phosphorus. [NIH] Parathyroid hormone: A substance made by the parathyroid gland that helps the body store

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and use calcium. Also called parathormone, parathyrin, or PTH. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Particle: A tiny mass of material. [EU] Parturition: The act or process of given birth to a child. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH] Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial. [NIH] Pelvic: Pertaining to the pelvis. [EU] Pelvic inflammatory disease: A bacteriological disease sometimes associated with intrauterine device (IUD) usage. [NIH] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perimenopausal: The time of a woman's life when menstrual periods become irregular. Refers to the time near menopause. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] PH: The symbol relating the hydrogen ion (H+) concentration or activity of a solution to that of a given standard solution. Numerically the pH is approximately equal to the negative logarithm of H+ concentration expressed in molarity. pH 7 is neutral; above it alkalinity increases and below it acidity increases. [EU] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of

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mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Physicochemical: Pertaining to physics and chemistry. [EU] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] 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] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [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] Plasmid: An autonomously replicating, extra-chromosomal DNA molecule found in many

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bacteria. Plasmids are widely used as carriers of cloned genes. [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] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Pneumonia: Inflammation of the lungs. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polycystic Ovary Syndrome: Clinical symptom complex characterized by oligomenorrhea or amenorrhea, anovulation, and regularly associated with bilateral polycystic ovaries. [NIH] 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] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of

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the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [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] Precipitation: The act or process of precipitating. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] 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] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Prenatal Care: Care provided the pregnant woman in order to prevent complications, and decrease the incidence of maternal and prenatal mortality. [NIH] Preoperative: Preceding an operation. [EU] Primary endpoint: The main result that is measured at the end of a study to see if a given treatment worked (e.g., the number of deaths or the difference in survival between the treatment group and the control group). What the primary endpoint will be is decided before the study begins. [NIH] Primary Prevention: Prevention of disease or mental disorders in susceptible individuals or populations through promotion of health, including mental health, and specific protection, as in immunization, as distinguished from the prevention of complications or after-effects of existing disease. [NIH] Proctitis: Inflammation of the rectum. [EU] 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] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH]

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Propylene Glycol: A clear, colorless, viscous organic solvent and diluent used in pharmaceutical preparations. [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] Prostatic Neoplasms: Tumors or cancer of the prostate. [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 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]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Psoriasis: A common genetically determined, chronic, inflammatory skin disease characterized by rounded erythematous, dry, scaling patches. The lesions have a predilection for nails, scalp, genitalia, extensor surfaces, and the lumbosacral region. Accelerated epidermopoiesis is considered to be the fundamental pathologic feature in psoriasis. [NIH] 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] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing.

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[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] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] 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] 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] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reactive Oxygen Species: Reactive intermediate oxygen species including both radicals and non-radicals. These substances are constantly formed in the human body and have been shown to kill bacteria and inactivate proteins, and have been implicated in a number of

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diseases. Scientific data exist that link the reactive oxygen species produced by inflammatory phagocytes to cancer development. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] 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] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see linear models) the relationship is constrained to be a straight line and least-squares analysis is used to determine the best fit. In logistic regression (see logistic models) the dependent variable is qualitative rather than continuously variable and likelihood functions are used to find the best relationship. In multiple regression the dependent variable is considered to depend on more than a single independent variable. [NIH]

Renal cell cancer: Cancer that develops in the lining of the renal tubules, which filter the blood and produce urine. [NIH] Renal cell carcinoma: A type of kidney cancer. [NIH] Reproductive History: An important aggregate factor in epidemiological studies of women's health. The concept usually includes the number and timing of pregnancies and their outcomes, the incidence of breast feeding, and may include age of menarche and menopause, regularity of menstruation, fertility, gynecological or obstetric problems, or contraceptive usage. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Ribonucleoside Diphosphate Reductase: An enzyme of the oxidoreductase class that catalyzes the formation of 2'-deoxyribonucleotides from the corresponding ribonucleotides using NADPH as the ultimate electron donor. The deoxyribonucleoside diphosphates are used in DNA synthesis. (From Dorland, 27th ed) EC 1.17.4.1. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saphenous: Applied to certain structures in the leg, e. g. nerve vein. [NIH]

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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] Screening: Checking for disease when there are no symptoms. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Selective estrogen receptor modulator: SERM. A drug that acts like estrogen on some tissues, but blocks the effect of estrogen on other tissues. Tamoxifen and raloxifene are SERMs. [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] 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] 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

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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] 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] Sister Chromatid Exchange: An exchange of segments between the sister chromatids of a chromosome, either between the sister chromatids of a meiotic tetrad or between the sister chromatids of a duplicated somatic chromosome. Its frequency is increased by ultraviolet and ionizing radiation and other mutagenic agents and is particularly high in Bloom syndrome. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small cell lung cancer: A type of lung cancer in which the cells appear small and round when viewed under the microscope. Also called oat cell lung cancer. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Problems: Situations affecting a significant number of people, that are believed to be sources of difficulty or threaten the stability of the community, and that require programs of amelioration. [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] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH]

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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] Spermatozoa: Mature male germ cells that develop in the seminiferous tubules of the testes. Each consists of a head, a body, and a tail that provides propulsion. The head consists mainly of chromatin. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Spotting: A slight discharge of blood via the vagina, especially as a side-effect of oral contraceptives. [EU] Squamous: Scaly, or platelike. [EU] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Squamous cell carcinoma: Cancer that begins in squamous cells, which are thin, flat cells resembling fish scales. Squamous cells are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the passages of the respiratory and digestive tracts. Also called epidermoid carcinoma. [NIH] Stable disease: Cancer that is neither decreasing nor increasing in extent or severity. [NIH] Sterile: Unable to produce children. [NIH] Sterility: 1. The inability to produce offspring, i.e., the inability to conceive (female s.) or to induce conception (male s.). 2. The state of being aseptic, or free from microorganisms. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU]

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Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Sudden cardiac death: Cardiac arrest caused by an irregular heartbeat. [NIH] 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] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Tamoxifen: A first generation selective estrogen receptor modulator (SERM). It acts as an agonist for bone tissue and cholesterol metabolism but is an estrogen antagonist in mammary and uterine. [NIH] 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] 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] Tetany: 1. Hyperexcitability of nerves and muscles due to decrease in concentration of extracellular ionized calcium, which may be associated with such conditions as parathyroid hypofunction, vitamin D deficiency, and alkalosis or result from ingestion of alkaline salts; it is characterized by carpopedal spasm, muscular twitching and cramps, laryngospasm with inspiratory stridor, hyperreflexia and choreiform movements. 2. Tetanus. [EU] Thigh: A leg; in anatomy, any elongated process or part of a structure more or less comparable to a leg. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] 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]

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Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] 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] 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] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcutaneous: Transdermal. [EU] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transforming Growth Factor beta: A factor synthesized in a wide variety of tissues. It acts synergistically with TGF-alpha in inducing phenotypic transformation and can also act as a negative autocrine growth factor. TGF-beta has a potential role in embryonal development, cellular differentiation, hormone secretion, and immune function. TGF-beta is found mostly as homodimer forms of separate gene products TGF-beta1, TGF-beta2 or TGF-beta3. Heterodimers composed of TGF-beta1 and 2 (TGF-beta1.2) or of TGF-beta2 and 3 (TGFbeta2.3) have been isolated. The TGF-beta proteins are synthesized as precursor proteins. [NIH]

Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH]

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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] Tryptophan Hydroxylase: An enzyme that catalyzes the hydroxylation of tryptophan to 5hydroxytryptophan in the presence of NADPH and molecular oxygen. It is important in the biosynthesis of serotonin. EC 1.14.16.4 [NIH] Tumor marker: A substance sometimes found in an increased amount in the blood, other body fluids, or tissues and which may mean that a certain type of cancer is in the body. Examples of tumor markers include CA 125 (ovarian cancer), CA 15-3 (breast cancer), CEA (ovarian, lung, breast, pancreas, and gastrointestinal tract cancers), and PSA (prostate cancer). Also called biomarker. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] 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]

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] Urokinase: A drug that dissolves blood clots or prevents them from forming. [NIH] Uterine Contraction: Contraction of the uterine muscle. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [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] Vascular endothelial growth factor: VEGF. A substance made by cells that stimulates new blood vessel formation. [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] Vasodilators: Any nerve or agent which induces dilatation of the blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU]

160

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Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. It is a mitotic inhibitor. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Vindesine: Vinblastine derivative with antineoplastic activity against acute leukemia, lung cancer, carcinoma of the breast, squamous cell carcinoma of the esophagus, head, and neck, and Hodgkin's and non-Hodgkin's lymphomas. Major side effects are myelosuppression and neurotoxicity. Vindesine is used extensively in chemotherapy protocols. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] 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] Waist circumference: To define the level at which the waist circumference is measured, a bony landmark is first located and marked. The subject stands, and the technician, positioned to the right of the subject, palpates the upper hip bone to locate the right ileum. Just above the uppermost lateral border of the right ileum, a horizontal mark is drawn and then crossed with a vertical mark on the midaxillary line. The measuring tape is then placed around the trunk, at the level of the mark on the right side, making sure that it is on a level horizontal plane on all sides. The tape is then tightened slightly without compressing the skin and underlying subcutaneous tissues. The measure is recorded in centimeters to the nearest millimeter. [NIH] Warts: Benign epidermal proliferations or tumors; some are viral in origin. [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

Dictionary 161

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] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]

163

INDEX A Abdomen, 115, 121, 138, 140, 146, 147, 156, 157 Abdominal, 3, 15, 115, 138, 146, 147, 159 Abdominal fat, 3, 115 Abdominal Pain, 115, 159 Abortion, 60, 115, 145 Acceptor, 115, 139, 146 Acetylcholine, 13, 115, 123, 144, 145 Acidity, 115, 147 Acne, 115, 127 Acute leukemia, 115, 130, 160 Adenine, 115 Adenocarcinoma, 37, 43, 52, 69, 70, 76, 115, 145 Adenosine, 63, 115, 148 Adenosine Triphosphate, 63, 115, 148 Adipocytes, 115, 139 Adipose Tissue, 115 Adjuvant, 11, 22, 25, 84, 115 Adrenal Cortex, 115, 117, 127, 131, 145, 150 Adverse Effect, 5, 9, 11, 12, 15, 17, 54, 116, 155 Afferent, 116, 139 Affinity, 116, 139, 155 Agar, 77, 116, 127, 136, 148 Age Groups, 10, 59, 116 Age of Onset, 116, 159 Aged, 80 and Over, 116 Agonist, 12, 26, 36, 41, 78, 116, 134, 152, 157 Airway, 53, 116 Algorithms, 116, 120 Alimentary, 116, 147 Alkaline, 116, 121, 157 Almitrine, 26, 116 Alopecia, 116, 127 Alpha Particles, 116, 152 Alternative medicine, 92, 116 Amenorrhea, 18, 28, 39, 86, 117, 149 Amino acid, 117, 118, 119, 127, 135, 144, 147, 149, 151, 154, 157, 159 Aminoglutethimide, 56, 62, 117 Amplification, 85, 117 Anal, 10, 117, 140 Analog, 117, 132, 139 Anaplastic, 51, 117

Androgenic, 117, 128, 129 Androgens, 116, 117, 119, 127, 141 Androstenedione, 65, 117 Anesthesia, 116, 117 Aneurysm, 117, 159 Angiogenesis, 47, 117, 141 Angiogram, 16, 117 Animal model, 11, 15, 117 Anisotropy, 117, 132 Anorexia, 32, 118 Anovulation, 118, 149 Anthracycline, 75, 118, 128, 130 Antibiotic, 11, 118, 128, 129, 130 Antibodies, 118, 135, 136, 137, 140, 152 Antibody, 44, 85, 116, 118, 124, 132, 136, 137, 141, 143, 152 Anticholinergic, 13, 118 Antiepileptic, 15, 118 Antigen, 85, 116, 118, 124, 132, 136, 137, 141 Anti-inflammatory, 14, 118, 122, 127, 133 Anti-Inflammatory Agents, 118, 122, 127 Antimetabolite, 118, 132, 142 Antineoplastic, 118, 127, 129, 132, 136, 142, 149, 160 Antioxidant, 45, 60, 118 Antiviral, 118, 138 Anus, 117, 118, 124 Apolipoproteins, 118, 139 Apoptosis, 26, 40, 52, 67, 118 Aqueous, 84, 87, 88, 119, 127, 129, 136 Arginine, 119, 145 Aromatase, 117, 119 Arterial, 3, 14, 26, 37, 49, 50, 91, 116, 119, 123, 136, 151 Arteries, 14, 119, 120, 121, 122, 126, 140, 142, 144 Arterioles, 119, 120, 144 Artery, 16, 60, 117, 119, 122, 126, 152 Atrophy, 64, 119 Attenuated, 20, 119, 159 Autonomic, 53, 115, 119 Axillary, 119, 121, 143 Axillary Artery, 119, 121 Axonal, 15, 119 B Bacteria, 118, 119, 125, 130, 135, 142, 149, 152, 159

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Bacteriophage, 119, 148 Bacterium, 119, 125, 132 Basophils, 119, 134, 139 Benign, 119, 128, 133, 144, 152, 160 Bilateral, 119, 149 Bile, 119, 133, 140, 156 Bioavailability, 43, 45, 119 Biochemical, 7, 79, 118, 120, 154 Biomarkers, 12, 14, 120 Biopsy, 18, 120 Biosynthesis, 120, 154, 159 Biotechnology, 22, 23, 92, 99, 120 Bladder, 120, 125, 151, 159 Blast Crisis, 79, 120 Blood Coagulation, 120, 121 Blood Glucose, 120, 134, 138 Blood Platelets, 120, 154 Blood pressure, 3, 8, 36, 120, 122, 136, 143, 155 Blood vessel, 117, 120, 121, 122, 130, 138, 155, 156, 157, 159 Blot, 19, 120 Body Composition, 10, 15, 120 Body Fluids, 120, 121, 132, 145, 155, 159 Body Mass Index, 17, 120, 146 Bone Density, 7, 9, 10, 21, 38, 41, 42, 63, 65, 120 Bone Marrow, 115, 120, 123, 134, 136, 140, 142, 143, 155 Bone Resorption, 42, 121 Bone scan, 12, 121 Bowel, 22, 85, 87, 117, 121, 137, 138, 139, 159 Brachial, 8, 121 Brachial Artery, 8, 121 Bradykinin, 121, 145, 148 Breast Feeding, 121, 153 Bronchitis, 121, 123 Bypass, 16, 121 C Cachexia, 32, 51, 121 Calcium, 9, 10, 36, 75, 121, 124, 141, 146, 147, 151, 157 Capsules, 121, 129 Carbohydrate, 38, 121, 127, 149 Carbon Dioxide, 116, 121, 123, 133, 148, 153 Carcinogen, 121, 131, 142 Carcinogenic, 121, 137, 156 Carcinoma, 20, 30, 35, 43, 52, 57, 60, 62, 65, 68, 69, 72, 76, 77, 121, 127, 141, 145, 156, 160

Carcinosarcoma, 68, 121 Cardiac, 8, 16, 53, 121, 126, 131, 144, 156, 157 Cardiac catheterization, 8, 121 Cardiovascular, 4, 14, 49, 50, 62, 122, 140, 154 Cardiovascular disease, 14, 122, 140 Carotid Arteries, 14, 122 Case report, 33, 58, 68, 122, 124 Case series, 122, 124 Castration, 122 Catheterization, 122 Caudal, 122, 128, 136, 150 Cause of Death, 16, 122 Celecoxib, 37, 122 Celiac Disease, 84, 85, 87, 122 Cell Adhesion, 61, 122 Cell Cycle, 122, 124, 127, 131 Cell Death, 118, 122, 131, 144 Cell Division, 119, 122, 131, 143, 148 Cell proliferation, 85, 122 Central Nervous System, 115, 122, 133, 154 Cerebral, 15, 52, 65, 122, 123, 131 Cerebrovascular, 122 Cerebrum, 122 Cervical, 7, 13, 33, 123 Cervix, 115, 123 Chemokines, 14, 123 Chemoreceptors, 116, 123 Chemotherapeutic agent, 54, 123 Chemotherapy, 45, 48, 51, 59, 60, 65, 67, 75, 76, 78, 123, 160 Cholesterol, 4, 12, 77, 119, 123, 126, 135, 139, 140, 152, 156, 157 Cholesterol Esters, 123, 139 Cholinergic, 13, 123 Chromatin, 118, 123, 130, 156 Chromosomal, 117, 123, 148 Chromosome, 123, 125, 132, 139, 155 Chronic, 26, 30, 52, 79, 87, 116, 121, 123, 130, 137, 149, 151, 156, 159 Chronic Disease, 121, 123 Chronic granulocytic leukemia, 123 Chronic myelogenous leukemia, 79, 123 Chronic Obstructive Pulmonary Disease, 26, 30, 116, 123 Chronic renal, 123, 149 Chylomicrons, 123, 139 Cisplatin, 36, 64, 76, 123 Clear cell carcinoma, 124, 128 Climacteric, 24, 25, 31, 44, 53, 60, 124

165

Clinical study, 22, 124 Clinical trial, 6, 12, 30, 99, 124, 126, 129, 152 Cloning, 120, 124 Coenzyme, 124, 132 Cognition, 4, 5, 13, 124 Colitis, 84, 85, 87, 124 Collagen, 117, 124, 132, 141, 149 Colon, 124, 137, 139, 159 Combination chemotherapy, 64, 77, 124 Complement, 124, 125, 148 Complementary and alternative medicine, 75, 81, 125 Complementary medicine, 75, 125 Compliance, 5, 6, 11, 21, 25, 92, 125 Computational Biology, 99, 125 Computed tomography, 120, 125 Computerized axial tomography, 125 Computerized tomography, 15, 125 Conception, 115, 125, 126, 132, 156 Congestion, 24, 125 Conjugated, 4, 12, 15, 16, 19, 21, 22, 24, 25, 27, 30, 36, 38, 39, 44, 46, 61, 63, 64, 66, 67, 85, 86, 125, 127 Conjugation, 125, 132 Connective Tissue, 120, 121, 124, 126, 128, 133, 140, 154 Consciousness, 126, 128, 151 Constriction, 126, 138 Contraceptive Agents, 126, 128 Contraindications, ii, 126 Control group, 126, 150, 152 Controlled study, 18, 126 Coronary, 8, 16, 52, 60, 122, 126, 135, 142, 144 Coronary Arteriosclerosis, 126, 144 Coronary Disease, 16, 126 Coronary heart disease, 122, 126, 135 Coronary Thrombosis, 126, 142, 144 Coronary Vessels, 126 Corpus, 126, 140, 150 Corpus Luteum, 126, 140, 150 Cortex, 126, 131 Cortical, 24, 126, 154 Corticosteroid, 127, 150 Cortisol, 56, 127 Culture Media, 116, 127 Cyclic, 20, 44, 60, 127, 134, 145 Cyclin, 27, 127 Cyclophosphamide, 77, 127 Cyproterone, 30, 32, 62, 127 Cyproterone Acetate, 30, 62, 127

Cysteine, 123, 127 Cytochrome, 64, 119, 127 Cytokine, 32, 127 Cytoplasm, 118, 119, 127, 130 Cytotoxic, 76, 79, 128, 152 Cytotoxicity, 124, 128 D Danazol, 79, 128 Daunorubicin, 128, 129 Degenerative, 128, 135 Deletion, 118, 128 Dementia, 4, 5, 128 Density, 4, 7, 9, 10, 11, 16, 28, 29, 33, 41, 49, 66, 92, 120, 128, 139, 140, 145, 149 Dermis, 128, 158 Desogestrel, 24, 128 Diabetes Mellitus, 8, 128, 133, 134 Diagnostic procedure, 83, 92, 128 Diencephalon, 128, 136 Diethylstilbestrol, 62, 128 Diffusion, 128, 136, 137 Digestion, 116, 119, 121, 128, 138, 140, 156 Dihydrotestosterone, 127, 128, 153 Dilatation, Pathologic, 128, 159 Dilation, 121, 128, 159 Direct, iii, 8, 14, 67, 128, 153 Distal, 119, 129 Dorsal, 20, 129, 149 Dorsum, 129 Dosage Forms, 84, 129 Double-blind, 4, 9, 12, 15, 18, 20, 24, 36, 54, 61, 129 Double-blinded, 9, 12, 15, 129 Doxorubicin, 70, 78, 129, 130 Dydrogesterone, 39, 55, 129 Dyspareunia, 129, 131 E Effector, 115, 124, 129 Efficacy, 4, 11, 16, 20, 31, 39, 76, 78, 129 Ejaculation, 129, 154 Electrolyte, 127, 129, 132, 145, 155 Electrons, 118, 129, 138, 146, 152 Embryo, 115, 129, 137, 145 Emphysema, 123, 129 Emulsions, 116, 129 Enanthate, 17, 79, 129 Endogenous, 86, 129 Endometrial, 11, 12, 18, 20, 25, 30, 33, 38, 39, 40, 46, 47, 55, 57, 60, 63, 68, 69, 76, 130, 141 Endometrium, 11, 18, 33, 40, 52, 64, 130 Endothelial cell, 52, 61, 130

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Endothelium, 36, 130, 145, 149 Endothelium, Lymphatic, 130 Endothelium, Vascular, 130 Endothelium-derived, 130, 145 End-stage renal, 123, 130, 149 Energy balance, 130, 139 Environmental Health, 98, 100, 130 Enzymatic, 20, 117, 121, 125, 130, 132, 135 Enzyme, 20, 55, 119, 124, 129, 130, 134, 148, 149, 151, 153, 157, 159, 160 Eosinophilic, 84, 85, 87, 130 Eosinophilic Gastroenteritis, 84, 85, 87, 130 Eosinophils, 130, 134, 139 Epidemiological, 87, 130, 153 Epirubicin, 26, 130 Epithelial, 20, 44, 115, 121, 130, 135 Epithelium, 130, 146 Esophagitis, 84, 85, 87, 130 Esophagus, 130, 131, 156, 160 Estramustine, 43, 62, 131 Estrogen receptor, 14, 18, 32, 40, 46, 131 Estrogen Replacement Therapy, 4, 16, 22, 24, 131 Estrone, 28, 46, 53, 86, 92, 131 Ethinyl Estradiol, 27, 30, 31, 63, 67, 131 Ethnic Groups, 17, 131 Etoposide, 75, 76, 131 Evoke, 131, 156 Excitability, 15, 131 Exemestane, 87, 131 Exogenous, 7, 21, 129, 131, 159 Extensor, 131, 151 Extracellular, 126, 131, 132, 141, 155, 157 Extracellular Matrix, 126, 131, 132, 141 Extracellular Matrix Proteins, 131, 141 F F Factor, 76, 132 Family Planning, 13, 46, 99, 132 Fat, 3, 4, 14, 115, 120, 121, 126, 127, 132, 139, 146, 159 Femoral, 10, 132 Femur, 132 Fetus, 115, 132, 148, 150, 159 Fibrinogen, 16, 132, 148, 149, 157 Fibrinolytic, 16, 40, 132 Fibroblasts, 41, 132, 138 Flatus, 132, 133 Fluid Therapy, 132, 145 Fluorescence, 20, 132 Fluorescence Polarization, 20, 132 Fluorouracil, 30, 76, 132

Forearm, 41, 120, 132 Free Radicals, 118, 132 Functional magnetic resonance imaging, 13, 133 G Gallbladder, 115, 133 Gamma Rays, 133, 152 Ganglia, 115, 133, 144 Gas, 62, 64, 121, 128, 132, 133, 135, 145 Gas exchange, 64, 133 Gastric, 129, 130, 133, 135 Gastrin, 133, 135 Gastrointestinal, 87, 121, 133, 154, 157, 159 Gastrointestinal tract, 87, 133, 154, 159 Gene, 19, 27, 35, 119, 120, 133, 135, 158 Gene Expression, 19, 35, 133 Genotype, 133, 148 Germ cell tumors, 77, 133 Germ Cells, 133, 146, 156, 157 Gestational, 8, 133 Gland, 115, 127, 133, 134, 140, 146, 151, 152, 154, 156, 158 Glioma, 51, 133 Glucocorticoid, 36, 59, 133, 150 Glucose, 4, 8, 67, 120, 128, 133, 134, 137, 154 Glucose Intolerance, 128, 133 Gluten, 122, 133 Glycoprotein, 132, 134 Gonad, 134 Gonadal, 13, 48, 134, 156 Gonadorelin, 134, 139 Gonadotropin, 36, 39, 41, 78, 134, 139 Goserelin, 24, 134 Governing Board, 134, 150 Graft, 16, 134 Grafting, 134, 137 Granulocyte, 14, 134 Guanylate Cyclase, 134, 145 H Haemorrhage, 115, 134 Heart attack, 122, 134 Heartbeat, 134, 157 Hematologic malignancies, 134, 140 Heme, 127, 134 Hemoglobin, 4, 134 Hemorrhage, 134, 156 Hemorrhoids, 84, 85, 87, 134 Hemostasis, 135, 154 Hepatitis, 7, 135 Hepatocytes, 135 Heredity, 133, 135

167

High-density lipoproteins, 12, 38, 135 Hirsutism, 127, 135 Histamine, 135 Histidine, 48, 135 Homodimer, 135, 158 Hormonal, 6, 8, 10, 11, 30, 43, 44, 51, 67, 76, 79, 119, 127, 131, 135, 142 Hormonal therapy, 67, 76, 135 Hormone Replacement Therapy, 3, 12, 14, 15, 19, 27, 30, 46, 62, 67, 86, 104, 135 Hormone therapy, 14, 45, 135, 141 Human growth hormone, 32, 135 Human papillomavirus, 7, 135 Hybridomas, 135, 138 Hydrogen, 115, 121, 131, 135, 136, 139, 143, 144, 146, 147, 151 Hydrogen Peroxide, 136, 139 Hydrolysis, 123, 136, 149, 151 Hydrophobic, 136, 139 Hydroxylation, 136, 159 Hydroxyurea, 76, 136 Hyperglycemia, 8, 136 Hyperplasia, 20, 46, 55, 136 Hypertension, 36, 122, 136 Hypertrophy, 136, 141 Hypothalamic, 9, 28, 48, 136 Hypothalamus, 19, 128, 134, 136 Hysterectomy, 16, 136 I Idiopathic, 41, 87, 136 Ileum, 136, 160 Immune function, 136, 158 Immune response, 85, 87, 115, 118, 127, 136, 137, 157, 160 Immune system, 136, 137, 140, 141, 160 Immunization, 136, 150 Immunochemistry, 20, 136 Immunodiffusion, 116, 136, 137 Immunoelectrophoresis, 116, 136 Immunoglobulin, 65, 118, 137, 143 Immunologic, 7, 87, 136, 137, 152 Immunology, 68, 115, 116, 137 Immunosuppressant, 132, 137, 142 Immunosuppressive, 127, 133, 137 Implantation, 53, 125, 137, 145 In vitro, 14, 20, 26, 41, 48, 51, 63, 72, 77, 137 In vivo, 18, 20, 137 Incision, 137, 138 Induction, 117, 137, 150 Infant, Newborn, 116, 137 Infarction, 137

Infection, 7, 130, 134, 136, 137, 140, 157, 160 Infiltration, 14, 137 Inflammation, 14, 63, 85, 115, 118, 121, 124, 130, 135, 137, 149, 150, 159 Inflammatory bowel disease, 84, 87, 137 Initiation, 25, 32, 67, 137 Inoperable, 64, 137 Inorganic, 123, 137, 143 Insulin, 4, 8, 14, 32, 137, 138, 159 Insulin-dependent diabetes mellitus, 138 Insulin-like, 32, 138 Interferon, 47, 63, 78, 138 Interferon-alpha, 47, 138 Interleukin-2, 45, 47, 60, 64, 65, 138 Interleukin-6, 25, 51, 138 Intermittent, 60, 132, 138 Intestinal, 122, 138, 141 Intestinal Mucosa, 122, 138 Intestine, 121, 138, 139 Intoxication, 138, 161 Intracellular, 137, 138, 145, 153 Intramuscular, 33, 42, 47, 57, 78, 138, 147 Intraperitoneal, 20, 63, 138 Intravascular, 16, 138 Intravenous, 138, 147 Invasive, 20, 138, 141 Ionizing, 116, 138, 152, 155 Ions, 115, 129, 135, 138, 151 Ischemia, 16, 119, 138 K Kb, 98, 138 L Lactation, 17, 138, 145, 150 Large Intestine, 130, 138, 139, 153, 155 Laxative, 116, 139 Least-Squares Analysis, 139, 153 Leptin, 37, 60, 139 Leukemia, 40, 52, 123, 129, 134, 139 Leukocytes, 14, 119, 120, 123, 130, 138, 139 Leuprolide, 62, 139 Levo, 139, 142, 145 Levonorgestrel, 18, 21, 32, 34, 38, 55, 139, 145 Ligaments, 126, 139 Likelihood Functions, 139, 153 Linear Models, 8, 139, 153 Linkages, 134, 139 Lipid, 3, 7, 8, 12, 25, 30, 52, 53, 67, 118, 129, 137, 139, 140, 159 Lipid Peroxidation, 52, 139 Lipophilic, 20, 139

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Medroxyprogesterone

Lipoprotein, 4, 12, 16, 48, 49, 55, 139, 140 Lipoprotein(a), 12, 140 Liver, 7, 48, 66, 115, 119, 127, 133, 135, 140 Liver metastases, 66, 140 Lobe, 135, 140 Localized, 135, 137, 140, 148 Logistic Models, 140, 153 Lomustine, 76, 140 Longitudinal study, 6, 10, 15, 140 Low-density lipoprotein, 12, 139, 140 Lumbar, 10, 140 Lung metastases, 43, 140 Lutein Cells, 140, 150 Lymph, 119, 123, 130, 140 Lymph node, 119, 123, 140 Lymphatic, 52, 130, 137, 140, 155, 156, 158 Lymphocyte, 118, 140, 141 Lymphoid, 79, 118, 140, 141 Lymphoma, 40, 134, 141 M Macrophage, 14, 141 Magnetic Resonance Imaging, 141 Malabsorption, 122, 141 Malignant, 18, 77, 115, 118, 121, 133, 134, 141, 144, 152, 154 Malignant tumor, 121, 141 Malnutrition, 119, 121, 141 Mammary, 25, 141, 152, 157 Manifest, 119, 141 Matrix metalloproteinase, 11, 20, 33, 141 Mediator, 14, 138, 141, 155 Medical castration, 48, 141 Medical Records, 141, 153 Medical Staff, 129, 141 MEDLINE, 99, 141 Medrogestone, 64, 141 Megestrol, 32, 46, 47, 76, 141 Megestrol Acetate, 32, 46, 76, 141 Melanocytes, 142 Melanoma, 77, 142 Melphalan, 76, 142 Membrane, 20, 125, 131, 142, 143, 148 Memory, 4, 118, 128, 142 Menarche, 142, 153 Meninges, 122, 142 Meningioma, 44, 65, 142 Menstruation, 86, 117, 142, 145, 153 Mental, iv, 4, 5, 98, 100, 124, 128, 142, 150, 151, 154 Mental Disorders, 142, 150 Mental Health, iv, 5, 98, 100, 142, 150, 151 Metabolite, 131, 142

Metastasis, 35, 141, 142 Metastatic, 20, 35, 43, 45, 47, 57, 69, 70, 76, 78, 134, 142, 154 Methotrexate, 30, 78, 142 Methyltestosterone, 22, 142 MI, 49, 84, 87, 113, 142 Microbe, 142, 158 Microorganism, 142, 147, 160 Midaxillary line, 143, 160 Migration, 14, 143 Milliliter, 120, 143 Millimeter, 143, 160 Mitosis, 118, 143 Mitotic, 131, 143, 160 Mobilization, 132, 143 Modification, 117, 143, 152 Modulator, 55, 143 Molecular, 11, 14, 26, 55, 99, 101, 120, 125, 132, 143, 149, 150, 153, 159 Molecule, 61, 118, 124, 125, 127, 129, 130, 136, 143, 146, 148, 152, 153 Monitor, 123, 143, 145 Monoclonal, 44, 135, 143 Monocyte, 14, 143 Monotherapy, 56, 143 Morphology, 19, 20, 143 Motility, 19, 143, 154 Mucosa, 143, 150 Mucus, 33, 143, 159 Mutagenic, 143, 155 Myelogenous, 143 Myelosuppression, 143, 160 Myocardial infarction, 16, 126, 142, 143, 144 Myocardial Ischemia, 54, 126, 144 Myocardium, 142, 143, 144 N Nausea, 129, 144 Necrosis, 118, 137, 142, 143, 144 Neoplasia, 7, 144 Neoplasm, 144, 154, 159 Neoplastic, 135, 141, 144 Nerve, 117, 119, 141, 144, 150, 153, 156, 158, 159 Nervous System, 116, 122, 123, 141, 144, 157 Neural, 19, 116, 144 Neuroanatomy, 13, 144 Neuromuscular, 115, 144 Neuromuscular Junction, 115, 144 Neuropeptide, 37, 144 Neurotoxicity, 144, 160

169

Neurotransmitter, 115, 117, 121, 135, 144, 157 Neutrons, 116, 144, 152 Neutrophil, 11, 145 Niacin, 145, 159 Nitric Oxide, 22, 37, 52, 145 Nitrogen, 117, 127, 131, 142, 145, 159 Non-small cell lung cancer, 36, 145 Norgestrel, 139, 145 Nuclear, 23, 26, 55, 125, 129, 133, 144, 145 Nucleus, 118, 119, 123, 127, 130, 133, 144, 145, 151 Nutritional Support, 37, 145 O Oestradiol, 27, 58, 145 Oestrogen, 26, 76, 145 Ointments, 129, 145 Oligomenorrhea, 145, 149 Oncology, 22, 24, 25, 30, 43, 45, 47, 55, 56, 57, 60, 65, 66, 68, 69, 70, 72, 76, 77, 78, 79, 145 Oophorectomy, 43, 145 Opacity, 128, 145 Optic Chiasm, 136, 146 Oral Manifestations, 7, 146 Osteoporosis, 9, 10, 12, 59, 80, 104, 131, 145, 146, 152 Ovariectomy, 61, 146 Ovaries, 119, 141, 145, 146, 149, 155 Ovary, 20, 117, 126, 131, 134, 145, 146 Overweight, 3, 58, 72, 146 Ovulation, 18, 50, 58, 118, 129, 141, 145, 146 Ovum, 126, 146, 150, 161 Oxidation, 115, 118, 127, 139, 146 Oxygenation, 52, 146 P Palliative, 127, 141, 145, 146 Pancreas, 115, 120, 137, 146, 159 Pancreatic, 52, 130, 146 Pancreatic cancer, 130, 146 Papillomavirus, 146 Paradoxical, 18, 146 Parathyroid, 51, 66, 146, 157 Parathyroid Glands, 146 Parathyroid hormone, 51, 66, 146 Parenteral, 84, 87, 88, 147 Particle, 56, 147 Parturition, 147, 150 Patch, 5, 147, 158 Pathogen, 85, 147 Pathogenesis, 14, 33, 147

Pathologic, 118, 120, 126, 147, 151 Pathologic Processes, 118, 147 Patient Satisfaction, 21, 147 Pelvic, 21, 24, 48, 147, 151 Pelvic inflammatory disease, 21, 147 Pelvis, 115, 140, 146, 147, 159 Peptide, 117, 139, 147, 149, 151 Perception, 21, 147, 154 Perimenopausal, 86, 147 Peripheral blood, 138, 147 Peritoneal, 138, 147 Peritoneal Cavity, 138, 147 PH, 15, 56, 57, 76, 78, 120, 147 Pharmaceutical Preparations, 147, 151 Pharmaceutical Solutions, 129, 147 Pharmacokinetic, 42, 59, 148 Pharmacologic, 59, 117, 148, 158 Phenotype, 19, 148 Phospholipids, 132, 139, 148 Phosphorus, 121, 146, 148 Phosphorylation, 52, 148 Physicochemical, 136, 148 Physiologic, 116, 120, 124, 142, 148, 153 Physiology, 22, 30, 37, 53, 69, 148 Pigment, 142, 148 Pilot study, 18, 37, 44, 64, 148 Placenta, 119, 131, 148, 150 Plants, 121, 133, 143, 148, 154, 158 Plaque, 52, 148 Plasma, 20, 38, 46, 48, 60, 62, 69, 118, 123, 130, 132, 133, 134, 135, 140, 148, 149, 151, 154 Plasma protein, 130, 148, 151 Plasmid, 132, 148 Plasmin, 149 Plasminogen, 20, 149 Plasminogen Activators, 149 Platelet Activation, 16, 149 Platelet Aggregation, 63, 145, 149 Platelets, 16, 143, 145, 149, 157, 158 Platinum, 123, 149 Pneumonia, 126, 149 Podophyllotoxin, 131, 149 Polycystic, 65, 67, 149 Polycystic Ovary Syndrome, 67, 149 Polyethylene, 84, 149 Polypeptide, 117, 124, 132, 149, 150 Polysaccharide, 118, 149 Posterior, 117, 129, 143, 146, 149 Postoperative, 72, 150 Postsynaptic, 19, 150 Practice Guidelines, 100, 150

170

Medroxyprogesterone

Precipitation, 15, 150 Precursor, 117, 127, 129, 130, 149, 150, 151, 158, 159 Prednisolone, 78, 150 Premenopausal, 17, 43, 61, 150 Prenatal, 21, 129, 150 Prenatal Care, 21, 150 Preoperative, 72, 150 Primary endpoint, 20, 150 Primary Prevention, 12, 150 Proctitis, 84, 87, 150 Progestogen, 16, 24, 150 Progression, 7, 117, 150 Progressive, 123, 128, 131, 144, 149, 150, 159 Prolactin, 19, 34, 150 Propylene Glycol, 84, 151 Prospective study, 3, 24, 54, 75, 140, 151 Prostate, 22, 120, 134, 145, 151, 159 Prostatic Neoplasms, 131, 151 Protein C, 118, 119, 139, 140, 151 Protein S, 120, 135, 151 Proteolytic, 20, 124, 132, 149, 151 Prothrombin, 46, 151, 157 Protons, 116, 135, 138, 151, 152 Psoriasis, 84, 85, 87, 151 Psychic, 124, 142, 151, 154 Psychoactive, 151, 161 Puberty, 28, 41, 151 Public Health, 9, 10, 13, 17, 57, 100, 151 Public Policy, 99, 151 Publishing, 23, 151 Pulmonary, 37, 40, 72, 120, 130, 152, 160 Pulmonary Artery, 120, 152, 160 Pulse, 3, 143, 152 Q Quality of Life, 31, 65, 152 Quaternary, 84, 152 R Race, 9, 12, 139, 142, 143, 145, 152 Racemic, 139, 142, 145, 152 Radiation, 23, 131, 132, 133, 138, 152, 155, 161 Radioactive, 121, 136, 137, 145, 152 Radioimmunotherapy, 152 Radiotherapy, 40, 152 Raloxifene, 12, 152, 154 Random Allocation, 152 Randomization, 16, 21, 152 Reactive Oxygen Species, 85, 152 Receptor, 18, 20, 26, 48, 55, 64, 76, 118, 127, 153, 154

Receptors, Serotonin, 153, 154 Recombinant, 36, 45, 63, 64, 153 Rectum, 85, 118, 124, 132, 133, 137, 139, 150, 151, 153 Reductase, 119, 142, 153 Refer, 1, 124, 144, 152, 153 Regimen, 42, 64, 92, 129, 153 Regression Analysis, 76, 153 Renal cell cancer, 78, 153 Renal cell carcinoma, 47, 55, 63, 76, 78, 153 Reproductive History, 17, 153 Respiration, 116, 121, 143, 153 Retrospective, 34, 153 Retrospective study, 34, 153 Ribonucleoside Diphosphate Reductase, 136, 153 Ribose, 115, 153 Risk factor, 4, 14, 16, 140, 151, 153 S Saphenous, 16, 153 Saponins, 154, 156 Sarcoma, 121, 154 Schizoid, 154, 161 Schizophrenia, 154, 161 Schizotypal Personality Disorder, 154, 161 Screening, 13, 124, 154 Secondary tumor, 142, 154 Secretion, 19, 20, 32, 41, 51, 127, 134, 135, 138, 143, 154, 158 Seizures, 15, 154 Selective estrogen receptor modulator, 12, 152, 154, 157 Semen, 39, 129, 151, 154 Semisynthetic, 131, 154 Senile, 146, 154 Serine, 134, 154 Serotonin, 19, 144, 153, 154, 159 Serous, 130, 155 Serum, 8, 12, 25, 27, 34, 40, 42, 46, 56, 61, 65, 77, 79, 86, 124, 134, 140, 155 Sex Characteristics, 117, 145, 151, 155, 157 Side effect, 5, 21, 31, 62, 78, 116, 127, 143, 155, 158, 160 Sister Chromatid Exchange, 55, 155 Skeletal, 12, 117, 155 Skeleton, 132, 155 Skull, 155, 157 Small cell lung cancer, 155 Small intestine, 123, 130, 135, 136, 138, 155 Smooth muscle, 14, 42, 135, 155, 157 Social Environment, 152, 155 Social Problems, 13, 155

171

Sodium, 84, 155 Solid tumor, 117, 129, 140, 155 Solvent, 147, 151, 155 Somatic, 124, 143, 155 Specialist, 105, 128, 155 Species, 143, 152, 156, 158, 160, 161 Sperm, 79, 117, 123, 133, 156, 157 Spermatozoa, 154, 156 Spinal cord, 121, 122, 123, 142, 144, 156 Spleen, 140, 156 Spotting, 7, 11, 156 Squamous, 145, 156, 160 Squamous cell carcinoma, 145, 156, 160 Stable disease, 45, 156 Sterile, 50, 51, 146, 156 Sterility, 33, 36, 38, 39, 40, 41, 48, 49, 51, 58, 64, 78, 127, 156 Steroid, 19, 40, 46, 55, 117, 119, 127, 128, 145, 154, 156 Stimulant, 116, 135, 156 Stimulus, 85, 156, 157 Stomach, 115, 130, 131, 133, 135, 144, 147, 155, 156 Stress, 33, 35, 127, 144, 156 Stroke, 67, 98, 122, 156 Subacute, 137, 156 Subclinical, 137, 154, 157 Subcutaneous, 45, 65, 115, 147, 157, 160 Substance P, 142, 150, 154, 157 Sudden cardiac death, 16, 157 Supplementation, 78, 157 Suppression, 56, 66, 76, 78, 127, 157 Symptomatic, 16, 157 Synergistic, 51, 88, 150, 157 Systemic, 37, 55, 120, 137, 150, 157 T Tamoxifen, 19, 25, 26, 56, 57, 60, 92, 154, 157 Temporal, 15, 20, 157 Testicles, 141, 157 Testicular, 48, 119, 157 Testis, 77, 117, 131, 145, 157 Testosterone, 20, 23, 39, 51, 65, 79, 117, 153, 157 Tetany, 146, 157 Thigh, 132, 157 Thorax, 115, 140, 157 Threshold, 131, 136, 157 Thrombin, 46, 132, 149, 151, 157 Thrombocytes, 149, 157 Thrombolytic, 149, 157 Thrombosis, 61, 63, 151, 156, 157

Thrombus, 126, 137, 144, 149, 157, 158 Thymus, 136, 140, 158 Thyroid, 51, 146, 158 Thyroid Gland, 146, 158 Tomography, 158 Toxic, iv, 126, 128, 142, 149, 158 Toxicity, 40, 158 Toxicology, 100, 158 Toxins, 118, 137, 152, 158 Trachea, 158 Transcutaneous, 49, 158 Transdermal, 5, 27, 49, 60, 64, 158 Transfection, 120, 158 Transforming Growth Factor beta, 63, 158 Transmitter, 115, 141, 158 Transplantation, 20, 123, 136, 158 Trauma, 131, 144, 158 Triglyceride, 4, 38, 159 Tryptophan, 19, 124, 154, 159 Tryptophan Hydroxylase, 19, 159 Tumor marker, 120, 159 Tumour, 48, 159 Type 2 diabetes, 4, 8, 159 U Ulcerative colitis, 84, 87, 137, 159 Urethra, 151, 159 Urine, 18, 120, 131, 153, 159 Urokinase, 20, 159 Uterine Contraction, 115, 159 Uterus, 12, 52, 115, 123, 126, 130, 136, 142, 146, 150, 159 V Vaccines, 159, 160 Vagina, 123, 128, 142, 156, 159 Vaginal, 7, 10, 12, 63, 64, 69, 159 Vascular, 3, 14, 16, 22, 37, 38, 61, 69, 128, 130, 137, 145, 148, 149, 158, 159 Vascular endothelial growth factor, 38, 69, 159 Vasodilation, 36, 159 Vasodilators, 145, 159 Vasomotor, 7, 20, 56, 64, 131, 159 Vein, 16, 117, 138, 145, 153, 160 Venous, 134, 151, 160 Ventricle, 136, 152, 160 Veterinary Medicine, 99, 160 Villous, 122, 160 Vinblastine, 76, 78, 160 Vinca Alkaloids, 160 Vincristine, 77, 78, 160 Vindesine, 72, 77, 160 Viral, 7, 160

172

Medroxyprogesterone

Virulence, 119, 158, 160 Virus, 7, 119, 135, 138, 148, 160 Vitro, 20, 160 Vivo, 160 W Waist circumference, 4, 160 Warts, 135, 149, 160 White blood cell, 118, 123, 130, 134, 139, 140, 141, 143, 145, 160 Windpipe, 158, 160

Withdrawal, 5, 39, 160 Womb, 159, 161 Wound Healing, 141, 161 X Xenograft, 117, 161 X-ray, 10, 11, 117, 120, 125, 132, 133, 145, 152, 161 Y Yeasts, 148, 161

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