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

PSORIATIC ARTHRITIS 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., 1960Psoriatic Arthritis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84566-2 1. Psoriatic Arthritis-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 psoriatic arthritis. 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 PSORIATIC ARTHRITIS............................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Psoriatic Arthritis ......................................................................... 5 E-Journals: PubMed Central ....................................................................................................... 13 The National Library of Medicine: PubMed ................................................................................ 13 CHAPTER 2. NUTRITION AND PSORIATIC ARTHRITIS ..................................................................... 57 Overview...................................................................................................................................... 57 Finding Nutrition Studies on Psoriatic Arthritis........................................................................ 57 Federal Resources on Nutrition ................................................................................................... 60 Additional Web Resources ........................................................................................................... 61 CHAPTER 3. CLINICAL TRIALS AND PSORIATIC ARTHRITIS ........................................................... 63 Overview...................................................................................................................................... 63 Recent Trials on Psoriatic Arthritis............................................................................................. 63 Keeping Current on Clinical Trials ............................................................................................. 65 CHAPTER 4. PATENTS ON PSORIATIC ARTHRITIS ........................................................................... 67 Overview...................................................................................................................................... 67 Patents on Psoriatic Arthritis ...................................................................................................... 67 Patent Applications on Psoriatic Arthritis .................................................................................. 72 Keeping Current .......................................................................................................................... 79 CHAPTER 5. BOOKS ON PSORIATIC ARTHRITIS ............................................................................... 81 Overview...................................................................................................................................... 81 Book Summaries: Federal Agencies.............................................................................................. 81 Book Summaries: Online Booksellers........................................................................................... 82 Chapters on Psoriatic Arthritis.................................................................................................... 82 CHAPTER 6. PERIODICALS AND NEWS ON PSORIATIC ARTHRITIS ................................................. 85 Overview...................................................................................................................................... 85 News Services and Press Releases................................................................................................ 85 Newsletter Articles ...................................................................................................................... 88 Academic Periodicals covering Psoriatic Arthritis ...................................................................... 89 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 91 Overview...................................................................................................................................... 91 U.S. Pharmacopeia....................................................................................................................... 91 Commercial Databases ................................................................................................................. 92 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 95 Overview...................................................................................................................................... 95 NIH Guidelines............................................................................................................................ 95 NIH Databases............................................................................................................................. 97 Other Commercial Databases....................................................................................................... 99 The Genome Project and Psoriatic Arthritis................................................................................ 99 APPENDIX B. PATIENT RESOURCES ............................................................................................... 103 Overview.................................................................................................................................... 103 Patient Guideline Sources.......................................................................................................... 103 Associations and Psoriatic Arthritis .......................................................................................... 113 Finding Associations.................................................................................................................. 113 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 115 Overview.................................................................................................................................... 115 Preparation................................................................................................................................. 115 Finding a Local Medical Library................................................................................................ 115 Medical Libraries in the U.S. and Canada ................................................................................. 115

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ONLINE GLOSSARIES................................................................................................................ 121 Online Dictionary Directories ................................................................................................... 123 PSORIATIC ARTHRITIS DICTIONARY................................................................................. 125 INDEX .............................................................................................................................................. 169

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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 psoriatic arthritis 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 psoriatic arthritis, 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 psoriatic arthritis, 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 psoriatic arthritis. 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 psoriatic arthritis, 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 psoriatic arthritis. 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 PSORIATIC ARTHRITIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on psoriatic arthritis.

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

Methotrexate Use in Psoriasis and Psoriatic Arthritis Source: Rheumatic Disease Clinics of North America. 23(4):797-809; November 1997. Summary: This journal article for health professionals discusses the use of methotrexate (MTX) in the treatment of psoriasis and psoriatic arthritis (PsA). It reviews studies on the efficacy of MTX therapy of psoriasis and PsA and on methotrexate-associated liver toxicity. Evidence shows that MTX is an extremely effective drug in treating these conditions, and it possesses a very high benefit-to-toxicity ratio compared with other therapies and immunosuppressive agents used in these disorders. Most adverse reactions related to MTX are mild, but serious and life-threatening reactions, particularly liver toxicity, may occur. Careful monitoring is needed to prevent most undesirable side effects. 75 references and 3 tables. (AA-M).

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Comparison of Cyclosporine, Sulfasalazine, and Symptomatic Therapy in the Treatment of Psoriatic Arthritis, A Source: Journal of Rheumatology. 28(10): 2274-2282. October 2001. Summary: This journal article provides health professionals with information on a study that compared the efficacy and tolerability of cyclosporine (CSA) with that of symptomatic therapy (ST) alone and sulfasalazine (SSZ) in the treatment of psoriatic arthritis (PsA). Twelve rheumatology centers recruited 99 patients with active PsA in a 24 week, prospective, randomized, open, controlled study. The patients were treated with CSA at a dose of 3 milligrams (mg)/kilogram (kg)/day or SSZ at a dose of 2,000 mg/day plus ST, or ST alone (nonsteroidal antiinflammatory drugs, analgesics, or prednisone at a dose of 5 mg or less per day). The primary end point was the 6 month change in pain. Analyses were based on an intention to treat principle. The study found that, in comparison with both SSZ and ST, there was a statistically significant difference in favor of CSA in terms of the mean changes in the pain score, which was considered the primary response variable. A significant decrease in favor of CSA versus ST alone was also observed for swollen joint count, tender joint count, joint/pain tenderness score, patient and physician global assessment by at least 1 point, total Arthritis Impact Measurement Scale score, and spondylitis functional index. There was a statistically significant difference in the American College of Rheumatology (ACR) 50 percent and ACR 70 percent response rates between the CSA and ST groups. Comparing the SSZ and ST alone groups, only the spondylitis functional index decreased significantly in the SSZ treated patients. The Psoriasis Area and Severity Index was significantly lower in the CSA group than in the ST and SSZ groups. Decrease in erythrocyte sedimentation rate was significant only in the SSZ versus the ST group, whereas reduction in C reactive protein was significant in the CSA treated patients compared with the ST group. The most common adverse event in the CSA group was mild, reversible kidney dysfunction. The article concludes that the results of the trial confirm that CSA is well tolerated by patients who have PsA and suggest that it is more efficacious than ST or SSZ. 2 figures, 4 tables, and 44 references. (AA-M).

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Multidisciplinary Approach to Psoriatic Arthropathy, A Source: Community Nurse. 5(4): 21-22. May 1999. Summary: This journal article provides nurses with information on the symptoms, diagnosis, and management of psoriatic arthropathy. This chronic form of arthritis occurs in people who also have psoriasis. Symptoms include inflammation, tenderness, pain, swelling, stiffness, and fatigue. Elbows, wrists, heels, and the jaw are commonly affected. Types of psoriatic arthropathy are asymmetrical oligoarthritis, symmetrical rheumatoid like arthritis, distal interphalangeal, arthritis mutilans, and spondylitis. Diagnosis is based on clinical presentation. The main goals of treatment are to reduce joint inflammation, maintain mobility, and prevent deformity. Daily therapeutic and recreational exercises and hydrotherapy should be encouraged to maintain joint movement. Drugs may also be needed to reduce inflammation within affected joints. Patients who are in the acute stages of their disease are best managed by both the rheumatology and dermatology teams. The community nurse can have an important role in caring for patients during the chronic phases of the disease because both patients and their families often need continued nursing support to care for themselves. 1 figure, 1 table, and 5 references.

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Stress Fracture in Long Term Methotrexate Treatment for Psoriatic Arthritis Source: Annals of the Rheumatic Diseases. 60(8): 736-738. August 2001. Summary: This journal article uses a case study to provide health professionals with information on the occurrence of stress fracture in long term methotrexate treatment for psoriatic arthritis. The case involved a 42 year old woman who presented at an outpatient rheumatology department with severe, incapacitating pain in her left leg. She had been diagnosed with psoriasis at age 17 and was treated with topical drugs. Periodically, she was prescribed etretinate and photochemotherapy as additional treatment. Oligoarthritis of her knees and ankles appeared at age 25. Nonsteroidal antiinflammatory drugs and an occasional intraarticular injection of corticosteroids controlled her symptoms. She developed a severe polyarthritis of her elbows, wrists, fingers, ankles, and metatarsophalangeal joints at age 37. Methotrexate (MTX) was used to manage the polyarthritis. The article presents findings from the physical examination, laboratory studies, and diagnostic imaging tests and discusses the course of treatment used to manage her condition. In addition, the article reports on osteoporotic fractures associated with MTX treatment. Evidence suggests that MTX may enhance osteoporosis, especially in patients who have inflammatory rheumatic diseases. In these patients, MTX might induce stress fractures. The article concludes by outlining the lessons learned from the case study. 2 figures and 28 references.

Federally Funded Research on Psoriatic Arthritis The U.S. Government supports a variety of research studies relating to psoriatic arthritis. 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 psoriatic arthritis. 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 psoriatic arthritis. The following is typical of the type of information found when searching the CRISP database for psoriatic arthritis: •

Project Title: ANTIGEN AND NONANTIGEN DRIVEN TCR REPERTOIRES IN ARTHRITIS Principal Investigator & Institution: Winchester, Robert; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2002 Summary: One overall goal of this project is to delineate changes in putative antigen and non antigen driven T-cell clonal repertoire in psoriatic arthritis synovia before and after

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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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receiving potential disease modifying therapy in pilot trials. Once progress has been made towards this end parallel studies will be initiated in rheumatoid arthritis as the second overall goal. The first objective is to validate this approach of repertoire analysis to gain insight into the mechanism and efficacy of therapeutic interventions and for advancing insight into the cognitive immune recognition events driving the disorder. This project is based on the preliminary observation that the vast majority of synovial Tcells in untreated psoriatic arthritis consists of apparently non antigen driven single sequence clones, with the balance containing oligoclonally expanded, and putatively autoantigen- driven, clones of both CD4 and CD8 lineage. After methotrexate, the uninflammed synovium, in striking contrast, exhibited a profound decrease in this polyclonal component and a marked expansion of clones identical in sequence to those found as a minor feature in the active synovitis sample from the same joint. Accordingly, we hypothesize that methotrexate is an example of an agents that acts to reduce the non antigen-specific polyclonal recruitment that underlies clinical synovitis, but does not significantly affect clonal expansions of autoreactive T-cells involved in the fundamental immune recognition events driving the psoriatic arthritis. The proposed experiments exploit the potential to determine whether novel therapeutic agents affect either the putative antigen specific oligoclonal or the non antigen specific polyclonal component of synovitis, or both. The methotrexate studies will be continued along with pilot studies exploring treatment of an additional group of patients with a novel CD3 Mab that appears to anergize activated TH1 cells, the sTNFR:Fc competitive inhibitor Embrel and, potentially CD40L Mab. With the hypothesis that SDF-1 plays a significant role in the localization of a autoimmune response to the joint and its subsequent development into autoimmune disease, an envisioned future trial of a CXCR4 blocking agent is preliminary sketched as an example of a concept developed out of a fundamental gene discovery effect on the distinctive phenotype of cultured rheumatoid arthritis synoviocytes. In a second objective additional proposed studies are proposed to increase information on the nature of the surprising CD4 clonal expansions that are made more evident upon methotrexate administration and initiate an understanding of their role in psoriatic arthritis. It is hypothesized that they illustrate an instance of the "three cell interaction" involved in the generation of effector cytotoxic T lymphocytes under the influence of a cognate regulatory helper cell interacting with a dendritic cell. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AUTOIMMUNITY CENTERS OF EXCELLENCE Principal Investigator & Institution: Chess, Leonard; Professor; Medicine; Columbia University Health Sciences New York, Ny 10032 Timing: Fiscal Year 2003; Project Start 28-SEP-1999; Project End 31-MAR-2008 Summary: (provided by applicant): The overall goals of this ACE renewal application will be to further develop our interdisciplinary basic and clinical research program at Columbia primarily focused on the evaluation of novel therapeutic approaches to human autoimmune diseases including systemic lupus erythematosus (SLE), rheumatoid and psoriatic arthritis (RA), multiple sclerosis (MS), type I diabetes mellitus (TIDM), biliary cirrhosis and scleroderma. In each of these diseases, there are ongoing basic and clinical research programs involving pathophysiologic and/or clinical immunotherapeutic studies. We hypothesize that there are four principal events involved in the immunopathogenesis of these diseases: (1) predisposing genes establish a T-cell repertoire capable of recognizing self peptides intrinsic to the autoimmune process; (2) previously tolerant autoreactive T-cell clones are activated, expand to change the T cell repertoire to reflect autoreactive effector T cells and migrate to sites of

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inflammation; (3) regulatory mechanisms, including cytokines and CD4+ and CD8+ regulatory T cells fail and (4) pathogenic autoantibodies and T cells effect tissue injury. We predict that reducing the clonal expansion and migration of relevant autoreactive T cells by blockade of TCR signaling with agents like anti-CD3 or interruption of the signaling and migration of autoreactive memory T cells with agents like anti-VLA-1 could down-modulate disease activity. We propose to test these hypotheses during the natural history of disease and during specific immune intervention. In this ACE renewal, we plan to continue ongoing studies of anti-CD3 therapy of TIDM, initiate trials of biliary cirrhosis employing Mycophenolate Mofetil and continue pre-clinical assessment of the VLA-1 pathway as a prelude to clinical trials with anti-VLA-1 moAbs anticipated to begin in 2004. During these studies, we will: (1) identify by PCR based CDR3 length techniques and TCR sequencing, autoantigen-driven expansions in the CD4 and CD8 cz_ TCR repertoire; (2) Identify changes in the T cell functional response to autoantigens and (3) directly study the regulatory interactions of TH1, TH2 as well as CD4+ and CD8+ T cells in controlling the TCR repertoire. In select patients, we will directly study cells at the site of inflammation (CNS, skin, kidney, joints) using HVS immortalization techniques as well as by laser capture technology for repertoire and microarray analysis of activated genes. In addition, we plan new basic studies of the control of the autoreactive T cell repertoire in autoimmune disease by analysis of EAE in the mouse and studies of human regulatory cells in TIDM. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLINICAL CENTER Principal Investigator & Institution: Wofsy, David; Professor; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 941222747 Timing: Fiscal Year 2003; Project Start 01-JUL-2003; Project End 30-JUN-2008 Summary: The University of California, San Francisco (UCSF) conducts clinical trials in a wide range of autoimmune diseases. This proposal focuses on three of these diseases (SLE, MS, and IDDM), and presents detailed descriptions of two potential clinical trials that demonstrate our interests and our ability to develop collaborative multicenter clinical trials for patients with autoimmune diseases. The two proposed clinical trials are: Protocol 1: Treatment of lupus nephritis with CTLA4Ig, a fusion protein that inhibits T cell costimulation via the CD28 pathway. This trial represents the culmination of a comprehensive bench-to-bedside research program conducted at UCSF by the PI of the Clinical Center and the PI of Project 2 in this application. The proposed trial will determine: (i) whether CTLA4Ig augments the benefit of cyclophosphamide (CTX) therapy in patients with lupus nephritis; (ii) whether CTLA4Ig can minimize the duration of therapy with CTX; (iii) whether combined therapy with CTX and CTLA4Ig can eliminate the need for maintenance therapy (induce 'tolerance'); and (iv) whether CTLA4Ig is better tolerated/safer than CTX. Protocol 2: Treatment with atorvastatin to prevent progression to MS after a clinically isolated first attack of CNS demyelination. This trial also represents a true bench-to-bedside collaboration among basic and clinical scientists involved in this application. It arose from studies by Dr. Scott Zamvil at UCSF, demonstrating that 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors ('statins') can prevent or reverse paralysis in murine models for MS. The proposed trial will determine whether atorvastatin can prevent progression to MS in patients at high risk for the developing the disease. Although it is not represented in this application by a detailed protocol, the Diabetes program at UCSF also has a very strong clinical trials component. The short-term goal of our clinical trials program in diabetes is to extend recent studies of anti-CD3 therapy to determine the potential of this approach

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to treat early IDDM and/or to prevent IDDM in people at high risk for the disease. We also are conducting trials to examine new strategies to facilitate islet transplantation. In addition to our studies in SLE, MS, and IDDM, investigators affiliated with our Center are currently conducting clinical trials in numerous other autoimmune diseases, including rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Sjogren syndrome, scleroderma, and Wegener's granulomatosis. This breadth of interests and experience at UCSF provides evidence of our ability to contribute across a broad range of potential ACE trials. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CLINICAL COMPONENT Principal Investigator & Institution: Moreland, Larry W.; Professor of Medicine and Associate Dean; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2008 Summary: The Clinical Component of the University of Alabama at Birmingham (UAB) Autoimmunity Center of Excellence (ACE) will be directed by Drs. Larry Moreland and Joseph Shanahan. The Clinical Director will serve as the Clinical Representative to the Steering Committee and will coordinate the effort of the UAB ACE with the national network. Dr. Moreland, in his roles as Director of the Arthritis Clinical Intervention Program (ACIP) and the UAB Pittman General Clinical Research Center (GCRC), will guide the infrastructure for clinical trials for UAB and ACE projects. The UAB ACIP has in place the infrastructure for regulatory and financial oversight. The UAB GCRC has the expertise in clinical coordination and data management necessary to perform the proposed clinical trials. The UAB-ACE Clinical Component includes expertise in autoimmune clinical trials from 6 specialties: Rheumatology; Endocrine/Transplantation; Hematology; Dermatology; Neurology; and Gastroenterology. Investigators in the UAB-ACE Clinical Component have outstanding track records in evaluation of novel therapeutic agents for autoimmune diseases as illustrated with the number of trials performed or underway and with publications in relevant diseases. The UAB ACE will bring together these clinical investigators to work across disciplinary lines to test new agents and develop new applications, while collaborating with the basic investigators to determine mechanisms of action. Two clinical trials are proposed. The first (PD: Carter) is a phase I trial in patients with systemic lupus erythematosus, to evaluate a novel, cytotoxic approach targeting Death Receptor 5 to selectively eliminate activated lymphocytes. The second (PD: Moreland) is a phase II trial evaluating IL-1 TRAP in patients with psoriatic arthritis, which illustrates the ability of UAB investigators to partner with the pharmaceutical industry to test new applications of translational agents. Proposed mechanistic studies by UAB investigators will test the concept of targeting only activated lymphocytes (Death Receptor 5) and investigate the role of IL-1 in psoriatic arthritis and the mechanisms of IL-1-driven inflammation and IL-1 signaling in inflammatory tissue (IL-1 TRAP). UAB has an outstanding record in testing of novel, translational therapies for autoimmune diseases. The UAB ACE Clinical Component is a multidisciplinary, collaborative program to unite these strengths to accelerate the testing of immunomodulatory therapies for autoimmune disease and to optimize the opportunity to use these trials to determine mechanisms of disease and treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: GENETIC RISK FACTORS FOR PSORIASIS Principal Investigator & Institution: Bowcock, Anne M.; Professor; Genetics; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2003; Project Start 04-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): Psoriasis is a common, chronic inflammatory skin disease, affecting approximately 2% of the population. Psoriatic arthritis is also seen in about 10% of patients. Despite the fact that the disease has an autoimmune etiology and has been associated with HLA alleles, particularly those from the class I region, there is significant genetic heterogeneity and at least ten non HLA loci have been described. The penetrance of associated alleles within HLA is about 10% and it is believed that epistasis with some of these non HLA alleles is required for disease development. There may also be loci that are entirely HLA-dependent. Some genetic risk factors associated with psoriasis may also predispose to other inflammatory diseases. Identifying genes involved in complex traits has been facilitated by the significant progress made by the genome project. Besides making available genetic sequence from susceptibility regions, genome annotation has permitted the localization of candidate genes and the identification of potentially novel transcripts. The development and localization of a dense set of polymorphic markers in the form of single nucleotide polymorphisms (SNPs) is facilitating the localization of complex traits through association mapping. We have a cohort of 242 nuclear families and 25 multiply affected families with psoriasis that have been used to localize susceptibility genes with linkage and association. Our next goal is to identify these genes and the underlying predisposing variants. The regions under investigation have been identified in at least two independent studies with different psoriasis family sets and lie within chromosomes 1q21, 6p21, 10q22-q23 and 17q24.3. In order to reduce the amount of SNP genotyping that is performed, conserved haplotype blocks will be identified with a dense set of SNPs. A subset of SNPs found in each conserved block will be used to test for association with psoriasis in a set of 250 psoriasis cases/controls and 242 nuclear families. Variants will be identified by DNA sequencing and examined for their frequency in affected families and unrelated controls. Studies of epistasis between predisposing loci will also be performed. Gene identification may be facilitated by the comprehensive gene expression data we have recently acquired in comparing involved and uninvolved psoriatic skin with normal skin. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: HOKT3 GAMMA 1 (ALA ALA) MONOCLONAL ANTIBODY FOR PSORIATIC ARTHRITIS Principal Investigator & Institution: Clark, Marcus R.; University of Chicago 5801 S Ellis Ave Chicago, Il 60637 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: NEW MRI SEQUENCES/RF COILS FOR HAND PSORIATIC ARTHRITIS Principal Investigator & Institution: Kwok, Wingchi E.; Radiology; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2003; Project Start 15-JUL-2003; Project End 30-JUN-2006

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Summary: (provided by applicant): The long-term objectives of our work are to establish an MR imaging technique to detect early changes of psoriaticarthritis (PsA) in the hand, and use that technique to improve our understanding of the disease mechanism and the effect of early treatment on the outcome of the disease. The recent work showed detection of lesions and cortical erosions with fat suppressed T2 weighted MRI have a significant role in the early stage of the disease, The purpose of this work is to advance the MR imaging technology to allow the detection of small lesions and early bone erosions in Spa in the hand. The specific aims of this work are: 1) to develop specifically designed phased arramy RF receiver coils for the hand and fingers to provide high signal sensitivity for high-resolution imaging of these specific anatomies; 2) to develop MR pulse sequences that improve fat suppression while acquiring both fat suppressed and non-fat suppressed images in a single scan time; 3) to evaluate the effect of chemical shift artifact elimination on the accurate measurements of anatomic structures and lesions in hand and fingers; 4) to conduct pilot evaluation of the usefulness of the new RF coil and pulse sequence technology in the detection of lesions in Spa patients. To accomplish our goal we will use our previous experience on phased array RF receiver coils to the design of special coils for the hand and for the fingers. Those coils will be tested on phantoms and normal subjects, and suitable ones will be used for further studies. The new pulse sequence development to acquire separate water and fat data in a single imaging time will be based on our preliminary experience in interleaved water and fat 3D gradient recall echo and 2D spin echo sequence development using spatial spectral excitation pulses. This will be further implemented on 2D spin echo, and 2D and 3Dfast spin echo sequences. We will develop post-processing algorithms to reconstruct water-only, fat-only and water plus-fat images from the acquired data. The new sequences will be tested on phantoms and normal subjects and their performance will be compared to that of the existing sequences. Fifteen patients with PsA as determined by plain film X-ray of the hand will be imaged using our new MRI technology to test its usefulness to detect PsA lesions. After completion of this study we will have the technology to detect early changes in PsA. This technology will allow us to start the clinical evaluation of the disease mechanism and the long-term effect of early treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: OSTEOCLASTIC BONE RESORPTION IN PSORIATIC ARTHRITIS Principal Investigator & Institution: Ritchlin, Christopher T.; Medicine; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2002; Project Start 01-SEP-2001; Project End 31-AUG-2004 Summary: Psoriatic Arthritis is an inflammatory joint disease that can lead to chronic pain and disability. Joint destruction can be extensive and unique patterns of subchondral bone erosion have been noted but the mechanisms that underlie these changes are poorly understood. The overall goal of this project is for the Principal Investigator to develop the research skills necessary to become an independently funded investigator in patient-oriented research by studying osteoclast biology and bone resorption in the psoriatic joint under the mentorship of accomplished investigators in the field. In addition, protected time will allow the investigator to purse a Masters Degree in Public Health with a concentration in Clinical Investigation. These skills will be applied to defining the underlying mechanisms of bone resorption in psoriatic arthritis. Based on preliminary data from our laboratory, we hypothesize that: 1. Activated osteoclasts mediate focal bone resorption in the psoriatic joint. 2. Psoriatic synovial lining cells promote osteoclast differentiation and activation in adjacent bone

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through the expression of receptor activator of NFKB ligand (RANKL) which binds to its receptor RANK on the surface of osteoclasts and osteoclast precursors. 3. The circulating osteoclast precursor population is expanded in the peripheral blood of patients with PsA. 4. Treatment of PsA patients with the soluble TNF-p75 fusion protein (etanercept) will lessen joint inflammation and bone resorption through direct inhibition of TNF-a and down-regulation of TNF-mediated RANKL expression. To test these hypotheses we plan to perform studies with the following Specific Aims: 1. To demonstrate presence of osteoclasts at sites of bone resorption in PsA. 2. To define the expression pattern of TNF-a, RANK, RANKL and osteoprotegerin (OPG) in the psoriatic joint. 3. To determine if osteoclast precursors are expanded in the peripheral blood of patients with PsA. 4. To determine the effects of etanercept on inflammation, bone erosion, RANK and RANKL expression and circulating osteoclast precursor frequency as monitored by serial gadolinium enhanced MRI. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THERAPY IN PSORIATIC ARTHRITIS--AN OPEN TRIAL OF 1,25 DIHYDROXYCHOLECALCIFEROL Principal Investigator & Institution: Felson, David; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: UAB AUTOIMMUNITY CENTER FOR EXCELLENCE Principal Investigator & Institution: Carter, Robert H.; Associate Professor; Medicine; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-MAR-2008 Summary: (provided by applicant): The University of Alabama at Birmingham (UAB) has an outstanding record in basic immunology and in testing of novel, translational therapies for autoimmune diseases. The UAB Autoimmunity Center of Excellence (ACE) is a multidisciplinary, collaborative program to unite these strengths to accelerate the development and testing of translational therapies for autoimmune disease. To accomplish this, the UAB ACE will promote basic and translational research and sponsor clinical trials of novel immunomodulatory agents. As part of this mission, the UAB ACE will foster communication between basic and clinical investigators and between those focused on different immune-mediated diseases at UAB and nationally. Four projects are proposed. The Clinical Component (Project 1) includes highly experienced investigators from six clinical areas. Two potential clinical trials are proposed, targeting Death Receptor 5 in Lupus, an approach developed at UAB, and IL1 in psoriatic arthritis, using a high affinity blocker brought to UAB investigators by the pharmaceutical industry. Three basic projects center on the unifying theme of analysis of the interaction of T cells and cytokines and/or TNF-family factors in maintenance or restoration of tolerance, including: Project 2) function of Death Receptor 5 on activated T cells in autoimmunity, Project 3) the role of cytokines and TNF-family proteins in reconstitution of T cell tolerance after immunosuppression, and Project 4) the function of IL10-expressing T cells in tolerance in mucosal immunity. The interactive nature of these projects is illustrated by the fact that each basic project involves assays or models derived from at least one of the others. The Administrative Core will coordinate ACE activities, facilitate interactions and collaborations, promote scientific development, set

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the strategic agenda, and perform continuous evaluation of ongoing projects. The Immunomodulatory Studies Core will promote analysis of changes in cells or cytokines in human tissues in disease and in mechanistic studies of participants receiving biologic therapies. Both cores will serve all proposed projects. Thus, the ACE will unite UAB investigators to bring the strength of immunological research and the breath of experience in clinical trials in a range of immune-mediated diseases to jointly develop new therapies for autoimmunity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: UNIVERSITY OF MICHIGAN RHEUMATIC DISEASES CORE CENTER Principal Investigator & Institution: Fox, David A.; Professor; Internal Medicine; University of Michigan at Ann Arbor 3003 South State, Room 1040 Ann Arbor, Mi 481091274 Timing: Fiscal Year 2002; Project Start 28-SEP-2001; Project End 31-JUL-2006 Summary: The University of Michigan proposes to establish a Rheumatic Disease Core Center. This will be a broadly based effort involving approximately 80 faculty from clinical and basic science departments at the University of Michigan and neighboring institutions. The Center will apply a broad range of research skills, backgrounds, and approaches to investigation of fundamental issues in the etiology and pathogenesis of rheumatic diseases and in development of a scientific basis for novel therapeutics. The Center will focus its activities by grouping investigators in four Major Programs (Model Systems for Innovative Therapeutics, Autoimmunity, Cell and Cytokine Interactions in Organ Inflammation and Damage, and Genetics and Patterns of Gene Expression in the Rheumatic Diseases); and also in Disease Focused Working Groups (Osteoarthritis, Psoriasis/Psoriatic Arthritis, Rheumatoid Arthritis and Systemic Lupus Erythematosis). Activities of the Center will be supported by six Biomedical Core Facilities including Flow Cytometry, Hybridoma, Vector, Transgenic Animal, Protein Structure and DNA Sequencing Cores. UM-RDCC faculty will have access to core services for rheumatic disease-related research at substantially discounted recharge rates. Two Pilot and Feasibility Projected are proposed, each of which is led by new faculty recently recruited to the University of Michigan. The UM-RDCC and its administrative unit will be directed by David A. Fox, M.D., who is experienced in administration of a broadly based Center through more than ten years directing the University of Michigan Multipurpose Arthritis and Musculoskeletal Diseases Center. Rory Marks, M.D., Associate Professor of Rheumatology is proposed as the UM-RDCC Associate Director, with special responsibilities for supervision of the biomedical cores. The Center leadership will maintain close links between the basic research activities of the UMRDCC and expanding clinical investigation in the rheumatic diseases at the University of Michigan. The Center's administrative team will be assisted by an Executive Committee, an Internal Advisory Committee, and an External Scientific Advisor, Dr. Bennis Carson. We have constructed the UM- RDCC to maximally engage the talents and resources of the University of Michigan to focus on basic research in the rheumatic diseases in the rheumatic diseases, so as to achieve substantial progress in improving understanding of etiology, pathogenesis and treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “psoriatic arthritis” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for psoriatic arthritis in the PubMed Central database: •

Genetic epidemiology: Psoriatic arthritis. by Barton AC.; 2002; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=128931

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Mechanisms of TNF-[alpha] -- and RANKL-mediated osteoclastogenesis and bone resorption in psoriatic arthritis. by Ritchlin CT, Haas-Smith SA, Li P, Hicks DG, Schwarz EM.; 2003 Mar 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=153764

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

3 4

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

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

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A comparison of cyclosporine, sulfasalazine, and symptomatic therapy in the treatment of psoriatic arthritis. Author(s): Salvarani C, Macchioni P, Olivieri I, Marchesoni A, Cutolo M, Ferraccioli G, Cantini F, Salaffi F, Padula A, Lovino C, Dovigo L, Bordin G, Davoli C, Pasero G, Alberighi OD. Source: The Journal of Rheumatology. 2001 October; 28(10): 2274-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11669169

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A comparison of ultrasonography and magnetic resonance imaging in the evaluation of temporomandibular joint involvement in rheumatoid arthritis and psoriatic arthritis. Author(s): Melchiorre D, Calderazzi A, Maddali Bongi S, Cristofani R, Bazzichi L, Eligi C, Maresca M, Ciompi M. Source: Rheumatology (Oxford, England). 2003 May; 42(5): 673-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12709544

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A double-blind placebo controlled trial of Efamol Marine on skin and joint symptoms of psoriatic arthritis. Author(s): Veale DJ, Torley HI, Richards IM, O'Dowd A, Fitzsimons C, Belch JJ, Sturrock RD. Source: British Journal of Rheumatology. 1994 October; 33(10): 954-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7921757

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A family with cases of adult onset Still's disease and psoriatic arthritis. Author(s): Maeda H, Konishi F, Hiyama K, Ishioka S, Yamakido M. Source: Intern Med. 2000 January; 39(1): 77-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10674856

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A host of novel agents for treating psoriasis, psoriatic arthritis stir interest. Author(s): Lamberg L. Source: Jama : the Journal of the American Medical Association. 2003 June 4; 289(21): 2779-80, 2783. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12783895

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A method to score radiographic change in psoriatic arthritis. Author(s): Wassenberg S, Fischer-Kahle V, Herborn G, Rau R. Source: Zeitschrift Fur Rheumatologie. 2001 June; 60(3): 156-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11475603

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A polyarticular onset predicts erosive and deforming disease in psoriatic arthritis. Author(s): Queiro-Silva R, Torre-Alonso JC, Tinture-Eguren T, Lopez-Lagunas I. Source: Annals of the Rheumatic Diseases. 2003 January; 62(1): 68-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12480674

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A preliminary study of etanercept in the treatment of severe, resistant psoriatic arthritis. Author(s): Yazici Y, Erkan D, Lockshin MD. Source: Clin Exp Rheumatol. 2000 November-December; 18(6): 732-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11138337

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A prospective, clinical and radiological study of early psoriatic arthritis: an early synovitis clinic experience. Author(s): Kane D, Stafford L, Bresnihan B, FitzGerald O. Source: Rheumatology (Oxford, England). 2003 December; 42(12): 1460-8. Epub 2003 October 01. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14523223

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A susceptibility gene for psoriatic arthritis maps to chromosome 16q: evidence for imprinting. Author(s): Karason A, Gudjonsson JE, Upmanyu R, Antonsdottir AA, Hauksson VB, Runasdottir EH, Jonsson HH, Gudbjartsson DF, Frigge ML, Kong A, Stefansson K, Valdimarsson H, Gulcher JR. Source: American Journal of Human Genetics. 2003 January; 72(1): 125-31. Epub 2002 December 09. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12474146

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Absence of pulmonary fibrosis in patients with psoriatic arthritis treated with weekly low-dose methotrexate. Author(s): Belzunegui J, Intxausti JJ, De Dios JR, Lopez-Dominguez L, Queiro R, Gonzalez C, Figueroa M. Source: Clin Exp Rheumatol. 2001 November-December; 19(6): 727-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11791648

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Accuracy of self-reported family history in psoriatic arthritis. Author(s): Rahman P, Beaton M, Schentag CT, Gladman DD. Source: The Journal of Rheumatology. 2000 March; 27(3): 824-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10743838

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Adhesion molecule expression in the synovial membrane of psoriatic arthritis. Author(s): Riccieri V, Spadaro A, Taccari E, Zoppini A, Koo E, Ortutay J, Sesztak M, Markus I. Source: Annals of the Rheumatic Diseases. 2002 June; 61(6): 569-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12006343

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Alefacept treatment in psoriatic arthritis: reduction of the effector T cell population in peripheral blood and synovial tissue is associated with improvement of clinical signs of arthritis. Author(s): Kraan MC, van Kuijk AW, Dinant HJ, Goedkoop AY, Smeets TJ, de Rie MA, Dijkmans BA, Vaishnaw AK, Bos JD, Tak PP. Source: Arthritis and Rheumatism. 2002 October; 46(10): 2776-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12384938

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Ankylosing spondylitis, psoriatic arthritis, and reactive arthritis show increased bone resorption, but differ with regard to bone formation. Author(s): Grisar J, Bernecker PM, Aringer M, Redlich K, Sedlak M, Wolozcszuk W, Spitzauer S, Grampp S, Kainberger F, Ebner W, Smolen JS, Pietschmann P. Source: The Journal of Rheumatology. 2002 July; 29(7): 1430-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12136902

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Antimalarials in the management of psoriatic arthritis? Author(s): Gordon MM, Sturrock RD. Source: Clin Exp Rheumatol. 2002 January-February; 20(1): 117. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11892699

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Anti-tumor necrosis factor alpha therapy in psoriatic arthritis and psoriasis. Author(s): Girolomoni G, Abeni D. Source: Archives of Dermatology. 2001 June; 137(6): 784-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11405771

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Assessing periarticular bone mineral density in patients with early psoriatic arthritis or rheumatoid arthritis. Author(s): Harrison BJ, Hutchinson CE, Adams J, Bruce IN, Herrick AL. Source: Annals of the Rheumatic Diseases. 2002 November; 61(11): 1007-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12379525

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Assessment of patients with psoriatic arthritis: a review of currently available measures. Author(s): Gladman DD, Helliwell P, Mease PJ, Nash P, Ritchlin C, Taylor W. Source: Arthritis and Rheumatism. 2004 January; 50(1): 24-35. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14730596

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Asymptomatic erosive peripheral psoriatic arthritis: a frequent finding in Italian patients. Author(s): Palazzi C, D'Agostino L, D'Amico E, Pennese E, Petricca A. Source: Rheumatology (Oxford, England). 2003 July; 42(7): 909-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12826714

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Bactericidal/permeability increasing protein and proinflammatory cytokines in synovial fluid of psoriatic arthritis. Author(s): Punzi L, Peuravuori H, Jokilammi-Siltanen A, Bertazzolo N, Nevalainen TJ. Source: Clin Exp Rheumatol. 2000 September-October; 18(5): 613-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11072604

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Balneotherapy at the Dead Sea area for patients with psoriatic arthritis and concomitant fibromyalgia. Author(s): Sukenik S, Baradin R, Codish S, Neumann L, Flusser D, Abu-Shakra M, Buskila D. Source: Isr Med Assoc J. 2001 February; 3(2): 147-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11344827

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Baseline relationships between psoriasis and psoriatic arthritis: analysis of 221 patients with active psoriatic arthritis. Department of Veterans Affairs Cooperative Study Group on Seronegative Spondyloarthropathies. Author(s): Cohen MR, Reda DJ, Clegg DO. Source: The Journal of Rheumatology. 1999 August; 26(8): 1752-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10451073

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Bilateral Baker's cyst in a patient with psoriatic arthritis of pediatric onset. Author(s): Lepore L, Rabusin M, Pennesi M, Randi M, Brizzi F. Source: Clin Exp Rheumatol. 1996 January-February; 14(1): 109-10. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8697649

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Bilateral upper limb lymphoedema associated with psoriatic arthritis: a case report and review of the literature. Author(s): Bohm M, Riemann B, Luger TA, Bonsmann G. Source: The British Journal of Dermatology. 2000 December; 143(6): 1297-301. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11122038

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Blue coloured skin in psoriatic arthritis. Author(s): Jajic I. Source: Clin Exp Rheumatol. 2001 July-August; 19(4): 478. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11491513

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Blue-coloured skin over involved joints in psoriatic arthritis. Author(s): Jajic J. Source: Clinical Rheumatology. 2001; 20(4): 304-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11529647

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Bone involvement in psoriatic arthritis. Author(s): Nolla JM, Fiter J, Rozadilla A, Gomez-Vaquero C. Source: The Journal of Rheumatology. 2002 May; 29(5): 1108-9; Author Reply 1109. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12022337

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Bone involvement in psoriatic arthritis. Author(s): Cortet B, Trouve MH, Flipo RM. Source: The Journal of Rheumatology. 2002 May; 29(5): 1107-8; Author Reply 1109. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12022336

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Bone mineral density in patients with peripheral psoriatic arthritis. Author(s): Nolla JM, Fiter J, Rozadilla A, Gomez-Vaquero C, Mateo L, RodriguezMoreno J, Roig-Escofet D. Source: Rev Rhum Engl Ed. 1999 October; 66(10): 457-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10567973

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Bone mineral density in patients with psoriatic arthritis. Author(s): Frediani B, Allegri A, Falsetti P, Storri L, Bisogno S, Baldi F, Filipponi P, Marcolongo R. Source: The Journal of Rheumatology. 2001 January; 28(1): 138-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11196516

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CARD15: a pleiotropic autoimmune gene that confers susceptibility to psoriatic arthritis. Author(s): Rahman P, Bartlett S, Siannis F, Pellett FJ, Farewell VT, Peddle L, Schentag CT, Alderdice CA, Hamilton S, Khraishi M, Tobin Y, Hefferton D, Gladman DD. Source: American Journal of Human Genetics. 2003 September; 73(3): 677-81. Epub 2003 July 23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12879366

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Characterization of changes in IgG associated oligosaccharide profiles in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis using fluorophore linked carbohydrate electrophoresis. Author(s): Martin K, Talukder R, Hay FC, Axford JS. Source: The Journal of Rheumatology. 2001 July; 28(7): 1531-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11469458

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Clinical and genetic aspects of psoriatic arthritis “sine psoriasis”. Author(s): Scarpa R, Cosentini E, Manguso F, Oriente A, Peluso R, Atteno M, Ayala F, D'Arienzo A, Oriente P. Source: The Journal of Rheumatology. 2003 December; 30(12): 2638-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14719207

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Clinical and radiological changes during psoriatic arthritis disease progression. Author(s): Khan M, Schentag C, Gladman DD. Source: The Journal of Rheumatology. 2003 May; 30(5): 1022-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12734899

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Clinical assessment of sacroiliitis and HLA-B27 are poor predictors of sacroiliitis diagnosed by magnetic resonance imaging in psoriatic arthritis. Author(s): Williamson L, Dockerty JL, Dalbeth N, McNally E, Ostlere S, Wordsworth BP. Source: Rheumatology (Oxford, England). 2004 January; 43(1): 85-8. Epub 2003 September 16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13130147

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Clinical features and predictive factors in psoriatic arthritis-related uveitis. Author(s): Queiro R, Torre JC, Belzunegui J, Gonzalez C, De Dios JR, Unanue F, Figueroa M. Source: Seminars in Arthritis and Rheumatism. 2002 February; 31(4): 264-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11836659

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Clinical features of late onset psoriatic arthritis. Author(s): Lopez-Montilla MD, Gonzalez J, Martinez FG, Fernandez-Moreno JR, Collantes E. Source: Experimental Gerontology. 2002 January-March; 37(2-3): 441-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11772531

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Clinical features of psoriatic arthritis. Author(s): Krueger GG. Source: Am J Manag Care. 2002 April; 8(6 Suppl): S160-70. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11990861

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Comparison of disability and quality of life in rheumatoid and psoriatic arthritis. Author(s): Sokoll KB, Helliwell PS. Source: The Journal of Rheumatology. 2001 August; 28(8): 1842-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11508587

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Comparison of radiological severity in psoriatic arthritis and rheumatoid arthritis. Author(s): Rahman P, Nguyen E, Cheung C, Schentag CT, Gladman DD. Source: The Journal of Rheumatology. 2001 May; 28(5): 1041-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11361186

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Co-occurrence of psoriatic arthritis with collagenous colitis: clinicopathologic findings of a case. Author(s): Taccari E, Spada S, Giuliani A, Riccieri V, Sorgi ML, Pecorella I, Onetti Muda A. Source: Clinical Rheumatology. 2002 August; 21(4): 335-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12189467

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Coping strategies and affect in rheumatoid and psoriatic arthritis. Relationship to pain and disability. Author(s): Stewart MW, Knight RG. Source: Arthritis Care and Research : the Official Journal of the Arthritis Health Professions Association. 1991 September; 4(3): 116-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11188596

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Current concepts and new developments in the treatment of psoriatic arthritis. Author(s): Pipitone N, Kingsley GH, Manzo A, Scott DL, Pitzalis C. Source: Rheumatology (Oxford, England). 2003 October; 42(10): 1138-48. Epub 2003 June 16. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12810935

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Current concepts in psoriatic arthritis. Author(s): Gladman DD. Source: Current Opinion in Rheumatology. 2002 July; 14(4): 361-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12118168

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Current perspectives in the recognition and management of psoriatic arthritis: implications for integrated patient care. Author(s): Ruderman EM. Source: Am J Manag Care. 2002 April; 8(6 Suppl): S171-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11990862

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Current treatment of psoriatic arthritis. Author(s): Mease PJ. Source: Rheumatic Diseases Clinics of North America. 2003 August; 29(3): 495-511. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12951864

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Cutting edge: susceptibility to psoriatic arthritis: influence of activating killer Ig-like receptor genes in the absence of specific HLA-C alleles. Author(s): Martin MP, Nelson G, Lee JH, Pellett F, Gao X, Wade J, Wilson MJ, Trowsdale J, Gladman D, Carrington M. Source: Journal of Immunology (Baltimore, Md. : 1950). 2002 September 15; 169(6): 281822. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12218090

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Cyclosporin treatment in psoriatic arthritis: a cause of severe leg pain. Author(s): Lawson CA, Fraser A, Veale DJ, Emery P. Source: Annals of the Rheumatic Diseases. 2003 May; 62(5): 489. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12695169

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Cytokine blockers in psoriatic arthritis. Author(s): Mease PJ. Source: Annals of the Rheumatic Diseases. 2001 November; 60 Suppl 3: Iii37-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11890650

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Cytokine gene polymorphisms: association with psoriatic arthritis susceptibility and severity. Author(s): Balding J, Kane D, Livingstone W, Mynett-Johnson L, Bresnihan B, Smith O, FitzGerald O. Source: Arthritis and Rheumatism. 2003 May; 48(5): 1408-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12746914

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Determination of tissue kallikrein and alpha 1-antitrypsin-tissue kallikrein complexes in synovial fluid of patients with rheumatoid, osteo and psoriatic arthritis. Author(s): Rahman MM, Worthy K, Elson CJ, Dieppe PA, Bhoola KD. Source: Agents Actions Suppl. 1992; 38 ( Pt 3): 389-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1462872

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Development and early experiences of a Swedish psoriatic arthritis register. Author(s): Svensson B, Holmstrom G, Lindqvist U; Psoriatric Arthritis Register Group of the Swedish Society for Rheumatology. Source: Scandinavian Journal of Rheumatology. 2002; 31(4): 221-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12369654

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Development of the PsAQoL: a quality of life instrument specific to psoriatic arthritis. Author(s): McKenna SP, Doward LC, Whalley D, Tennant A, Emery P, Veale DJ. Source: Annals of the Rheumatic Diseases. 2004 February; 63(2): 162-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14722205

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Diagnosis and management of psoriatic arthritis. Author(s): Brockbank J, Gladman D. Source: Drugs. 2002; 62(17): 2447-57. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12421102

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Diagnostic overview. Psoriatic arthritis. Author(s): Althoff DG. Source: Orthopaedic Nursing / National Association of Orthopaedic Nurses. 1983 September-October; 2(5): 50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6560379

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Differences in the expression of spondyloarthropathy: a comparison between ankylosing spondylitis and psoriatic arthritis. Author(s): Gladman DD, Brubacher B, Buskila D, Langevitz P, Farewell VT. Source: Clinical and Investigative Medicine. Medecine Clinique Et Experimentale. 1993 February; 16(1): 1-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8467576

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Differential association of polymorphisms in the TNFalpha region with psoriatic arthritis but not psoriasis. Author(s): Hohler T, Grossmann S, Stradmann-Bellinghausen B, Kaluza W, Reuss E, de Vlam K, Veys E, Marker-Hermann E. Source: Annals of the Rheumatic Diseases. 2002 March; 61(3): 213-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11830425

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Differentiation between psoriatic arthritis and rheumatoid arthritis: a biochemical and statistical analysis of fingernail amino acids. Author(s): Greaves MS, Fieller NR, Moll JM. Source: Scandinavian Journal of Rheumatology. 1979; 8(1): 33-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=432560

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Digital denervation associated with absence of nail and distal interphalangeal joint involvement in psoriatic arthritis. Author(s): Mulherin D, Bresnihan B, FitzGerald O. Source: The Journal of Rheumatology. 1995 June; 22(6): 1211-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7674263

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Discovertebral erosions and destruction in psoriatic arthritis. Author(s): Scarpa R. Source: The Journal of Rheumatology. 2000 April; 27(4): 975-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10782825

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Disease manifestations and HLA antigens in psoriatic arthritis in northern Sweden. Author(s): Alenius GM, Jidell E, Nordmark L, Rantapaa Dahlqvist S. Source: Clinical Rheumatology. 2002 September; 21(5): 357-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12223981

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Disease mechanisms in psoriasis and psoriatic arthritis. Author(s): Costello P, FitzGerald O. Source: Curr Rheumatol Rep. 2001 October; 3(5): 419-27. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11564374

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Disease-modifying antirheumatic drug therapy for psoriatic arthritis. Author(s): Salvarani C, Cantini F, Olivieri I. Source: Clin Exp Rheumatol. 2002 November-December; 20(6 Suppl 28): S71-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12463452

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Distal extremity swelling with pitting edema in psoriatic arthritis: a case-control study. Author(s): Cantini F, Salvarani C, Olivieri I, Macchioni L, Niccoli L, Padula A, Falcone C, Boiardi L, Bozza A, Barozzi L, Pavlica P. Source: Clin Exp Rheumatol. 2001 May-June; 19(3): 291-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11407082

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Distal extremity swelling with pitting edema in psoriatic arthritis: evidence of 2 pathological mechanisms. Author(s): Salvarani C, Cantini F, Olivieri I, Niccoli L, Senesi C, Macchioni L, Boiardi L, Padula A. Source: The Journal of Rheumatology. 1999 August; 26(8): 1831-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10451085

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Do viruses play an etiologic role in ankylosing spondylitis or psoriatic arthritis? Author(s): Luxembourg A, Cailla H, Roux H, Roudier J. Source: Clinical Immunology and Immunopathology. 1987 November; 45(2): 292-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3665203

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Does early and aggressive treatment improve the prognosis in psoriatic arthritis? Comment on the article by Wong et al. Author(s): Brockbank J, Leach M, Snaith M, Adebajo A. Source: Arthritis and Rheumatism. 1999 January; 42(1): 189. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9920032

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Does injectable gold retard radiologic evidence of joint damage in psoriatic arthritis? Author(s): Mader R, Gladman DD, Long J, Gough J, Farewell VT. Source: Clinical and Investigative Medicine. Medecine Clinique Et Experimentale. 1995 April; 18(2): 139-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7788959

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Double disease in rheumatology: coexistence of rheumatoid arthritis and psoriatic arthritis. Author(s): Mazzucchelli R, Yebra M, Barbadillo C, Berrocal E, Gea JC, Andreu-Sanchez JL. Source: Clin Exp Rheumatol. 1992 January-February; 10(1): 83-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1551285

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Drug-induced peripheral neuropathy in a patient with psoriatic arthritis. Author(s): Rothenberg RJ, Sufit RL. Source: Arthritis and Rheumatism. 1987 February; 30(2): 221-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3030337

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Echographic test and cyclosporin therapy in psoriatic arthritis. Author(s): Stefano I, Eugenio R, Antonio R. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2000 May; 14(3): 232-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11032079

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Effectiveness of psoriatic arthritis therapies. Author(s): Gladman DD. Source: Seminars in Arthritis and Rheumatism. 2003 August; 33(1): 29-37. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12920694

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Efficacy of infliximab in psoriatic arthritis resistant to treatment with disease modifying antirheumatic drugs: an open pilot study. Author(s): Provenzano G, Termini A, Le Moli C, Rinaldi F. Source: Annals of the Rheumatic Diseases. 2003 July; 62(7): 680-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12810436

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Efficacy of infliximab in resistant psoriatic arthritis. Author(s): Salvarani C, Cantini F, Olivieri I, Macchioni P, Padula A, Niccoli L, Catanoso MG, Scocco GL, Boiardi L. Source: Arthritis and Rheumatism. 2003 August 15; 49(4): 541-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12910561

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Elevated anticardiolipin antibodies in a patient with vibration-white-finger, valvular heart disease and psoriatic arthritis. Author(s): McHugh NJ, Elvins DM, Ring EF. Source: Clinical Rheumatology. 1993 March; 12(1): 70-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8467615

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Endomysial antibodies in psoriatic arthritis patients. Author(s): Dockerty JL, Williamson L, Wordsworth BP. Source: Rheumatology (Oxford, England). 2002 October; 41(10): 1195-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12364645

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Enthesitis of the elbow in psoriatic arthritis. Author(s): Taylor PW, Stoecker W. Source: The Journal of Rheumatology. 1997 November; 24(11): 2268-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9375901

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Epidemiology of psoriatic arthritis in northwest Greece, 1982-2001. Author(s): Alamanos Y, Papadopoulos NG, Voulgari PV, Siozos C, Psychos DN, Tympanidou M, Drosos AA. Source: The Journal of Rheumatology. 2003 December; 30(12): 2641-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14719208

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Epidemiology of psoriatic arthritis. Author(s): Taylor WJ. Source: Current Opinion in Rheumatology. 2002 March; 14(2): 98-103. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11845012

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Etanercept for severe psoriasis and psoriatic arthritis: observations on combination therapy. Author(s): Davison SC, Bunker CB, Basarab T. Source: The British Journal of Dermatology. 2002 October; 147(4): 831-2; Author Reply 832. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12366452

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Etanercept for severe psoriasis and psoriatic arthritis: observations on combination therapy. Author(s): Iyer S, Yamauchi P, Lowe NJ. Source: The British Journal of Dermatology. 2002 January; 146(1): 118-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11841377

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Etanercept for the treatment of human immunodeficiency virus-associated psoriatic arthritis. Author(s): Aboulafia DM, Bundow D, Wilske K, Ochs UI. Source: Mayo Clinic Proceedings. 2000 October; 75(10): 1093-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11040859

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Etanercept in the treatment of psoriatic arthritis and psoriasis: a randomised trial. Author(s): Mease PJ, Goffe BS, Metz J, VanderStoep A, Finck B, Burge DJ. Source: Lancet. 2000 July 29; 356(9227): 385-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10972371

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Etanercept in the treatment of severe, resistant psoriatic arthritis: continued efficacy and changing patterns of use after two years. Author(s): Yazici Y, Erkan D, Lockshin MD. Source: Clin Exp Rheumatol. 2002 January-February; 20(1): 115. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11892697

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Etanercept, a TNF antagonist for treatment for psoriatic arthritis and psoriasis. Author(s): Mease PJ. Source: Skin Therapy Letter. 2003 January; 8(1): 1-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12728284

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Etanercept: a new era in the treatment of psoriatic arthritis. Author(s): Mease PJ. Source: Am J Manag Care. 2002 April; 8(6 Suppl): S181-93. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11990863

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Etanercept: an updated review of its use in rheumatoid arthritis, psoriatic arthritis and juvenile rheumatoid arthritis. Author(s): Culy CR, Keating GM. Source: Drugs. 2002; 62(17): 2493-537. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12421111

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Evaluation and management of psoriatic arthritis: the role of biologic therapy. Author(s): Ruderman EM. Source: Journal of the American Academy of Dermatology. 2003 August; 49(2 Suppl): S125-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12894136

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Excessive paternal transmission in psoriatic arthritis. Author(s): Rahman P, Gladman DD, Schentag CT, Petronis A. Source: Arthritis and Rheumatism. 1999 June; 42(6): 1228-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10366116

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Expression of the pro-inflammatory protein S100A12 (EN-RAGE) in rheumatoid and psoriatic arthritis. Author(s): Foell D, Kane D, Bresnihan B, Vogl T, Nacken W, Sorg C, Fitzgerald O, Roth J. Source: Rheumatology (Oxford, England). 2003 November; 42(11): 1383-9. Epub 2003 June 27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12832707

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F-18 FDG uptake in a patient with psoriatic arthritis: imaging correlation with patient symptoms. Author(s): Yun M, Kim W, Adam LE, Alnafisi N, Herman C, Alavi A. Source: Clinical Nuclear Medicine. 2001 August; 26(8): 692-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11452176

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Familial occurrence of psoriatic arthritis. Author(s): Moll JM, Wright V. Source: Annals of the Rheumatic Diseases. 1973 May; 32(3): 181-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4715537

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Fascia lata interpositional arthroplasty in the treatment of temporomandibular joint ankylosis caused by psoriatic arthritis. Author(s): Paterson AW, Shepherd JP. Source: International Journal of Oral and Maxillofacial Surgery. 1992 June; 21(3): 137-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1640124

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Fatty acids and antioxidant micronutrients in psoriatic arthritis. Author(s): Azzini M, Girelli D, Olivieri O, Guarini P, Stanzial AM, Frigo A, Milanino R, Bambara LM, Corrocher R. Source: The Journal of Rheumatology. 1995 January; 22(1): 103-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7699656

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Fibroblast function in psoriatic arthritis. I. Alteration of cell kinetics and growth factor responses. Author(s): Espinoza LR, Aguilar JL, Espinoza CG, Cuellar ML, Scopelitis E, Silveira LH. Source: The Journal of Rheumatology. 1994 August; 21(8): 1502-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7983654

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Fibroblast function in psoriatic arthritis. II. Increased expression of beta platelet derived growth factor receptors and increased production of growth factor and cytokines. Author(s): Espinoza LR, Espinoza CG, Cuellar ML, Scopelitis E, Silveira LH, Grotendorst GR. Source: The Journal of Rheumatology. 1994 August; 21(8): 1507-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7983655

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Flare of psoriasis and psoriatic arthritis following treatment with granulocyte colonystimulating factor. Author(s): Kavanaugh A. Source: The American Journal of Medicine. 1996 November; 101(5): 567-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8948284

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Folic acid and cyanocobalamin levels in serum and erythrocytes during low-dose methotrexate therapy of rheumatoid arthritis and psoriatic arthritis patients. Author(s): Leeb BF, Witzmann G, Ogris E, Studnicka-Benke A, Andel I, Schweitzer H, Smolen JS. Source: Clin Exp Rheumatol. 1995 July-August; 13(4): 459-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7586777

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Followup in psoriatic arthritis: relationship to disease characteristics. Author(s): Brubacher B, Gladman DD, Buskila D, Langevitz P, Farewell VT. Source: The Journal of Rheumatology. 1992 June; 19(6): 917-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1404129

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Frequency of HLA antigens in patients with psoriasis or psoriatic arthritis. Author(s): McKendry RJ, Sengar DP, DesGroseilliers JP, Dunne JV. Source: Can Med Assoc J. 1984 February 15; 130(4): 411-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6692237

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Frequency of psoriatic arthritis in general population and among the psoriatics in Department of Dermatology. Author(s): Barisic-Drusko V, Dobric I, Pasic A, Paljan D, Jukic Z, Basta-Juzbasic A, Marinovic B. Source: Acta Derm Venereol Suppl (Stockh). 1994; 186: 107-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8073803

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From wheels to feet: a dramatic response of severe chronic psoriatic arthritis to etanercept. Author(s): ElKayam O, Yaron M, Caspi D. Source: Annals of the Rheumatic Diseases. 2000 October; 59(10): 839. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11203155

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Fructose-induced hyperuricemia in psoriasis and psoriatic arthritis. Author(s): Maso G, Baggio B, Tonon R, Fiocco U, Gambari PF, Todesco S. Source: Clin Exp Rheumatol. 1983 April-June; 1(2): 149-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6681134

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Fumaric acid therapy for psoriatic arthritis. A randomized, double-blind, placebocontrolled study. Author(s): Peeters AJ, Dijkmans BA, van der Schroeff JG. Source: British Journal of Rheumatology. 1992 July; 31(7): 502-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1628175

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Gastrointestinal amyloidosis in psoriatic arthritis. Author(s): Ferguson A, Downie WW. Source: Annals of the Rheumatic Diseases. 1968 May; 27(3): 245-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5655315

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Gastrointestinal-related arthritis and psoriatic arthritis. Author(s): Gladman D. Source: Current Opinion in Rheumatology. 1991 August; 3(4): 575-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1911052

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Gelatinase expression and activity in the synovium and skin of patients with erosive psoriatic arthritis. Author(s): Hitchon CA, Danning CL, Illei GG, El-Gabalawy HS, Boumpas DT. Source: The Journal of Rheumatology. 2002 January; 29(1): 107-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11824946

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Generalised pustular psoriasis, psoriatic arthritis and nephrotic syndrome associated with systemic amyloidosis. Author(s): David M, Abraham D, Weinberger A, Feuerman EJ. Source: Dermatologica. 1982 September; 165(3): 168-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7128885

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Genetic epidemiology. Psoriatic arthritis. Author(s): Barton AC. Source: Arthritis Research. 2002; 4(4): 247-51. Epub 2002 January 31. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12106495

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Genetic studies of psoriatic arthritis: dissecting joints and skin. Author(s): Barton AC, Bruce IN, Silman AJ. Source: The Journal of Rheumatology. 2001 January; 28(1): 3-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11196539

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Genetics of ankylosing spondylitis, psoriatic arthritis and Reiter's syndrome. Author(s): Moller P. Source: Clin Exp Rheumatol. 1987; 5 Suppl 1: S35-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3498597

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Giant cell arteritis associated with pericarditis and pancreatic insufficiency in a patient with psoriatic arthritis. Author(s): Clementz GL, Gold F, Khaiser N, Zolin WD, Jalovec L. Source: The Journal of Rheumatology. 1989 January; 16(1): 128-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2716001

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Gold salts and somatostatin: a new combined analgesic treatment for psoriatic arthritis. Author(s): Matucci-Cerinic M, Pignone A, Lotti T, Partsch G, Livi R, Cagnoni M. Source: Drugs Exp Clin Res. 1992; 18(2): 53-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1353720

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Gold-induced fulminant colitis in a patient with psoriatic arthritis. Author(s): Lee FY, Lin HY, Pan S, Lin JK, Cheng SF, Tsui CY. Source: Journal of Clinical Gastroenterology. 1988 February; 10(1): 116-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2833542

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Gut inflammation in psoriatic arthritis: a prospective ileocolonoscopic study. Author(s): Schatteman L, Mielants H, Veys EM, Cuvelier C, De Vos M, Gyselbrecht L, Elewaut D, Goemaere S. Source: The Journal of Rheumatology. 1995 April; 22(4): 680-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7791163

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Health-related quality of life of patients with psoriatic arthritis: a comparison with patients with rheumatoid arthritis. Author(s): Husted JA, Gladman DD, Farewell VT, Cook RJ. Source: Arthritis and Rheumatism. 2001 April; 45(2): 151-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11324779

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Hepatitis C virus infection: prevalence in psoriasis and psoriatic arthritis. Author(s): Taglione E, Vatteroni ML, Martini P, Galluzzo E, Lombardini F, Delle Sedie A, Bendinelli M, Pasero G, Bencivelli W, Riente L. Source: The Journal of Rheumatology. 1999 February; 26(2): 370-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9972971

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Herpes simplex hepatitis in a patient with psoriatic arthritis taking prednisone and methotrexate. Report and review of the literature. Author(s): Aboguddah A, Stein HB, Phillips P, Amar J, English R. Source: The Journal of Rheumatology. 1991 September; 18(9): 1406-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1757946

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Heterogenous nuclear RNP C1 and C2 core proteins are targets for an autoantibody found in the serum of a patient with systemic sclerosis and psoriatic arthritis. Author(s): Stanek D, Vencovsky J, Kafkova J, Raska I. Source: Arthritis and Rheumatism. 1997 December; 40(12): 2172-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9416854

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Hidden psoriatic arthritis in seronegative oligoarthritis: a 14-year follow-up study. Author(s): Kaarela K, Mattila J, Lehtinen K, Kotaniemi A, Luukkainen R. Source: Clinical Rheumatology. 1989 December; 8(4): 504-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2612119

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High free and latent collagenase activity in psoriatic arthritis synovial fluid. Author(s): Cawston TE, Clark IM, Hazleman BL. Source: British Journal of Rheumatology. 1995 January; 34(1): 83-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7881846

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High free and latent collagenase activity in psoriatic arthritis synovial fluids. Author(s): Partsch G, Petera P, Leeb B, Meretey K, Koo E, Dunky A, Broll H, Zamani O, Fertschak W, Matucci-Cerinic M, et al. Source: British Journal of Rheumatology. 1994 August; 33(8): 702-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7519955

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High-density lipoprotein cholesterol in patients with psoriatic arthritis. Author(s): Skoczynska AH, Turczyn B, Barancewicz-Losek M, Martynowicz H. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2003 May; 17(3): 362-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12702094

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Highly increased levels of tumor necrosis factor-alpha and other proinflammatory cytokines in psoriatic arthritis synovial fluid. Author(s): Partsch G, Steiner G, Leeb BF, Dunky A, Broll H, Smolen JS. Source: The Journal of Rheumatology. 1997 March; 24(3): 518-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9058659

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HLA and juvenile psoriatic arthritis. Author(s): Ansell B, Beeson M, Hall P, Bedford P, Woo P. Source: British Journal of Rheumatology. 1993 September; 32(9): 836-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8369900

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HLA antigens in Japanese patients with psoriatic arthritis. Author(s): Muto M, Nagai K, Mogami S, Nakano J, Sasazuki T, Asagami C. Source: Tissue Antigens. 1995 May; 45(5): 362-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7652746

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HLA antigens in psoriatic arthritis subtypes of a Spanish population. Author(s): Lopez-Larrea C, Torre Alonso JC, Rodriguez Perez A, Coto E. Source: Annals of the Rheumatic Diseases. 1990 May; 49(5): 318-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2344212

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HL-A antigens in psoriatic arthritis. Author(s): Karvonen J, Lassus A, Sievers U, Tiilikainen A. Source: Ann Clin Res. 1974 October; 6(5): 304-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4447342

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HLA antigens may influence the age of onset of psoriasis and psoriatic arthritis. Author(s): Queiro R, Torre JC, Gonzalez S, Lopez-Larrea C, Tinture T, Lopez-Lagunas I. Source: The Journal of Rheumatology. 2003 March; 30(3): 505-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12610809

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HLA class II and T cell receptor gene polymorphisms in psoriatic arthritis and psoriasis. Author(s): Sakkas LI, Loqueman N, Bird H, Vaughan RW, Welsh KI, Panayi GS. Source: The Journal of Rheumatology. 1990 November; 17(11): 1487-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2273489

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HLA markers and progression in psoriatic arthritis. Author(s): Gladman DD, Farewell VT, Kopciuk KA, Cook RJ. Source: The Journal of Rheumatology. 1998 April; 25(4): 730-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9558177

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HLA studies in psoriatic arthritis: current situation and future needs. Author(s): Gladman DD, Farewell VT. Source: The Journal of Rheumatology. 2003 January; 30(1): 4-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12508382

Studies

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HLA-C locus alleles in patients with psoriatic arthritis (PsA). Author(s): Gladman DD, Cheung C, Ng CM, Wade JA. Source: Human Immunology. 1999 March; 60(3): 259-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10321964

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HLA-DRB1*04 alleles in psoriatic arthritis: comparison with rheumatoid arthritis and healthy controls. Author(s): Gladman DD, Farewell VT, Rahman P, Schentag CT, Pellett F, Ng CM, Wade JA. Source: Human Immunology. 2001 November; 62(11): 1239-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11704286

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Human immunodeficiency virus-associated psoriasis, psoriatic arthritis, and Reiter's syndrome: a disease continuum? Author(s): Reveille JD, Conant MA, Duvic M. Source: Arthritis and Rheumatism. 1990 October; 33(10): 1574-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2222538

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Idiopathic Lambert-Eaton myasthenic syndrome associated with minimal-change glomerulonephritis and psoriatic arthritis. Author(s): Timmermann L, Lindner V, Poepping M, Austermann K, Deuschl G. Source: Journal of Neurology. 2001 February; 248(2): 145-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11284135

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IgA antibodies to gliadin and coeliac disease in psoriatic arthritis. Author(s): Lindqvist U, Rudsander A, Bostrom A, Nilsson B, Michaelsson G. Source: Rheumatology (Oxford, England). 2002 January; 41(1): 31-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11792877

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IgVH-genes analysis from psoriatic arthritis shows involvement of antigen-activated synovial B-lymphocytes. Author(s): Gerhard N, Krenn V, Magalhaes R, Morawietz L, Brandlein S, Konig A. Source: Zeitschrift Fur Rheumatologie. 2002 December; 61(6): 718-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12491138

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IL-10 improves skin disease and modulates endothelial activation and leukocyte effector function in patients with psoriatic arthritis. Author(s): McInnes IB, Illei GG, Danning CL, Yarboro CH, Crane M, Kuroiwa T, Schlimgen R, Lee E, Foster B, Flemming D, Prussin C, Fleisher TA, Boumpas DT. Source: Journal of Immunology (Baltimore, Md. : 1950). 2001 October 1; 167(7): 4075-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11564829

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Imaging features of psoriatic arthritis and Reiter's syndrome. Author(s): Klecker RJ, Weissman BN. Source: Seminars in Musculoskeletal Radiology. 2003 June; 7(2): 115-26. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12920649

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Immediate and delayed effects of treatment at the Dead Sea in patients with psoriatic arthritis. Author(s): Elkayam O, Ophir J, Brener S, Paran D, Wigler I, Efron D, Even-Paz Z, Politi Y, Yaron M. Source: Rheumatology International. 2000; 19(3): 77-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10776684

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Immunomodulating drugs in the management of psoriatic arthritis. Author(s): Jackson CG. Source: American Journal of Clinical Dermatology. 2001; 2(6): 367-75. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11770391

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Impaired expression of erythrocyte glycosyl-phosphatidylinositol-anchored membrane CD59 in patients with psoriatic arthritis. Relation to terminal complement pathway activation. Author(s): Triolo G, Accardo-Palumbo A, Salli L, Ciccia F, Ferrante A, Tedesco L, Salli S, Giardina E, Pappalardo A, Licata G. Source: Clin Exp Rheumatol. 2003 March-April; 21(2): 225-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12747280

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Incidence of antiperinuclear factor in patients with psoriatic arthritis. Author(s): Calzavara-Pinton PG, Franceschini F, Manera C, Zane C, Prati E. Source: Advances in Experimental Medicine and Biology. 1999; 455: 215-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10599346

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Inconstant bursa between head of 5th metatarsal bone and tendon of abductor digiti minimi in psoriatic arthritis. Author(s): Ciancio G, Benjamin M, Scarano E, Padula A, Olivieri I. Source: The Journal of Rheumatology. 2002 April; 29(4): 851-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11950033

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Increased perivascular synovial membrane expression of myeloid-related proteins in psoriatic arthritis. Author(s): Kane D, Roth J, Frosch M, Vogl T, Bresnihan B, FitzGerald O. Source: Arthritis and Rheumatism. 2003 June; 48(6): 1676-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12794836

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Inflamed retrocalcaneal bursa and Achilles tendonitis in psoriatic arthritis demonstrated by ultrasonography. Author(s): Balint PV, Sturrock RD. Source: Annals of the Rheumatic Diseases. 2000 December; 59(12): 931-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11087694

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Infliximab for psoriasis and psoriatic arthritis. Author(s): Antoni C, Manger B. Source: Clin Exp Rheumatol. 2002 November-December; 20(6 Suppl 28): S122-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12463461

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Influence of HLA-B27 on the clinical presentation of psoriatic arthritis. Author(s): Dalbeth N, Dockerty JL, Williamson L. Source: The Journal of Rheumatology. 2003 November; 30(11): 2511; Author Reply 25112. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14677202

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Interaction of monocytes from patients with psoriatic arthritis with cultured microvascular endothelial cells. Author(s): Neumuller J, Dunky A, Burtscher H, Jilch R, Menzel JE. Source: Clinical Immunology (Orlando, Fla.). 2001 January; 98(1): 143-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11141337

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Interleukin 13 in synovial fluid and serum of patients with psoriatic arthritis. Author(s): Spadaro A, Rinaldi T, Riccieri V, Valesini G, Taccari E. Source: Annals of the Rheumatic Diseases. 2002 February; 61(2): 174-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11796407

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Interleukin 1alpha, interleukin 1beta and interleukin 1 receptor gene polymorphisms in psoriatic arthritis. Author(s): Ravindran JS, Owen P, Lagan A, Lewis J, Korendowych E, Welsh K, McHugh N. Source: Rheumatology (Oxford, England). 2004 January; 43(1): 22-6. Epub 2003 July 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12890860

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Interventions for psoriatic arthritis. Author(s): Jones G, Crotty M, Brooks P. Source: Cochrane Database Syst Rev. 2000; (3): Cd000212. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10908464

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Interventions for psoriatic arthritis. Author(s): Jones G, Crotty M, Brooks P. Source: Cochrane Database Syst Rev. 2000; (2): Cd000212. Review. Update In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10796328

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Intravenous anti TNF-alpha antibody therapy leads to elevated triglyceride and reduced HDL-cholesterol levels in patients with rheumatoid and psoriatic arthritis. Author(s): Cauza E, Cauza K, Hanusch-Enserer U, Etemad M, Dunky A, Kostner K. Source: Wiener Klinische Wochenschrift. 2002 December 30; 114(23-24): 1004-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12635469

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Jaccoud's arthropathy and psoriatic arthritis. Author(s): Tishler M, Yaron M. Source: Clin Exp Rheumatol. 1993 November-December; 11(6): 663-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8299262

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Joint symmetry in early and late rheumatoid and psoriatic arthritis: comparison with a mathematical model. Author(s): Helliwell PS, Hetthen J, Sokoll K, Green M, Marchesoni A, Lubrano E, Veale D, Emery P. Source: Arthritis and Rheumatism. 2000 April; 43(4): 865-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10765932

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Juvenile onset psoriatic arthritis in a patient with X-linked agammaglobulinemia (Bruton's disease). Author(s): Palazzi C, D'Amico E, Cacciatore P, Pennese E, Petricca A, Olivieri I. Source: Scandinavian Journal of Rheumatology. 2003; 32(5): 309-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14690146

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Juvenile psoriatic arthritis and HLA antigens. Author(s): Hamilton ML, Gladman DD, Shore A, Laxer RM, Silverman ED. Source: Annals of the Rheumatic Diseases. 1990 September; 49(9): 694-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2241285

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Juvenile psoriatic arthritis with nail psoriasis in the absence of cutaneous lesions. Author(s): Duran-McKinster C, Ortiz-Solis D, Granados J, Tamayo L, OrozcoCovarrubias L, Ruiz-Maldonado R. Source: International Journal of Dermatology. 2000 January; 39(1): 32-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10651963

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Juvenile psoriatic arthritis, or juvenile arthritis with psoriasis? Author(s): Petty RE. Source: Clin Exp Rheumatol. 1994 September-October; 12 Suppl 10: S55-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7955628

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Juvenile psoriatic arthritis. Author(s): Ansell BM. Source: Baillieres Clin Rheumatol. 1994 May; 8(2): 317-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8076390

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Juvenile psoriatic arthritis. Author(s): Koo E, Balogh Z, Gomor B. Source: Clinical Rheumatology. 1991 September; 10(3): 245-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1790632

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Juvenile psoriatic arthritis: a new clinical entity? Author(s): Scarpa R. Source: The Journal of Rheumatology. 1997 February; 24(2): 408-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9035009

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Juvenile psoriatic arthritis: followup and evaluation of diagnostic criteria. Author(s): Roberton DM, Cabral DA, Malleson PN, Petty RE. Source: The Journal of Rheumatology. 1996 January; 23(1): 166-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8838527

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Juvenile psoriatic arthritis--an analysis of 60 cases. Author(s): Shore A, Ansell BM. Source: The Journal of Pediatrics. 1982 April; 100(4): 529-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7199570

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Kaposi's sarcoma in psoriatic arthritis. Author(s): Selvi E, De Stefano R, Manganelli S, Marcolongo R. Source: Rheumatology (Oxford, England). 2003 February; 42(2): 389. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12595648

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Laboratory features of psoriatic arthritis. Author(s): Partsch G. Source: Zeitschrift Fur Rheumatologie. 1987 September-October; 46(5): 220-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3321753

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Laboratory findings and pathology of psoriatic arthritis. Author(s): Troughton PR, Morgan AW. Source: Baillieres Clin Rheumatol. 1994 May; 8(2): 439-63. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8076397

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Lack of association between promoter polymorphism of the tumor necrosis factoralpha gene and psoriatic arthritis in Japanese patients. Author(s): Hamamoto Y, Tateno H, Ishida T, Muto M. Source: The Journal of Investigative Dermatology. 2000 December; 115(6): 1162-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11121160

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Lack of association of TNF-238A and -308A in Japanese patients with psoriasis vulgaris, psoriatic arthritis and generalized pustular psoriasis. Author(s): Nishibu A, Oyama N, Nakamura K, Kaneko F. Source: Journal of Dermatological Science. 2002 September; 29(3): 181-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12234707

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Leflunomide decreases joint erosions and induces reparative changes in a patient with psoriatic arthritis. Author(s): Cuchacovich M, Soto L. Source: Annals of the Rheumatic Diseases. 2002 October; 61(10): 942-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12228172

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Life-table analysis of cyclosporin A treatment in psoriatic arthritis: comparison with other disease-modifying antirheumatic drugs. Author(s): Spadaro A, Taccari E, Mohtadi B, Riccieri V, Sensi F, Zoppini A. Source: Clin Exp Rheumatol. 1997 November-December; 15(6): 609-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9444416

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Lipoproteins and their subfractions in psoriatic arthritis: identification of an atherogenic profile with active joint disease. Author(s): Jones SM, Harris CP, Lloyd J, Stirling CA, Reckless JP, McHugh NJ. Source: Annals of the Rheumatic Diseases. 2000 November; 59(11): 904-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11053070

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Listeria monocytogenes joint infection in a patient with psoriatic arthritis. Author(s): Marangos MN, Keroack BJ, Claffey TF. Source: The Journal of Rheumatology. 1996 November; 23(11): 2005-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8923390

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LMP polymorphisms do not influence disease expression in psoriatic arthritis. Author(s): Hohler T, Schneider PM, Rittner C, Hasenclever P, Meyer zum Buschenfelde KH, Marker-Hermann E. Source: Clin Exp Rheumatol. 1996 November-December; 14(6): 661-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8978963

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Localized monocyte chemotactic protein-1 production correlates with T cell infiltration of synovium in patients with psoriatic arthritis. Author(s): Ross EL, D'Cruz D, Morrow WJ. Source: The Journal of Rheumatology. 2000 October; 27(10): 2432-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11036841

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Long term experience with oral gold in psoriatic arthritis. Author(s): Barbieri P, Ciompi ML, Bini C, Pasero G. Source: Clinical Rheumatology. 1986 June; 5(2): 274-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3089674

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Longitudinal study of clinical and radiological progression in psoriatic arthritis. Author(s): Gladman DD, Stafford-Brady F, Chang CH, Lewandowski K, Russell ML. Source: The Journal of Rheumatology. 1990 June; 17(6): 809-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2388203

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Longterm methotrexate therapy in psoriatic arthritis: clinical and radiological outcome. Author(s): Abu-Shakra M, Gladman DD, Thorne JC, Long J, Gough J, Farewell VT. Source: The Journal of Rheumatology. 1995 February; 22(2): 241-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7738945

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Long-term safety and efficacy of low-dose cyclosporin A in severe psoriatic arthritis. Author(s): Sarzi-Puttini P, Cazzola M, Panni B, Turiel M, Fiorini T, Belai-Beyene N, Cherie-Ligniere EL. Source: Rheumatology International. 2002 April; 21(6): 234-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12036210

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Longterm therapy of psoriatic arthritis: intramuscular gold or methotrexate? Author(s): Lacaille D, Stein HB, Raboud J, Klinkhoff AV. Source: The Journal of Rheumatology. 2000 August; 27(8): 1922-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10955334

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Low dose cyclosporine A in psoriatic arthritis: relation between soluble interleukin 2 receptors and response to therapy. Author(s): Salvarani C, Macchioni P, Boiardi L, Rossi F, Casadei Maldini M, Mancini R, Beltrandi E, Lodi L, Bisighini G, Portioli I. Source: The Journal of Rheumatology. 1992 January; 19(1): 74-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1556703

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Low incidence of hepatotoxicity associated with long-term, low-dose oral methotrexate in treatment of refractory psoriasis, psoriatic arthritis, and rheumatoid arthritis. An acceptable risk/benefit ratio. Author(s): Lanse SB, Arnold GL, Gowans JD, Kaplan MM. Source: Digestive Diseases and Sciences. 1985 February; 30(2): 104-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3967557

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Low serum hyaluronan in psoriatic arthritis patients in comparison to rheumatoid arthritis patients. Author(s): Partsch G, Leeb B, Stancikova M, Raffayova H, Eberl G, Hitzelhammer H, Smolen JS. Source: Clin Exp Rheumatol. 1996 July-August; 14(4): 381-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8871836

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Lymphedema of the upper limb in patients with psoriatic arthritis. Author(s): Mulherin DM, FitzGerald O, Bresnihan B. Source: Seminars in Arthritis and Rheumatism. 1993 April; 22(5): 350-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8511598

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Lymphocyte depletion with fludarabine in patients with psoriatic arthritis: clinical and immunological effects. Author(s): Takada K, Danning CL, Kuroiwa T, Schlimgen R, Tassiulas IO, Davis JC Jr, Yarboro CH, Fleisher TA, Boumpas DT, Illei GG. Source: Annals of the Rheumatic Diseases. 2003 November; 62(11): 1112-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14583577

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Macrophage-derived cytokine and nuclear factor kappaB p65 expression in synovial membrane and skin of patients with psoriatic arthritis. Author(s): Danning CL, Illei GG, Hitchon C, Greer MR, Boumpas DT, McInnes IB. Source: Arthritis and Rheumatism. 2000 June; 43(6): 1244-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10857783

Studies

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Matrix metalloproteinase 9 (MMP-9) in patients with psoriatic arthritis and rheumatoid arthritis. Author(s): Alenius GM, Jonsson S, Wallberg Jonsson S, Ny A, Rantapaa Dahlqvist S. Source: Clin Exp Rheumatol. 2001 November-December; 19(6): 760. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11791658

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Measurement of disease activity in psoriatic arthritis. Extended report. Author(s): Ujfalussy I, Koo E. Source: Zeitschrift Fur Rheumatologie. 2003 February; 62(1): 60-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12624805

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Mechanism of joint sparing in a patient with unilateral psoriatic arthritis and a longstanding hemiplegia. Author(s): Veale D, Farrell M, Fitzgerald O. Source: British Journal of Rheumatology. 1993 May; 32(5): 413-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7684307

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Mechanisms of TNF-alpha- and RANKL-mediated osteoclastogenesis and bone resorption in psoriatic arthritis. Author(s): Ritchlin CT, Haas-Smith SA, Li P, Hicks DG, Schwarz EM. Source: The Journal of Clinical Investigation. 2003 March; 111(6): 821-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12639988

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Membranous nephropathy with severe tubulointerstitial and vascular changes in a patient with psoriatic arthritis treated with non-steroidal anti-inflammatory drugs. Author(s): Grcevska L, Polenakovic M, Ferluga D, Vizjak A, Stavric G. Source: Clinical Nephrology. 1993 May; 39(5): 250-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8513600

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Methotrexate and cyclosporin combined therapy in severe psoriatic arthritis. A pilot study. Author(s): Mazzanti G, Coloni L, De Sabbata G, Paladini G. Source: Acta Derm Venereol Suppl (Stockh). 1994; 186: 116-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8073808

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Methotrexate in psoriatic arthritis. Author(s): Cutolo M, Seriolo B, Pizzorni C, Craviotto C, Sulli A. Source: Clin Exp Rheumatol. 2002 November-December; 20(6 Suppl 28): S76-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12463453

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Methotrexate in psoriatic arthritis. Author(s): Singh YN, Verma KK, Kumar A, Malaviya AN. Source: J Assoc Physicians India. 1994 November; 42(11): 860-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7868484

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Methotrexate use in psoriasis and psoriatic arthritis. Author(s): Cuellar ML, Espinoza LR. Source: Rheumatic Diseases Clinics of North America. 1997 November; 23(4): 797-809. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9361156

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MICA rather than MICB, TNFA, or HLA-DRB1 is associated with susceptibility to psoriatic arthritis. Author(s): Gonzalez S, Martinez-Borra J, Lopez-Vazquez A, Garcia-Fernandez S, TorreAlonso JC, Lopez-Larrea C. Source: The Journal of Rheumatology. 2002 May; 29(5): 973-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12022360

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Mice lacking endogenous major histocompatibility complex class II develop arthritis resembling psoriatic arthritis at an advanced age. Author(s): Bardos T, Zhang J, Mikecz K, David CS, Glant TT. Source: Arthritis and Rheumatism. 2002 September; 46(9): 2465-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12355495

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Microscopic inflammatory changes in colon of patients with both active psoriasis and psoriatic arthritis without bowel symptoms. Author(s): Scarpa R, Manguso F, D'Arienzo A, D'Armiento FP, Astarita C, Mazzacca G, Ayala F. Source: The Journal of Rheumatology. 2000 May; 27(5): 1241-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10813294

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Mig, GRO alpha and RANTES messenger RNA expression in lining layer, infiltrates and different leucocyte populations of synovial tissue from patients with rheumatoid arthritis, psoriatic arthritis and osteoarthritis. Author(s): Konig A, Krenn V, Toksoy A, Gerhard N, Gillitzer R. Source: Virchows Archiv : an International Journal of Pathology. 2000 May; 436(5): 44958. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10881738

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Modification of the inflammatory activity of psoriatic arthritis in patients treated with extract of Polipodium leucotomos (Anapsos) Author(s): Navarro-Blasco FJ, Sempere JM. Source: British Journal of Rheumatology. 1998 August; 37(8): 912. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9734685

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Modified anti-CD3 therapy in psoriatic arthritis: a phase I/II clinical trial. Author(s): Utset TO, Auger JA, Peace D, Zivin RA, Xu D, Jolliffe L, Alegre ML, Bluestone JA, Clark MR. Source: The Journal of Rheumatology. 2002 September; 29(9): 1907-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12233885

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Mortality studies in psoriatic arthritis: results from a single outpatient center. II. Prognostic indicators for death. Author(s): Gladman DD, Farewell VT, Wong K, Husted J. Source: Arthritis and Rheumatism. 1998 June; 41(6): 1103-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9627021

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Mortality studies in psoriatic arthritis: results from a single outpatient clinic. I. Causes and risk of death. Author(s): Wong K, Gladman DD, Husted J, Long JA, Farewell VT. Source: Arthritis and Rheumatism. 1997 October; 40(10): 1868-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9336423

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MPO antibody-positive vasculitis in a patient with psoriatic arthritis and goldinduced membranous glomerulonephritis. Author(s): Quarenghi MI, Del Vecchio L, Casartelli D, Manunta P, Rossi R. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1998 August; 13(8): 2104-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9719174

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Musculoskeletal surgery in psoriatic arthritis. Author(s): Zangger P, Gladman DD, Bogoch ER. Source: The Journal of Rheumatology. 1998 April; 25(4): 725-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9558176

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Nail lesions in psoriatic arthritis: recovery with sulfasalazine treatment. Author(s): Gerster JC, Hohl D. Source: Annals of the Rheumatic Diseases. 2002 March; 61(3): 277. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11830442

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Nailfold capillary permeability in psoriatic arthritis. Author(s): Grassi W, Core P, Carlino G, Cervini C. Source: Scandinavian Journal of Rheumatology. 1992; 21(5): 226-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1439630

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Natural history of psoriatic arthritis. Author(s): Gladman DD. Source: Baillieres Clin Rheumatol. 1994 May; 8(2): 379-94. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8076393

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Natural killer cell function and expression of beta 7 integrin in psoriatic arthritis. Author(s): McQueen FM, Skinner MA, Krissansen GW, Robinson E, Tan PL. Source: The Journal of Rheumatology. 1994 December; 21(12): 2266-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7535357

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Neutrophil functions and IL-8 in psoriatic arthritis and in cutaneous psoriasis. Author(s): Biasi D, Carletto A, Caramaschi P, Bellavite P, Maleknia T, Scambi C, Favalli N, Bambara LM. Source: Inflammation. 1998 October; 22(5): 533-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9793799

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New psoriasis treatments based upon a deeper understanding of the pathogenesis of psoriasis vulgaris and psoriatic arthritis: a personal appraisal of their use in practice. Author(s): Callen JP. Source: Journal of the American Academy of Dermatology. 2003 August; 49(2): 351-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12894099

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New signposts on the road to understanding psoriatic arthritis. Author(s): Vasey FB, Seleznick MJ, Fenske NA, Espinoza LR. Source: The Journal of Rheumatology. 1989 November; 16(11): 1405-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2574747

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Newly available treatments for psoriatic arthritis and their impact on skin psoriasis. Author(s): Galadari H, Fuchs B, Lebwohl M. Source: International Journal of Dermatology. 2003 March; 42(3): 231-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12653923

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Nitroblue tetrazolium test in psoriatic arthritis, rheumatoid arthritis, and osteoarthrosis. Author(s): Lambert JR, Roberts M, Wright V. Source: Annals of the Rheumatic Diseases. 1978 August; 37(4): 363-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=686869

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Normal values of laboratory tests in elderly onset psoriatic arthritis. Author(s): Nava A. Source: Annals of the Rheumatic Diseases. 2000 March; 59(3): 239. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10777420

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On the postulated co-existence of rheumatoid arthritis and psoriatic arthritis. Author(s): Helliwell PS, Wright V. Source: Clin Exp Rheumatol. 1992 November-December; 10(6): 625. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1483318

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Open-label study of infliximab treatment for psoriatic arthritis: clinical and magnetic resonance imaging measurements of reduction of inflammation. Author(s): Antoni C, Dechant C, Hanns-Martin Lorenz PD, Wendler J, Ogilvie A, Lueftl M, Kalden-Nemeth D, Kalden JR, Manger B. Source: Arthritis and Rheumatism. 2002 October 15; 47(5): 506-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12382299

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Operational definitions and observer reliability of the plain radiographic features of psoriatic arthritis. Author(s): Taylor WJ, Porter GG, Helliwell PS. Source: The Journal of Rheumatology. 2003 December; 30(12): 2645-58. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14719209

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Oral 2-chlorodeoxyadenosine in psoriatic arthritis. A preliminary report. Author(s): Eibschutz B, Baird SM, Weisman MH, Amox DG, Spellman M, Piacquadio D, Carrera CJ, Carson DA. Source: Arthritis and Rheumatism. 1995 November; 38(11): 1604-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7488281

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Outcome in patients hospitalised for psoriatic arthritis. Author(s): Coulton BL, Thomson K, Symmons DP, Popert AJ. Source: Clinical Rheumatology. 1989 June; 8(2): 261-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2758772

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Pathogenesis of psoriatic arthritis. Author(s): Fearon U, Veale DJ. Source: Clinical and Experimental Dermatology. 2001 June; 26(4): 333-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11422185

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Patterns of joint involvement at onset differentiate oligoarticular juvenile psoriatic arthritis from pauciarticular juvenile rheumatoid arthritis. Author(s): Huemer C, Malleson PN, Cabral DA, Huemer M, Falger J, Zidek T, Petty RE. Source: The Journal of Rheumatology. 2002 July; 29(7): 1531-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12136915

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Polymorphism in MICA rather than HLA-B/C genes is associated with psoriatic arthritis in the Jewish population. Author(s): Gonzalez S, Brautbar C, Martinez-Borra J, Lopez-Vazquez A, Segal R, BlancoGelaz MA, Enk CD, Safriman C, Lopez-Larrea C. Source: Human Immunology. 2001 June; 62(6): 632-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11390038

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Posterior scleritis in psoriatic arthritis. Author(s): Altan-Yaycioglu R, Akova YA, Kart H, Cetinkaya A, Yilmaz G, Aydin P. Source: Retina (Philadelphia, Pa.). 2003 October; 23(5): 717-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14574264

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Potential of tumor necrosis factor inhibitors in psoriasis and psoriatic arthritis. Author(s): Krueger G, Callis K. Source: Archives of Dermatology. 2004 February; 140(2): 218-25. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14967799

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Progression of peripheral joint disease in psoriatic arthritis: a 5-yr prospective study. Author(s): McHugh NJ, Balachrishnan C, Jones SM. Source: Rheumatology (Oxford, England). 2003 June; 42(6): 778-83. Epub 2003 March 14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12730539

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Psoriasis and psoriatic arthritis, axial type. Author(s): White KL. Source: Dermatology Online Journal [electronic Resource]. 2001 December; 7(2): 12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12165228

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Psoriasis vulgaris and psoriatic arthritis share a 100 kb susceptibility region telomeric to HLA-C. Author(s): Martinez-Borra J, Gonzalez S, Santos-Juanes J, Sanchez del Rio J, TorreAlonso JC, Lopez-Vazquez A, Blanco-Gelaz MA, Lopez-Larrea C. Source: Rheumatology (Oxford, England). 2003 September; 42(9): 1089-92. Epub 2003 April 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12730526

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Psoriatic arthritis and alpha-interferon. Author(s): Olivieri I, Padula A, Ciancio G, La Civita L. Source: Scandinavian Journal of Rheumatology. 2001; 30(3): 175. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11469531

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Psoriatic arthritis as a mountain. Author(s): Berthelot JM. Source: Reumatismo. 2003; 55(1): 6-15. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12649695

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Psoriatic arthritis joint fluids are characterized by CD8 and CD4 T cell clonal expansions appear antigen driven. Author(s): Costello PJ, Winchester RJ, Curran SA, Peterson KS, Kane DJ, Bresnihan B, FitzGerald OM. Source: Journal of Immunology (Baltimore, Md. : 1950). 2001 February 15; 166(4): 287886. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11160357

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Psoriatic arthritis. Author(s): Holdsworth J. Source: Nursing Standard : Official Newspaper of the Royal College of Nursing. 2003 October 15-21; 18(5): 47-52; Quiz 54-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14603767

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Psoriatic arthritis. Author(s): Veale D, FitzGerald O. Source: Best Practice & Research. Clinical Rheumatology. 2002 September; 16(4): 523-35. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12406425

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Psoriatic arthritis: a guide for dermatology nurses. Author(s): Gottlieb AB. Source: Dermatology Nursing / Dermatology Nurses' Association. 2003 April; 15(2): 107-10, 113-8; Quiz 119. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12751345

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Psoriatic arthritis: clinical aspects, genetics, and the role of T cells. Author(s): Hohler T, Marker-Hermann E. Source: Current Opinion in Rheumatology. 2001 July; 13(4): 273-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11555727

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Psoriatic arthritis: performance of rheumatologists in daily practice. Author(s): Gorter S, van der Heijde DM, van der Linden S, Houben H, Rethans JJ, Scherpbier AJ, van der Vleuten CP. Source: Annals of the Rheumatic Diseases. 2002 March; 61(3): 219-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11830426

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Psoriatic arthritis: the role of TNF inhibition and the effect of its inhibition with etanercept. Author(s): Mease P. Source: Clin Exp Rheumatol. 2002 November-December; 20(6 Suppl 28): S116-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12463460

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Psoriatic arthritis--emerging concepts. Author(s): Patel S, Veale D, FitzGerald O, McHugh NJ. Source: Rheumatology (Oxford, England). 2001 March; 40(3): 243-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11285369

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Psoriatic arthritis--pathogenesis and epidemiology. Author(s): Veale DJ, FitzGerald O. Source: Clin Exp Rheumatol. 2002 November-December; 20(6 Suppl 28): S27-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12463443

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Pyoderma gangrenosum in a patient with psoriatic arthritis. Author(s): Spangler JG. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 2001 November-December; 14(6): 466-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11757891

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Quadricepital tendon enthesitis in psoriatic arthritis and rheumatoid arthritis: ultrasound examinations and clinical correlations. Author(s): Frediani B, Falsetti P, Storri L, Allegri A, Bisogno S, Baldi F, Marcolongo R. Source: The Journal of Rheumatology. 2001 November; 28(11): 2566-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11708443

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Radiographic changes in the condyle of the temporomandibular joint in psoriatic arthritis. Author(s): Kononen M. Source: Acta Radiologica (Stockholm, Sweden : 1987). 1987 March-April; 28(2): 185-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2953375

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Radiographic signs in the temporomandibular and hand joints in patients with psoriatic arthritis. Author(s): Kononen M, Wolf J, Kilpinen E, Melartin E. Source: Acta Odontologica Scandinavica. 1991 August; 49(4): 191-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1927282

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Radiological assessment in psoriatic arthritis. Author(s): Rahman P, Gladman DD, Cook RJ, Zhou Y, Young G, Salonen D. Source: British Journal of Rheumatology. 1998 July; 37(7): 760-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9714353

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Radiological changes in the sacro-iliac joints and spine of patients with psoriatic arthritis and psoriasis. Author(s): Jajic I. Source: Annals of the Rheumatic Diseases. 1968 January; 27(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5640840

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Randomized, double-blind, placebo controlled trial of low-dose pulse methotrexate in psoriatic arthritis. Author(s): Willkens RF, Williams HJ, Ward JR, Egger MJ, Reading JC, Clements PJ, Cathcart ES, Samuelson CO Jr, Solsky MA, Kaplan SB, et al. Source: Arthritis and Rheumatism. 1984 April; 27(4): 376-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6712754

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Recent developments in psoriatic arthritis. Author(s): Cuellar ML, Silveira LH, Espinoza LR. Source: Current Opinion in Rheumatology. 1994 July; 6(4): 378-84. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8068509

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Reduced synovial membrane macrophage numbers, ELAM-1 expression, and lining layer hyperplasia in psoriatic arthritis as compared with rheumatoid arthritis. Author(s): Veale D, Yanni G, Rogers S, Barnes L, Bresnihan B, Fitzgerald O. Source: Arthritis and Rheumatism. 1993 July; 36(7): 893-900. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7686370

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Reiter's syndrome and psoriatic arthritis. Their roentgen spectra and some interesting similarities. Author(s): Peterson CC Jr, Silbiger ML. Source: Am J Roentgenol Radium Ther Nucl Med. 1967 December; 101(4): 860-71. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6073381

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Relationship between human lymphocyte antigen-B27 and clinical features of psoriatic arthritis. Author(s): Tsai YG, Chang DM, Kuo SY, Wang WM, Chen YC, Lai JH. Source: J Microbiol Immunol Infect. 2003 June; 36(2): 101-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12886960

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Relationship of the Arthritis Impact Measurement Scales to changes in articular status and functional performance in patients with psoriatic arthritis. Author(s): Husted J, Gladman DD, Long JA, Farewell VT. Source: The Journal of Rheumatology. 1996 November; 23(11): 1932-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8923369

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Release of cartilage and bone macromolecules into synovial fluid: differences between psoriatic arthritis and rheumatoid arthritis. Author(s): Mansson B, Gulfe A, Geborek P, Heinegard D, Saxne T. Source: Annals of the Rheumatic Diseases. 2001 January; 60(1): 27-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11114278

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Reliability of measurements of active and damaged joints in psoriatic arthritis. Author(s): Gladman DD, Farewell V, Buskila D, Goodman R, Hamilton L, Langevitz P, Thorne JC. Source: The Journal of Rheumatology. 1990 January; 17(1): 62-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2313676

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Remission in psoriatic arthritis. Author(s): Gladman DD, Hing EN, Schentag CT, Cook RJ. Source: The Journal of Rheumatology. 2001 May; 28(5): 1045-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11361187

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Remission of psoriatic arthritis after porto-caval anastomosis in a patient with primary biliary cirrhosis. Author(s): D'Amico E, Palazzi C, Capani F. Source: The Journal of Rheumatology. 1999 January; 26(1): 236. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9918274

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Renal abnormalities in a population of patients with psoriatic arthritis. Author(s): Alenius GM, Stegmayr BG, Dahlqvist SR. Source: Scandinavian Journal of Rheumatology. 2001; 30(5): 271-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11727841

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Renal affection in patients with ankylosing spondylitis and psoriatic arthritis. Author(s): Omdal R, Husby G. Source: Clinical Rheumatology. 1987 March; 6(1): 74-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3581701

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Responsiveness of health status instruments to changes in articular status and perceived health in patients with psoriatic arthritis. Author(s): Husted JA, Gladman DD, Cook RJ, Farewell VT. Source: The Journal of Rheumatology. 1998 November; 25(11): 2146-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9818657

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Reticulosis as a long-term side-effect of methotrexate therapy in a patient with generalized psoriasis and psoriatic arthritis. Author(s): Schroter R, Kelleter R, Kuhn D. Source: Dermatologica. 1971; 143(2): 131-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5171831

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Risk factors for the development of psoriatic arthritis: a population based nested case control study. Author(s): Thumboo J, Uramoto K, Shbeeb MI, O'Fallon WM, Crowson CS, Gibson LE, Michet CJ Jr, Gabriel SE. Source: The Journal of Rheumatology. 2002 April; 29(4): 757-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11950018

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Role of novel biological therapies in psoriatic arthritis: effects on joints and skin. Author(s): Braun J, Sieper J. Source: Biodrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy. 2003; 17(3): 187-99. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12749755

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Serum levels of hyaluronic acid in patients with psoriatic arthritis. Author(s): Elkayam O, Yaron I, Shirazi I, Yaron M, Caspi D. Source: Clinical Rheumatology. 2000; 19(6): 455-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11147755

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Serum levels of IL-10, IL-6, IL-1ra, and sIL-2R in patients with psoriatic arthritis. Author(s): Elkayam O, Yaron I, Shirazi I, Yaron M, Caspi D. Source: Rheumatology International. 2000; 19(3): 101-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10776688

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Serum osteocalcin levels in patients with psoriatic arthritis: an extended report. Author(s): Franck H, Ittel T. Source: Rheumatology International. 2000; 19(5): 161-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10984132

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Sonographic study of calcaneal entheses in erosive osteoarthritis, nodal osteoarthritis, rheumatoid arthritis and psoriatic arthritis. Author(s): Falsetti P, Frediani B, Fioravanti A, Acciai C, Baldi F, Filippou G, Marcolongo R. Source: Scandinavian Journal of Rheumatology. 2003; 32(4): 229-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14626630

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Spotlight on etanercept in rheumatoid arthritis, psoriatic arthritis and juvenile rheumatoid arthritis. Author(s): Culy CR, Keating GM. Source: Biodrugs : Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy. 2003; 17(2): 139-45. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12641492

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Stress fracture in long term methotrexate treatment for psoriatic arthritis. Author(s): Wijnands M, Burgers A. Source: Annals of the Rheumatic Diseases. 2001 August; 60(8): 736-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11454635

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Subsets in psoriatic arthritis formed by cluster analysis. Author(s): Koo T, Nagy Z, Sesztak M, Ujfalussy I, Meretey K, Bohm U, Forgacs S, Szilagyi M, Czirjak L, Farkas V. Source: Clinical Rheumatology. 2001; 20(1): 36-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11254239

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Successful radiosynoviorthesis of an olecranon bursitis in psoriatic arthritis. Author(s): Berliner MN, Bretzel RG, Klett R. Source: Annals of the Rheumatic Diseases. 2002 February; 61(2): 187-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11796417

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Successful rechallenge with anti-tumor necrosis factor alpha for psoriatic arthritis after development of demyelinating nervous system disease during initial treatment: comment on the article by Mohan et al. Author(s): Cisternas M, Gutierrez M, Jacobelli S. Source: Arthritis and Rheumatism. 2002 November; 46(11): 3107-8; Author Reply 3108-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12428265

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Sulfasalazine-induced extrinsic allergic alveolitis in a patient with psoriatic arthritis. Author(s): Woltsche M, Woltsche-Kahr I, Roeger GM, Aberer W, Popper H. Source: European Journal of Medical Research. 2001 November 20; 6(11): 495-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11726310

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Systemic, secondary amyloidosis in a patient with psoriatic arthritis. Author(s): Ujfalussy I, Bely M, Koo E, Sesztak M. Source: Clin Exp Rheumatol. 2001 March-April; 19(2): 225. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11326492

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Termination of disease-modifying antirheumatic drugs in rheumatoid arthritis and in psoriatic arthritis. A comparative study of 270 cases. Author(s): Ujfalussy I, Koo E, Sesztak M, Gergely P. Source: Zeitschrift Fur Rheumatologie. 2003 April; 62(2): 155-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12721703

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The cervical spine in patients with psoriatic arthritis. Author(s): Laiho K, Kauppi M. Source: Annals of the Rheumatic Diseases. 2002 July; 61(7): 650-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12079912

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The direct cost of care for psoriasis and psoriatic arthritis in the United States. Author(s): Javitz HS, Ward MM, Farber E, Nail L, Vallow SG. Source: Journal of the American Academy of Dermatology. 2002 June; 46(6): 850-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12063481

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The Influence of the HLA-DRB1 rheumatoid arthritis shared epitope on the clinical characteristics and radiological outcome of psoriatic arthritis. Author(s): Korendowych E, Dixey J, Cox B, Jones S, McHugh N. Source: The Journal of Rheumatology. 2003 January; 30(1): 96-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12508396

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The Kobner phenomenon and psoriatic arthritis. Author(s): Saini R, Tutrone WD, Strober BE. Source: Cutis; Cutaneous Medicine for the Practitioner. 2003 November; 72(5): 405-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14655783

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Treatment of psoriatic arthritis and psoriasis vulgaris with the tumor necrosis factor inhibitor infliximab. Author(s): Cauza E, Spak M, Cauza K, Hanusch-Enserer U, Dunky A, Wagner E. Source: Rheumatology International. 2002 November; 22(6): 227-32. Epub 2002 September 04. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12426660

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Treatment of psoriatic arthritis with granulocyte and monocyte adsorption apheresis. Author(s): Kanekura T, Kawabata H, Maruyama I, Kanzaki T. Source: Journal of the American Academy of Dermatology. 2004 February; 50(2): 242-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14726879

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Treatment of recalcitrant psoriatic arthritis with anti-tumor necrosis factor-alpha antibody. Author(s): Wollina U, Konrad H. Source: Journal of the European Academy of Dermatology and Venereology : Jeadv. 2002 March; 16(2): 127-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12046813

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Treatment of refractory psoriatic arthritis with infliximab: a 12 month observational study of 16 patients. Author(s): Feletar M, Brockbank JE, Schentag CT, Lapp V, Gladman DD. Source: Annals of the Rheumatic Diseases. 2004 February; 63(2): 156-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14722204

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Tumour necrosis factor-alpha polymorphism and the HLA-Cw*0602 allele in psoriatic arthritis. Author(s): Al-Heresh AM, Proctor J, Jones SM, Dixey J, Cox B, Welsh K, McHugh N. Source: Rheumatology (Oxford, England). 2002 May; 41(5): 525-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12011375

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Ultrasonography and psoriatic arthritis. Author(s): Wakefield RJ, Emery P, Veale D. Source: The Journal of Rheumatology. 2000 June; 27(6): 1564-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10852294

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Ultrasound and clinical evaluation of quadricipital tendon enthesitis in patients with psoriatic arthritis and rheumatoid arthritis. Author(s): Frediani B, Falsetti P, Storri L, Allegri A, Bisogno S, Baldi F, Marcolongo R. Source: Clinical Rheumatology. 2002 August; 21(4): 294-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12189456

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Ultrasound and clinical evaluation of quadricipital tendon enthesitis in patients with psoriatic arthritis and rheumatoid arthritis. Author(s): Frediani B, Falsetti P, Storri L, Allegri A, Bisogno S, Baldi F, Marcolongo R. Source: Clinical Rheumatology. 2002 June; 21(3): 203-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12111624

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Ultrasound measurements at the proximal phalanges in male patients with psoriatic arthritis. Author(s): Taccari E, Sensi F, Spadaro A, Riccieri V, Rinaldi T. Source: Osteoporosis International : a Journal Established As Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the Usa. 2001; 12(5): 412-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11444091

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Upper limb lymphedema in psoriatic arthritis. Author(s): Salvarani C, Macchioni PL, Veneziani M, Rossi F, Lodi L, Baricchi R, Boiardi L, Portioli I. Source: The Journal of Rheumatology. 1990 February; 17(2): 273-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2319531

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Upregulation of cytokine receptors sTNF-R55, sTNF-R75, and sIL-2R in psoriatic arthritis synovial fluid. Author(s): Partsch G, Wagner E, Leeb BF, Dunky A, Steiner G, Smolen JS. Source: The Journal of Rheumatology. 1998 January; 25(1): 105-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9458212

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Use of antimalarial drugs for the treatment of psoriatic arthritis. Author(s): Sayers ME, Mazanec DJ. Source: The American Journal of Medicine. 1992 October; 93(4): 474-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1415314

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Use of disease-modifying antirheumatic drugs in patients with psoriatic arthritis. Author(s): Marguerie L, Flipo RM, Grardel B, Beaurain D, Duquesnoy B, Delcambre B. Source: Joint, Bone, Spine : Revue Du Rhumatisme. 2002 May; 69(3): 275-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12102274

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V2 regions of 16S ribosomal RNA used as a molecular marker for the species identification of streptococci in peripheral blood and synovial fluid from patients with psoriatic arthritis. Author(s): Wang Q, Vasey FB, Mahfood JP, Valeriano J, Kanik KS, Anderson BE, Bridgeford PH. Source: Arthritis and Rheumatism. 1999 October; 42(10): 2055-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10524676

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Validating the SF-36 health survey questionnaire in patients with psoriatic arthritis. Author(s): Husted JA, Gladman DD, Farewell VT, Long JA, Cook RJ. Source: The Journal of Rheumatology. 1997 March; 24(3): 511-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9058658

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Validation of the revised and expanded version of the Arthritis Impact Measurement Scales for patients with psoriatic Arthritis. Author(s): Husted J, Gladman DD, Farewell VT, Long JA. Source: The Journal of Rheumatology. 1996 June; 23(6): 1015-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8782133

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Validity assessment of the disabilities of arm, shoulder, and hand questionnaire (DASH) for patients with psoriatic arthritis. Author(s): Navsarikar A, Gladman DD, Husted JA, Cook RJ. Source: The Journal of Rheumatology. 1999 October; 26(10): 2191-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10529138

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Vasculitis and psoriatic arthritis associated with Down's syndrome. Author(s): Jorgensen C, Bologna C, Sany J. Source: Clin Exp Rheumatol. 1995 November-December; 13(6): 749-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8835250

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Vertical asymmetry of the mandibular ramus and condylar heights measured with a new method from dental panoramic radiographs in patients with psoriatic arthritis. Author(s): Mattila M, Kononen M, Mattila K. Source: Journal of Oral Rehabilitation. 1995 October; 22(10): 741-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8606331

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What do rheumatologists think about psoriatic arthritis today? Author(s): Scarpa R. Source: The Journal of Rheumatology. 1999 December; 26(12): 2509-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10606353

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CHAPTER 2. NUTRITION AND PSORIATIC ARTHRITIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and psoriatic arthritis.

Finding Nutrition Studies on Psoriatic Arthritis 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 “psoriatic arthritis” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

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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 “psoriatic arthritis” (or a synonym): •

A multicentre double-blind comparison of auranofin, intramuscular gold thiomalate and placebo in patients with psoriatic arthritis. Author(s): Rheumatic Diseases Unit, Northern General Hospital, Edinburgh. Source: Palit, J Hill, J Capell, H A Carey, J Daunt, S O Cawley, M I Bird, H A Nuki, G BrJ-Rheumatol. 1990 August; 29(4): 280-3 0263-7103

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Abnormal T-cell function in patients with psoriatic arthritis: evidence for decreased interleukin 2 production. Author(s): Division of Rheumatology, Jefferson Medical College, Philadelphia, PA. Source: Fort, J G Smith, J B Abruzzo, J L Rheumatol-Int. 1993; 13(4): 151-4 0172-8172

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Agranulocytosis in a patient with psoriatic arthritis receiving auranofin and ibuprofen. Author(s): Department of Internal Medicine, Paivarinne Hospital, Muhos, Finland. Source: Hakala, M Timonen, T T Rossi, O Koivisto, O Koistinen, P O Scand-J-Rheumatol. 1987; 16(5): 375-6 0300-9742

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Clinical response to auranofin in patients with psoriatic arthritis. Author(s): 2 Divisione di Medicina (Unita Reumatologica) USL N9, Reggio Emilia, Italy. Source: Salvarani, C Zizzi, F Macchioni, P Mantovani, W Rossi, F Baricchi, R Bellelli, A Capozzoli, N Frizziero, L Portioli, I Clin-Rheumatol. 1989 March; 8(1): 54-7 0770-3198

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Comparison of etretinate (Tigason) and parenteral gold in the treatment of psoriatic arthropathy. Author(s): Department of Rheumatology and Dermatology, University Central Hospital, Tampere, Finland. Source: Seppala, J Laulainen, M Reunala, T Clin-Rheumatol. 1988 December; 7(4): 498503 0770-3198

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Constrictive bronchiolitis obliterans following gold therapy for psoriatic arthritis. Author(s): Dept of Medicine, Royal Victoria Hospital, Montreal, Quebec, Canada. Source: Schwartzman, K J Bowie, D M Yeadon, C Fraser, R Sutton, E D Levy, R D EurRespir-J. 1995 December; 8(12): 2191-3 0903-1936

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Corticosteroid prescribing in rheumatoid arthritis and psoriatic arthritis. Author(s): Department of Rheumatology, University of Ancona, Italy. Source: Grassi, W De Angelis, R Cervini, C Clin-Rheumatol. 1998; 17(3): 223-6 0770-3198

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Cutaneous lymphocyte antigen-positive T lymphocytes preferentially migrate to the skin but not to the joint in psoriatic arthritis. Author(s): United Medical and Dental Schools of Guy's Hospital, London, England. Source: Pitzalis, C Cauli, A Pipitone, N Smith, C Barker, J Marchesoni, A Yanni, G Panayi, G S Arthritis-Rheum. 1996 January; 39(1): 137-45 0004-3591

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Cyclical psoriatic arthritis responding to anti-oestrogen therapy. Author(s): Department of Dermatology and Rheumatology, Royal Free Hospital and School of Medicine, London, U.K. Source: Stevens, H P Ostlere, L S Black, C M Jacobs, H S Rustin, M H Br-J-Dermatol. 1993 October; 129(4): 458-60 0007-0963

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Effects of dietary supplementation with polyunsaturated ethyl ester lipids (Angiosan) in patients with psoriasis and psoriatic arthritis. Author(s): Department of Dermatology, University Central Hospital, Helsinki, Finland. Source: Lassus, A Dahlgren, A L Halpern, M J Santalahti, J Happonen, H P J-Int-MedRes. 1990 Jan-February; 18(1): 68-73 0300-0605

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Expression of the cutaneous lymphocyte antigen and its counter-receptor E-selectin in the skin and joints of patients with psoriatic arthritis. Author(s): Royal National Hospital for Rheumatic Diseases, University of Bath. Source: Jones, S M Dixey, J Hall, N D McHugh, N J Br-J-Rheumatol. 1997 July; 36(7): 74857 0263-7103

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Improvement of psoriatic arthritis in a patient treated with bromocriptine for hyperprolactinemia. Author(s): Ben-Gurion University, Rheumatic Disease Unit, Beer-Sheva, Israel. Source: Buskila, D Sukenik, S Holcberg, G Horowitz, J J-Rheumatol. 1991 April; 18(4): 611-2 0315-162X

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Pilot study of etretinate in psoriatic arthritis. Author(s): Division of Dermatology, University of British Columbia, Vancouver, ON, Canada. Source: Klinkhoff, A V Gertner, E Chalmers, A Gladman, D D Stewart, W D Schachter, G D Schachter, R K J-Rheumatol. 1989 June; 16(6): 789-91 0315-162X

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Psoriatic arthritis (PSA)--an analysis of 220 patients. Author(s): University of Toronto Rheumatic Disease Unit, Women's College Hospital, Ontario, Canada. Source: Gladman, D D Shuckett, R Russell, M L Thorne, J C Schachter, R K Q-J-Med. 1987 February; 62(238): 127-41 0033-5622

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Psoriatic arthritis. Is something changing? Author(s): Department of Internal Medicine, University Federico II, Naples, Italy. Source: Scarpa, R Adv-Exp-Med-Biol. 1999; 455207-14 0065-2598

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Psoriatic arthritis: recent advances in pathogenesis and treatment. Author(s): University of Toronto, Wellesley Hospital, Ontario, Canada. Source: Gladman, D D Rheum-Dis-Clin-North-Am. 1992 February; 18(1): 247-56 0889857X

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Somatostatin treatment of psoriatic arthritis. Author(s): Istituto di Clinica Medica IV, Cattedra di Patologia Medica, Universita di Firenze, Italia. Source: Matucci Cerinic, M Lotti, T Cappugi, P Boddi, V Fattorini, L Panconesi, E Int-JDermatol. 1988 Jan-February; 27(1): 56-8 0011-9059

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T and B cell function in psoriasis and psoriatic arthropathy. Author(s): Servicio de Medicina Interna, Hospital Nacional Marques de Valdecilla, Facultad de Medicina, Universidad de Cantabria, Santander, Spain. Source: Zarrabeitia, M T Farinas, M C Rodriguez Valverde, V Riancho, J A Llaca, H F Allergol-Immunopathol-(Madr). 1989 May-June; 17(3): 155-9 0301-0546

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Therapeutic value of colchicine in the treatment of patients with psoriatic arthritis. Author(s): Department of Medicine, Ottawa General Hospital, Canada. Source: McKendry, R J Kraag, G Seigel, S al Awadhi, A Ann-Rheum-Dis. 1993 November; 52(11): 826-8 0003-4967

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Tigason (etretinate) treatment in psoriatic arthritis. Author(s): Institute of Medical Pathology, University of Pisa, Italy. Source: Ciompi, M L Bazzichi, L Marotta, G Pasero, G Int-J-Tissue-React. 1988; 10(1): 257 0250-0868

•

Toxic epidermal necrolysis in a patient with psoriatic arthritis. Author(s): Department of Dermatology, University of Malta Medical School.

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Source: Pace, J Adami, J Z Mallia, C Mizzi, A Adv-Exp-Med-Biol. 1999; 455557-60 00652598 •

Treatment of chronic plaque-stage psoriasis and psoriatic arthritis with mycophenolate mofetil. Author(s): Department of Dermatology, Johann Wolfgang Goethe University, Frankfurt/Main, Germany. Source: Grundmann Kollmann, M Mooser, G Schraeder, P Zollner, T Kaskel, P Ochsendorf, F Boehncke, W H Kerscher, M Kaufmann, R Peter, R U J-Am-AcadDermatol. 2000 May; 42(5 Pt 1): 835-7 0190-9622

•

Treatment of HIV associated psoriatic arthritis with oral gold. Author(s): Department of Medicine, Elmhurst Hospital Center, NY, USA. Source: Shapiro, D L Masci, J R J-Rheumatol. 1996 October; 23(10): 1818-20 0315-162X

•

Treatment of psoriatic arthritis with auranofin and gold sodium thiomalate. Author(s): Rheuma-Einheit der Ludwig-Maximilians-Universitat Munchen. Source: Bruckle, W Dexel, T Grasedyck, K Schattenkirchner, M Clin-Rheumatol. 1994 June; 13(2): 209-16 0770-3198

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/

•

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

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

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

•

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

•

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

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

•

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

•

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

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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 psoriatic arthritis; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Minerals Sulfur Source: Integrative Medicine Communications; www.drkoop.com

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

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

Literacy in Arthritis Management Condition(s): Rheumatoid Arthritis; Psoriatic Arthritis Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Purpose - Excerpt: This study will test a new patient education program designed for people who do not read well. It will also look at how poor reading skills affect a person's health and how people who do not read well learn best. We will randomly assign patients who have a rheumatic condition (arthritis) that causes inflammation throughout the body (rheumatoid arthritis, psoriatic arthritis, and seronegative polyarthritis) to three groups that will receive different types of educational materials. We will use the new, experimental patient education program in one of these groups. Each group will have a similar percentage of people from each of three reading level categories: 8th grade or lower, 9th to 11th grade, and 12th grade and higher readers. We will follow patients for one year after the education program to look for changes in health status, disease activity, communication with the doctor, belief that they can manage their own disease (known as self-efficacy), understanding and continued use of prescribed treatments, satisfaction, and health care use. Phase(s): Phase II Study Type: Interventional

8

These are listed at www.ClinicalTrials.gov.

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Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00023205 •

Study of Psoriatic Arthritis Condition(s): Psoriasis; Psoriatic Arthritis Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Purpose - Excerpt: This study will examine the genetic and immune factors involved in the cause and development of psoriatic arthritis-a disease of both the skin and joints. It will describe the medical features and natural course of the disease and determine participants' eligibility for experimental treatment protocols. Patients with known or suspected psoriatic arthritis 5 years of age and older and their relatives may enroll in this study. Patients will be evaluated with a medical history and physical examination, electrocardiogram, blood tests and X-rays. Additional procedures may include: 1. Leukapheresis-Collection of white blood cells for genetic analysis. Whole blood is collected through a needle placed in an arm vein. The blood circulates through a machine that separates it into its components. The plasma is removed and the cells are returned to the body through a second needle placed in the other arm. 2. Skin biopsyRemoval of a small skin sample for microscopic analysis. An area of skin is numbed with an anesthetic and one to three small circular portions (about 1/4 inch in diameter) are cut and removed. 3. Joint aspiration-Removal of a small sample of synovial fluid (lubricating joint fluid). An area of skin around the biopsy site is numbed with an anesthetic, and a needle is inserted into the joint to pull out a small fluid sample. 4. Synovial needle biopsy-Removal of a small sample of synovial tissue (tissue lining the joint). An area of skin around the biopsy site is numbed with an anesthetic and a large needle is inserted into the joint. A smaller needle attached to a syringe is then placed inside the larger needle and small pieces of synovial tissue are removed. 5. Genetic studies-Saliva and blood samples will be collected for gene testing. Saliva is collected by rinsing the mouth with a tablespoon of salt water and spitting into a test tube. Patients will be followed once or twice a year and may be evaluated for participation in an experimental treatment study. Participating relatives of patients will fill out a brief medical history questionnaire and provide a DNA sample (blood sample or tissue swab from the inside of the cheek). Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001420

•

A Controlled Trial of Intermittent Fludarabine for Psoriatic Arthritis Condition(s): Arthritis, Psoriatic; Psoriasis Study Status: This study is completed. Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Purpose - Excerpt: This is a placebo controlled study evaluating the role of fludarabine (a nucleoside analog targeting both resting and proliferating lymphocytes) in the treatment of moderate to severe psoriotic arthritis. Patients should have failed at least one disease modifying antirheumatic drug.

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Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001422 •

Safety, Efficacy and Pharmacokinetics of an Antibody for Psoriatic Arthritis Condition(s): Psoriatic Arthritis Study Status: This study is not yet open for patient recruitment. Sponsor(s): XOMA Purpose - Excerpt: The purpose of this study is to determine whether a humanized monoclonal antibody (efalizumab) is safe and effective in the treatment of psoriatic arthritis (PsA) Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00051662

•

Study of Remicade (Infliximab) in Psoriatic Arthritis Condition(s): Psoriatic Arthritis Study Status: This study is completed. Sponsor(s): Centocor Purpose - Excerpt: To assess the effectiveness and safety of infliximab for use in active Psoriatic Arthritis Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00051623

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “psoriatic arthritis” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical

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trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

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

•

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

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

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

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

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

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

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

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

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

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

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

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

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

•

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

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

Patents on Psoriatic Arthritis By performing a patent search focusing on psoriatic arthritis, 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. 9Adapted

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 psoriatic arthritis: •

Apparatus and method for treating rheumatoid and psoriatic arthritis Inventor(s): Diamond; Donald A. (5416 Harbor Rd., Bradenton, FL 34209-1832) Assignee(s): None Reported Patent Number: 5,511,563 Date filed: February 18, 1994 Abstract: An apparatus and method for irradiating an inflamed joint of a patient having rheumatoid or psoriatic arthritis are presented. A noncoherent source of radiation having a predetermined wavelength range is utilized to transilluminate affected tissues of the subject for a predetermined duration. The radiation source has sufficient intensity and is applied for sufficient duration to reducing inflammation and substantially halt disease progression. Excerpt(s): This invention relates to apparatus and methods for therapeutic intervention of the complex immune response in rheumatoid and psoriatic arthritis. Arthritis is a general term that encompasses several distinguishable joint disorders, such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis. Osteoarthritis, also known as degenerative joint disease, is caused by long-term wear and tear on the protective cartilage that lines the inner surfaces of joints. Although typically a disorder of old age, certain predisposing conditions can hasten the degenerative process in younger persons. Symptoms may include joint aching and stiffness, with x rays showing a narrowing of the joint space and new bone formation adjacent to the joint. Treatment includes anti-inflammatory medication, heat, and physical therapy; in severe cases refractory to conservative treatment surgery, including joint replacement, may be necessary. Web site: http://www.delphion.com/details?pn=US05511563__

•

Human aggrecanase and nucleic acid compositions encoding the same Inventor(s): Allard; John David (Cupertino, CA), Ileller; Renu Anand (Stanford, CA), Klonowski; Paul (Cambridge, MA), VanWart; Harold Edgar (Los Altos, CA) Assignee(s): Syntex (u.s.a.) Llc (palo Alto, Ca) Patent Number: 6,649,377 Date filed: May 9, 2000 Abstract: Human aggrecanase and polypeptides related thereto, as well as nucleic acid compositions encoding the same, are provided. The subject polypeptides and nucleic acid compositions find use in a variety of applications, including research, diagnostic, and therapeutic agent screening applications. Also provided are methods of inhibiting aggrecanase activity in a host and methods of treating disease conditions associated with aggrecanase activity, e.g. rheumatoid arthritis, osteo-arthritis, infectious arthritis, gouty arthritis, psoriatic arthritis, spondolysis, sports injury, joint trauma, pulmonary disease, fibrosis, and the like. Excerpt(s): The field of the invention is proteases, particularly proteases that cleave aggrecan. Cartilage matrix structure as dry weight of the tissue is made up of 70%

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collagen and 20-30% proteoglycans. The proteoglycan component confers mechanical flexibility to load bearing tissues and imparts viscoelastic properties to cartilage. Its loss leads to rapid structural damage as is seen most frequently in arthritic joint diseases and joint injury. The G1 domain of the core protein forms a stable ternary complex by binding to hyaluronic acid and link proteins in the matrix. Any enzymatic cleavage in this region destabilizes the cartilage matrix structure, leads to the loss of the major proteoglycan aggrecan and exposes type II collagen to collagenases, causing cartilage loss and the consequent development of joint disease. Since a variety of anti-arthritic drugs do not target aggrecanase and are incapable of blocking cleavage of aggrecan, the aggrecanase site plays a key role in the proteolytic degradation of aggrecan. Web site: http://www.delphion.com/details?pn=US06649377__ •

Method for therapeutically treating psoriatic arthritis using vitamin D analogues and metabolites Inventor(s): Gilbert; Lawrence (Hingham, MA), Holick; Michael F. (Sudbury, MA) Assignee(s): Trustees of Boston University (boston, Ma) Patent Number: 5,098,899 Date filed: December 14, 1990 Abstract: A novel and effective treatment of psoriatic arthritis is provided using biologically active forms of vitamin D analogues and metabolites, and preferrably 1,25dihydroxy vitamin D.sub.3. The administration of vitamin D analogues and metabolites may be made orally, topically, or parenterally. Substitive improvements in both the arthritic condition and skin lesions result after approximately two month's treatment when effective dosages are provided and maintained. Excerpt(s): The present invention is concerned with specific disease states and pathological disorders, and is particularly directed to therapeutically treating psoriatic arthritis as a singular disease and pathological state. Although psoriatic arthritis is today recognized and as a distinct disease and pathological state based on its natural evolution, prognosis, and response to available modes of treatment, its consideration and present status as a distinct and separate clinical entity separate from either psoriasis and/or rheumatoid arthritis required both time and in-depth medical knowledge. In retrospect, the first detailed description of psoriatic arthritis appeared in the doctoral thesis of Charles Bourdillion [Psoriasis et Arthropathies, These de Paris, Volume 298, 1988]; and in several mid-19th century case reports of a unique relationship between psoriasis and arthritis published by 1904 [Menzen, J., Arch. Dermatol. Syph. 70:239-240 (1904)]. For about 30 years thereafter, the idea of psoriatic arthritis being an individual and discrete entity, as opposed to the coincidental occurrence of rheumatoid arthritis and psoriasis, was not generally accepted. Consequently, it was not until the demonstration of rheumatoid factor (RF) in the serum of most patients with typical rheumatoid arthritis in 1948 that the distinction became firmly established. The demonstration and meaning of rheumatoid factor (RF) divided inflammatory arthritis into seropositive and seronegative groupings. Consequently, the realization that the majority of patients with coincident psoriasis and arthritis were in fact seronegative, coupled with the introduction of specific and reliable criteria for the diagnosis of rheumatoid arthritis itself, then firmly established psoriatic arthritis as a separate and distinct disease entity [Rose et al., Proc. Soc. Exp. Biol. Med. 68:1-6 (1948); Ragan, C., Arthritis And Allied Conditions, (J.L. Hollander and D.J. McCarthy, editors) 8th Edition, Lee & Febiger, Philadelphia, 1972; Ropes et al., Bull. Rheum. Dis. 7:121-124 (1956); and

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Ropes et al., Bull. Rheum. Dis. 9:175-176 (1959)]. Today, rheumatologists have generally accepted the concept of distinctive clinical and radiological features for psoriatic arthritis; and employ them to identify subjects suffering from psoriasis alone and to distinguish those persons suffering from either seronegative or seropositive rheumatoid arthritis without psoriasis. A series of clinical characteristics suggestive of psoriatic arthritis have been developed and verified. Similarly, a detailed description and evaluation of the pathology, etiology, clinical features, patterns of disease onset and distribution, laboratory tests, and radiographic findings of psoriatic arthritic have been extensively investigated and documented. A comprehensive and well documented description of these diagnostic, clinical, and pathological developments and findings identifying psoriatic arthritis as a distinctive disease state and entity is provided by Robert N. Bennett in Arthritis And Allied Conditions, A Textbook Of Rheumatology, (Daniel J. McCarthy, Editor) Lee & Febiger, 11th Edition, 1989, pages 954-971, the text of which is expressly incorporated by reference herein. Web site: http://www.delphion.com/details?pn=US05098899__ •

Photo radiation treatment apparatus and method Inventor(s): Diamond; Donald A. (5416 Harbor Rd., Bradenton, FL 34209-1832) Assignee(s): None Reported Patent Number: 5,337,741 Date filed: June 21, 1991 Abstract: An apparatus for radiating high intensity energy at a subject for treating diseases such as rheumatoid or psoriatic arthritis and a method for using the same. A radiation source generating radiation at a predetermined output wavelength transilluminates affected tissues of the subject for a predetermined duration. The radiation source has sufficient intensity and is applied for sufficient duration to photolyze disease-specific antigens within the transilluminated tissues responsible for evoking complex immune response, thus reducing inflammation and disease progression. Excerpt(s): This invention relates to apparatus and methods for therapeutic intervention of the complex immune response in rheumatoid and psoriatic arthritis. More specifically, this invention relates to the treatment of arthritis by transilluminating electromagnetic radiation having a predetermined bandwidth and power density to photolyze the antigen evoking the complex immune response. The correlation of palliation of the symptoms of rheumatoid arthritis with a subject's exposure to direct sunlight has been well established for more than a century, as has seasonal severity of flare-ups of the disease syndrome. These data suggest a photoreactive mechanism is involved. Many devices which generate and project radiation transcutaneously have been used to treat arthritics, such as diathermy and laser devices. The transient antiinflammatory action of induced hyperthermia is well-established. Examples of these devices are disclosed in German Patent No. DE 3103731 A1 and Soviet Union Patent Publications SET 993959 and SU 741889. SU 993959 discloses introducing the antibiotic tetracycline into the subject's interarticular space and then irradiating the joint with a helium-neon laser for two to four minutes. SU 741889 discloses introducing dye material into the joint cavity and then applying a 488 nm argon laser to the joint for five minutes. These techniques are palliative, but do not suggest a permanent remission of the disease, or sustained action in arresting the progression of the disease. Further, these techniques require invasive procedures and hypodermic introduction of materials.

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Web site: http://www.delphion.com/details?pn=US05337741__ •

Synthetic peptide for treatment of autoimmune arthritis Inventor(s): Kang; Andrew H. (Memphis, TN), Myers; Linda K. (Memphis, TN), Seyer; Jerome M. (Memphis, TN) Assignee(s): The University of Tennessee Research Corp. (knoxville, Tn) Patent Number: 6,423,315 Date filed: April 20, 1995 Abstract: Peptides that are capable of suppressing autoimmune arthritis are disclosed. The polypeptides described by the present invention which are capable of suppressing autoimmune arthritis in mammals include analogues of CII 245-270. The peptides do not provoke a material immunogenic response from T cells, and thus are useful therapeutic agents for suppressing autoimmune arthritis, rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, spondylo arthritis, relapsing polychondritis and other connective tissue diseases. A method of surpressing autoimmune arthritis in mammals is also provided by the present invention. Excerpt(s): The present invention provides peptides for suppressing autoimmune arthritis that do not provoke a material immunogenic response from T cells. Autoimmune arthritis afflicts a large number of people and takes many forms including, rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, spondylo arthritis, relapsing polychondritis and other connective tissue diseases. These arthritic conditions occur in mammals when T cells are activated by particular antigens or complexes containing antigens. When such activation occurs, proteolytic enzymes are produced which degrade tissues of the person or mammal afflicted by arthritis. The tissue targets of autoimmune arthritis are constituents of connective tissues in joints and tendons of mammals and ordinarily include type II collagen. Indeed autoimmune arthritis can be induced in mice, humans and other mammal by immunizing them with type collagen II derived from cartilage of the same or different mammals. See, Andriopoulos N A, Mestecky J. Miller E J, Bradley E L: Antibodies to native and denatured collagen in sera of patients with rheumatoid arthritis. Arth. Rheum. 19:613-617, 1976; Wooley P H, Luthra S. Singh S. Huse A, Stuart J M, David C S: Passive transfer of arthritis in mice by human anti-type II collagen antibody. Mayo Clinic Proc. 59:737-743, 1984. Autoimmune arthritis in mammals develops when T cells are activated by immunogenic complexes referred to as trimolecular complexes. These complexes are formed between antigenic peptides and major histocompatibility complex molecules (MHC). Buus, S., A. Sette, and H. M. Grey, (1987) "The interaction between protein-derived immunogenic peptides and Ia". Immuno. Rev. 98:115. These complexes then are recognized by the T cell receptors of antigen-specific T cells to form the tri-molecular complexes which result in the activation and subsequent functioning of T cells and in the development of arthritis. Web site: http://www.delphion.com/details?pn=US06423315__

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

Bovine aggrecanase-1 Inventor(s): Cook, Michael N.; (Drexil Hill, PA), Feild, John; (Wayne, PA) Correspondence: Ratner & Prestia- SB Division; One Westlakes; Suite 301; Berwyn; PA; 19482; US Patent Application Number: 20020160492 Date filed: July 25, 2001 Abstract: Bovine aggrecanase-1 polypeptides and polynucleotides and method for producing such polypeptides by recombinant techniques are disclosed. Also disclosed are methods for screening for compounds that either agonize or antagonize bovine aggrecanase-1. Such compounds are expected to be useful in treatment of human diseases, including, but not limited to: osteoarthritis, rheumatoid arthritis, joint injury, reactive and psoriatic arthritis and other diseases of bone. Excerpt(s): This application claims priority of U.S. Provisional Application Serial No. 60/220,541 filed on Jul. 25, 2000. This invention relates to newly identified polypeptides and polynucleotides encoding such polypeptides, to their use in identifying compounds that may be agonists and/or antagonists that are potentially useful in therapy, and to production of such polypeptides and polynucleotides. The drug discovery process is currently undergoing a fundamental revolution as it embraces `functional genomics`, that is, high throughput genome- or gene-based biology. This approach is rapidly superseding earlier approaches based on `positional cloning`. A phenotype, that is a biological function or genetic disease, would be identified and this would then be tracked back to the responsible gene, based on its genetic map position. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

•

Herbal composition for treating various disorders including psoriasis, a process for preparation thereof and method for treatment of such disorders Inventor(s): Arora, Sudershan Kumar; (Maharashtra, IN), Gupta, Lavleen Kumar; (Maharashtra, IN), Sanganabhatla, Narender; (Maharashtra, IN), Saraf, Dinesh Balakrishna; (Maharashtra, IN), Srivastava, Vandita; (Maharashtra, IN) Correspondence: Ladas & Parry; 26 West 61 Street; New York; NY; 10023; US Patent Application Number: 20030194456 Date filed: January 10, 2003 Abstract: The invention provides a novel herbal composition containing the extracts of the leaves and/or stem of Argemone mexicana plant, optionally containing the extracts of the fruits of Cuminum cyminum, which exhibits useful in vitro, in vivo and interesting immunological and pharmacological activities; a process for preparation thereof; and a method of treatment of psoriasis and related immunological and

10

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

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biological disorders by administration of the said novel herbal composition. The useful in vitro, in vivo and interesting immunological and pharmacological activities exhibited by the extracts and fractions of the leaves and/or stem of Argemone mexicana plant include immunosuppression, lymphoproliferation inhibition, cytokine modulation such as IL-2 inhibition, IFNgamma inhibition, IL-10 induction, keratinocyte proliferation inhibition, keratolytic activity, endothelial cell proliferation inhibition, inhibition of cell adhesion molecule expression such as ICAM-1, MEST inhibition, and enzymes inhibition such as p60src Tyrosine kinase, which are known to be involved in antipsoriatic activity. The novel herbal composition(s) is useful in the treatment of various disorders, such as psoriasis including plaque psoriasis, gutatte psoriasis, pustular psoriasis and psoriasis of the nails; dermatitis and scleroderma; eczema; inflammatory disorders and other autoimmune diseases like psoriatic arthritis, rheumatoid arthritis, Crohn's disease, multiple sclerosis, irritable bowel disease, ankylosing spondilitis, systemic lupus erythremetosus and Sjogren's syndrome; allergies like asthma and chronic obstructive pulmonary disease and is safe, well-tolerated, non-toxic, with minimal and reversible adverse reactions or side effects, and most importantly, with minimal relapse or recurrence of the disease following completion of a treatment regimen. The invention also describes the presence of phosphodiesterase (III, IV and V) inhibition and 5-Lipoxygenase inhibition in the aqueous, ethanolic or aqueous-ethanolic extracts of fruits of Cuminum cyminum plant. Excerpt(s): The present invention relates to a herbal composition comprising aqueous, ethanolic or aqueous-ethanolic extracts obtained from leaves and/or stem of Argemone mexicana plant, containing a mixture of alkaloids, flavonoids, organic acids, amino acids, sugars/glycosides and salts, which exhibit useful in vitro and in vivo immunological and pharmacological activities, hitherto not known and which provide significant reduction in the rate of Psoriasis Area and Severity Index (PASI) score with better tolerability within the range of normal permissible limit. The present invention also relates to a herbal composition comprising fractions of the aqueous, ethanolic and aqueous-ethanolic extracts obtained from leaves and/or stem of Argemone mexicana plant, containing a mixture of alkaloids, flavonoids, organic acids, amino acids, sugars/glycosides and salts, which exhibit useful in vitro and in vivo immunological and pharmacological activities, hitherto not known. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Material and methods relating to a novel retrovirus Inventor(s): Griffiths, David J.; (London, GB), Venables, Patrick; (London, GB), Weiss, Robert A.; (London, GB) Correspondence: Dann Dorfman Herrell & Skillman; Suite 720; 1601 Market Street; Philadelphia; PA; 19103-2307; US Patent Application Number: 20020094576 Date filed: August 1, 2001 Abstract: The present invention relates to a novel retrovirus associated with autoimmune disease. The present invention provides nucleotide and amino acid sequences relating to GAG, PRO and POL proteins of the retrovirus as well as diagnostic techniques and antibodies for use in diagnosis. The retrovirus (HRV-5) according to the present invention has been detected in inflamed joints (RA, osteoarthritis (OA), reactive arthritis and psoriatic arthritis) but not normal synovium.

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Further, HRV-5 proviral DNA has been detected in blood from patients with RA and systemic lupus erythematosus (SLE). Excerpt(s): The present application is a continuation-in-part of U.S. application Ser. No. 09/280,329 filed Mar. 29, 1999, which claims priority under 35 U.S.C.sctn.119(e) to GB9806649.1 entitled Material and Methods Relating to a New Retrovirus" filed Mar. 27, 1998 and U.S. Provisional Application, No. 60/115,268 of the same title, filed Jan. 8, 1999. The disclosures of all of the above-identified applications are hereby incorporated by reference as though set forth in full herein. The present invention concerns materials and methods relating to a novel retrovirus associated with autoimmune disease, as well as diagnostic techniques and kits, to antibodies which bind said retrovirus and their use in diagnosis. Also included are methods of treatment of autoimmune disease and compositions for use in those methods. A substantial body of indirect data supports the hypothesis that a retrovirus may be the etiological agent in a range of autoimmune diseases such as rheumatoid arthritis (RA), Sjogren's syndrome (SS) and systemic lupus erythematosus (SLE), but convincing direct evidence is still lacking. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Method of modulating memory effector T-cells and compositions Inventor(s): Magilavy, Daniel; (Kensington, NH) Correspondence: Louis Myers; Fish & Richardson P.C.; 225 Franklin Street; Boston; MA; 02110-2804; US Patent Application Number: 20020009446 Date filed: February 27, 2001 Abstract: This invention relates to methods of using inhibitors of the CD2/LFA-3 interaction in treating conditions characterized by the presence of activated T cells in mammals, including humans. Such conditions include inflammatory bowel diseases, psoriatic arthritis, rheumatoid arthritis, and multiple sclerosis. Excerpt(s): This invention relates to methods of using inhibitors of the CD2/LFA-3 interaction in treating conditions characterized by the presence of activated T cells in mammals. including humans. Such conditions include inflammatory bowel diseases, psoriatic arthritis, rheumatoid arthritis, and multiple sclerosis. Antigen presenting cells (APC) express a high density of Class II major histocompatibility complex (MHC) antigen on the cell surface. MHC Class II molecules bind peptides derived from endocytosed antigen and are recognized primarily by helper T lymphocytes. The T cell receptor on T cells recognizes antigen as a peptide fragment bound to the cell-surface molecules encoded by the MHC (Springer, "Adhesion Receptors of the Immune System", Nature, 346, pp. 425-27 (1990)). There are many interactions between molecules expressed on the surface of such APC and the surface of T cells, in addition to the T cell receptor/MHC interaction. These surface molecules, often referred to as adhesion molecules, participate in a number of functions including cellular adhesion, antigen recognition, co-stimulatory signaling in T cell activation and stimulation of effectors of T cell cytotoxicity ("Adhesion Molecules in Diagnosis and Treatment of Inflammatory Diseases", The Lancet, 336, pp. 1351-52 (1990)). Such cell adhesion appears to be involved in activation of T cell proliferation in the generation of an immune response (Hughes et al "The Endothelial Cell as a Regulator of T-cell Function", Immunol. Rev., 117, pp. 85-102 (1990)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods and compounds for the treatment of immunologically-mediated skin disorders Inventor(s): Prestidge, Ross; (Auckland, NZ), Tan, Paul L.J.; (Auckland, NZ), Watson, James D.; (Auckland, NZ) Correspondence: Speckman Law Group; Suite 100; 1501 Western Avenue; Seattle; WA; 98101; US Patent Application Number: 20030007976 Date filed: June 13, 2001 Abstract: Methods for the treatment of skin disorders, including psoriasis, atopic dermatitis, allergic contact dermatitis, alopecia areata, skin cancers, and related disorders, such as psoriatic arthritis are provided, such methods comprising administering a composition having antigenic and/or adjuvant properties. Compositions which may be usefully employed in the inventive methods include inactivated M. vaccae cells, delipidated and deglycolipidated M. vaccae cells, M. vaccae culture filtrate and compounds present in or derived therefrom, together with combinations of such compositions. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 09/324,542, filed Jun. 2, 1999, which is a continuation-in-part of U.S. patent application Ser. No. 08/997,080, filed Dec. 23, 1997, now U.S. Pat. No. 5,968,524. This invention relates generally to the treatment by vaccination or immunotherapy of skin disorders such as psoriasis, atopic dermatitis, allergic contact dermatitis, alopecia areata, the skin cancers basal cell carcinoma, squamous cell carcinoma and melanoma, and related disorders, such psoriatic arthritis. In particular, the invention is related to the use of compounds which are present in or have been derived from Mycobacterium vaccae (M. vaccae) or from the culture filtrate of M. vaccae. This invention deals with treatment of disorders of skin which appear to be associated with factors that influence the balance of thymus-derived (T) immune cells known as Th1 and Th2. These T cells are identified by their cytokine secretion phenotype. A common feature of treatment is the use of compounds prepared from M. vaccae which have immunomodulating properties that alter the balance of activities of these T cells as well as other immune cells. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods of treating psoriatic arthritis with chimeric anti-TNF antibodies Inventor(s): Daddona, Peter; (Menlo Park, CA), Ghrayeb, John; (Downingtown, PA), Knight, David; (Berwyn, PA), Le, Junming; (Jackson Heights, NY), Siegel, Scott; (Westborough, MA), Vilcek, Jan; (New York, NY) Correspondence: Hamilton, Brook, Smith & Reynolds, P.C.; 530 Virginia Road; P.O. Box 9133; Concord; MA; 01742-9133; US Patent Application Number: 20030204066 Date filed: February 21, 2003 Abstract: Anti-TNF antibodies, fragments and regions thereof which are specific for human tumor necrosis factor-.alpha. (TNF.alpha.) and are useful in vivo diagnosis and therapy of a number of TNF.alpha.-mediated pathologies and conditions, as well as polynucleotides coding for murine and chimeric antibodies, methods of producing the

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antibody, methods of use of the anti-TNF antibody, or fragment, region or derivative thereof, in immunoassays and immunotherapeutic approaches are provided. Excerpt(s): This application is a divisional of U.S. application Ser. No. 09/756,398, filed Jan. 8, 2001, which is a divisional of U.S. application Ser. No. 09/133,119, filed Aug. 12, 1998, now U.S. Pat. No. 6,277,969, issued Aug. 21, 2001, which is a divisional of U.S. application Ser. No. 08/570,674, filed Dec. 11, 1995, now abandoned, which is a continuation-in-part of U.S. application Ser. No. 08/324,799, filed Oct. 18, 1994, now U.S. Pat. No. 5,698,195, issued Dec. 16, 1997, which is a continuation-in-part of U.S. application Ser. Nos. 08/192,102, now U.S. Pat. No. 5,656,272, issued Aug. 12, 1997, Ser. No. 08/192,861, now U.S. Pat. No. 5,919,452, issued Jul. 6, 1999, and Ser. No. 08/192,093, now U.S. Pat. No. 6,284,471, issued September 4, 2001, all filed on Feb. 4, 1994 which are continuations-in-part of U.S. application Ser. No. 08/010,406, filed Jan. 29, 1993, now abandoned, and U.S. application Ser. No. 08/013,413, filed Feb. 2, 1993, now abandoned, which is a continuation-in-part of U.S. application Ser. No. 07/943,852, filed Sep. 11, 1992, now abandoned, which is a continuation-in-part of U.S. application Ser. No. 07/853,606, filed Mar. 18, 1992, now abandoned, which is a continuation-in-part of U.S. application Ser. No. 07/670,827, filed Mar. 18, 1991, now abandoned. Each of the above applications are entirely incorporated herein by reference. The present invention in the field of immunology and medicine relates to anti-tumor necrosis factor (TNF) antibodies, anti-TNF peptides and nucleic acids encoding therefor, and to pharmaceutical and diagnostic compositions and production, diagnostic and therapeutic methods thereof, and to methods for treating human TNF-mediated pathologies. Monocytes and macrophages secrete cytokines known as tumor necrosis factor-.alpha. (TNF.alpha.) and tumor necrosis factor-.beta. (TNF.beta.) in response to endotoxin or other stimuli. TNF.alpha. is a soluble homotrimer of 17 kD protein subunits (Smith, et al., J. Biol. Chem. 262:6951- 6954 (1987)). A membrane-bound 26 kD precursor form of TNF also exists (Kriegler, et al., Cell 53:45-53 (1988)). For reviews of TNF, see Beutler, et al., Nature 320:584 (1986), Old, Science 230:630 (1986), and Le, et al., Lab. Invest. 56:234. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Methods to treat autoimmune and inflammatory conditions Inventor(s): Shepard, H. Michael; (Encinitas, CA) Correspondence: Mccutchen, Doyle, Brown & Enersen Llp; Suite 1800; Three Embarcadero Center; San Francisco; CA; 94111; US Patent Application Number: 20020151519 Date filed: January 18, 2002 Abstract: This invention provides methods for treating inflammatory or autoimmune diseases by contacting the affected cell or tissue with a therapeutic compound as described herein. Such pathologies include, but are not limited to rheumatoid arthritis, systemic lupus erythmatosus, psoriatic arthritis, reactive arthritis, Crohn's disease, ulcerative colitis and scleroderma. Therapeutic compounds useful in the methods of this invention are selected from the group consisting of a 1,5-substituted pyrimidine derivative or analog and substituted furano-pyrimidone analog. Excerpt(s): This application claims priority under 35 U.S.C.sctn. 119(e) of U.S. Provisional Application No. 60/262,849, filed Jan. 19, 2001, the contents of which are hereby incorporated by reference into the present disclosure. The present invention is in the field of medicinal chemistry and relates to other areas such as pharmacology and

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immunology. In particular, it provides methods to treat autoimmune disorders and inflammatory conditions. The function of tumor suppressor genes is a major focus of recent attempts to develop innovative therapeutics for the treatment cancer. The products of tumor suppressor gene expression are generally characterized as negative regulators of cell proliferation (Knudson, A. G. (1993), Weinberg, R. A. (1995)). Thus, therapeutic approaches to date include gene therapies to restore inactive or missing tumor suppressor function in cancer cells to re-establish normal cellular function or induce apoptosis (Clayman, G. L. (2000), Knudson, A. G. (1993)). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Substances for use in treating psoriasis Inventor(s): Napoli, Guido Di; (Collonge-Bellerive, CH) Correspondence: Clifford W. Browning, Woodard, Emhardt,; Naughton, Moriarty & Mcnett; Bank One Center/tower; 111 Monument Circle, Suite 3700; Indianapolis; IN; 46204-5137; US Patent Application Number: 20020143057 Date filed: March 2, 2001 Abstract: It is disclosed the use of diacerein or a pharmaceutically acceptable derivative thereof for the manufacture of a pharmaceutical composition for the treatment of psoriasis or diseases associated therewith, such as psoriatic arthritis. Excerpt(s): This invention relates to substances for use in treating psoriasis and diseases associated therewith. Psoriasis is a heterogeneous, chronic inflammatory disease of the skin of unknown aetiology. The prevalence of psoriasis in the world population is estimated at around 2 to 3% and varies from minimal lesions of the elbows and knees to a large number of lesions scattered over the skin, with men and women being equally affected. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Therapeutic approaches to diseases by suppression of the NURR subfamily of nuclear transcription factors Inventor(s): Bresnihan, Barry; (Dublin, IE), Conneely, Orla M.; (Houston, TX), Fitzgerald, Oliver; (Dublin, IE), Murphy, Evelyn; (Dublin, IE) Correspondence: Fulbright & Jaworski, Llp; 1301 Mckinney; Suite 5100; Houston; TX; 77010-3095; US Patent Application Number: 20020049151 Date filed: May 11, 2001 Abstract: Synovial CRH functions in a paracrine manner to induce the nuclear transcription factor NURR1, which is abundantly expressed in the inflammatory cells of both rheumatoid arthritis and psoriatic arthritis synovium. This induction is suppressed by glucocorticoids. The invention is directed to the pivotal role the NURR subfamily of transcription factors plays in modulation of peripheral CRH and CRH-mediated signaling through the CRH-receptor subtype R1.alpha., particularly in the inflammatory process in human arthritis.

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Excerpt(s): This application claims priority to U.S. Provisional Patent Application Ser. No. 60/203,645, filed May 12, 2000. The present invention generally relates to the central role of the NURR subfamily of transcription factors in mediating multiple inflammatory signals. More particularly the invention relates to the nuclear receptors NURR1, NUR77 and NOR1 and their role in modulation of peripheral CRH and CRH-mediated signaling, which is an important component of inflammatory processes such as in human arthritis. Many aspects of vertebrate development, differentiation and homeostasis are regulated by small molecular hormones and signaling molecules which control gene expression in a ligand-dependent manner through binding to nuclear receptors. These molecules include sex steroids, corticosteroids, thyroid hormones, and vitamin D3, many of which have been cloned. In spite of the diversity in ligands and biological functions, these receptors belong to the structurally and genetically related nuclear receptor superfamily. The common structural feature of this superfamily is a tripartite domain structure consisting of a hypervariable N-terminus which contributes to the transactivation function; a highly conserved DNA binding domain which is responsible for DNA recognition and dimerization; and the conserved C-terminus, which contains subdomains II and III, and is involved in nuclear localization, ligand binding, receptor dimerization, silencing and transactivation (see, e.g., Evans, 1988; O'Malley, 1990; Beato, 1991; and Tsai and O'Malley, 1994). The most conserved feature of this superfamily is the DNA binding domain (DBD) which contains 65-68 amino acid residues. Eight of the nine non-variant cysteines form two type II zinc modules. The sequence identity in the DBD of any member to the rest of family ranges between 40 to 99%. The high degree of conservation of this segment led to the discovery of many more structurally-related receptors in recent years, which are termed orphan receptors as the identity of ligands and physiological functions are unknown (see, e.g., O'Malle, 1988; Beato, 1991; Laudet et al., 1992; O'Malley and Conneely, 1992). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Use of nimesulide for the treatment of psoriasis and psoriatic arhtritis Inventor(s): Macchi, Fabio; (Pazzallo-Lugano, CH), Scarzi-Puttini, Piercarlo; (PazzalloLugano, CH), Villa, Giuliana; (Pazzallo-Lugano, CH) Correspondence: Nixon & Vanderhye P.C.; 8th Floor; 1100 North Glebe Road; Arlington; VA; 22201-4714; US Patent Application Number: 20020016369 Date filed: June 13, 2001 Abstract: The invention relates to a method of treatment of psoriatic arthritis comprising the administration to patients in need of such treatment of an effective amount of Nimesulide or of a physiologically equivalent form thereof. Excerpt(s): The present invention relates to a method of treatment of psoriasis and of psoriatic arthritis by use of Nimesulide. More particularly, the invention relates to a method of treatment of psoriasis or psoriatic arthritis comprising the administration to patients in need of such treatment of an effective amount of Nimesulide or of a physiologically equivalent form thereof. Psoriatic arthritis is a rheumatoid-like arthritis, usually negative for the rheumatoid factor, associated to classic psoriasis of the skin or nails. This disease is present in up to 0.1% of world population and it usually begins between 30-50 years of age, in both sexes. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Keeping Current In order to stay informed about patents and patent applications dealing with psoriatic arthritis, 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 “psoriatic arthritis” (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 psoriatic arthritis. You can also use this procedure to view pending patent applications concerning psoriatic arthritis. 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 PSORIATIC ARTHRITIS Overview This chapter provides bibliographic book references relating to psoriatic arthritis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on psoriatic arthritis include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Practical Psoriasis Therapy. Second Edition Source: St. Louis, MO: Mosby-Year Book, Inc. 1993. 322 p. Contact: Available from Mosby-Year Book, Inc., 11830 Westline Industrial Drive, St. Louis, MO 63416. Summary: This book for health professionals serves as a guide for physicians who manage patients with psoriasis. Chapters explain the differential diagnosis of psoriasis; describe the histopathology of psoriasis; discuss the selection of therapy for psoriasis patients; and examine the use of topical steroids and other topical agents, Coal tars, keratolytics, emollients, anthralin, phototherapy, psoralen ultraviolet A (PUVA) therapy, synthetic retinoids, systemic chemotherapy, and cyclosporine in the treatment of psoriasis. Chapters also discuss psoriasis day care centers and therapies for childhood psoriasis, scalp psoriasis, pustular psoriasis, exfoliative and erythrodermic psoriasis, nail

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psoriasis, and psoriatic arthritis. Appendices provide patients with information and instructions concerning topical therapies, topical corticosteroids, anthralin, ultraviolet phototherapy, home ultraviolet therapy, psoralen phototherapy, etretinate, methotrexate, cyclosporine, childhood psoriasis, and arthritic psoriasis. Numerous references, 22 figures, and 58 tables.

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

Psoriatic Arthritis by Lynn H. Gerber (Editor), Luis R. Espinoza; ISBN: 0808917099; http://www.amazon.com/exec/obidos/ASIN/0808917099/icongroupinterna

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Psoriatic Arthritis (Bailliere's Clinical Rheumatology) by V. Wright, P. Helliwell; ISBN: 0702018201; http://www.amazon.com/exec/obidos/ASIN/0702018201/icongroupinterna

Chapters on Psoriatic Arthritis In order to find chapters that specifically relate to psoriatic arthritis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and psoriatic arthritis using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “psoriatic arthritis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on psoriatic arthritis: •

Chapter 10: Psoriatic Arthritis Source: in Klippel, J.H., et al., eds. Primer on the Rheumatic Diseases. 12th ed. Atlanta, GA: Arthritis Foundation. 2001. p. 233-238. Contact: Available from Arthritis Foundation. P.O. Box 1616, Alpharetta, GA 300091616. (800) 207-8633. Fax (credit card orders only) (770) 442-9742. Website: www.arthritis.org. PRICE: $69.95 plus shipping and handling. ISBN: 0912423293. Summary: This chapter provides health professionals with information on the epidemiology, pathogenesis, clinical features, treatment, and prognosis of psoriatic arthritis. This heterogeneous disease presents in various forms, including monarthritis, asymmetric oligoarthritis, or symmetric polyarthritis. Although the etiology of psoriasis and psoriatic arthritis is not known, genetic, environmental, and immunologic factors appear to influence susceptibility and disease expression. Data support a role for class I

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human leukocyte antigens in the pathogenesis of psoriatic arthritis. Environmental factors such as infectious agents and physical trauma are likely to be important in the pathogenesis as well. T cells have an important pathogenic role in the skin and joint manifestations of psoriatic arthritis. From a diagnostic and therapeutic standpoint, patients may be classified into the following groups: mono-or oligoarthritis with enthesitis resembling reactive arthritis, symmetric polyarthritis resembling rheumatoid arthritis (RA), and predominantly axial disease with or without peripheral joint disease. Nail involvement is the one clinical feature that identifies patients with psoriasis who are likely to develop arthritis. Several radiographic features are characteristic of psoriatic arthritis. The bone changes in psoriatic arthritis are a combination of erosion and bone production in a specific distribution. Although certain features distinguish psoriatic arthritis from RA, distinguishing between psoriatic arthritis and other seronegative spondyloarthropathies can be more difficult. The initial treatment for stable plaque psoriasis is topical therapy with emollients and keratolytic agents alone or in combination with anthralin, corticosteroids, vitamin D derivatives, and topical retinoids. Treatment for joint disease depends on the type and on the severity of joint and skin involvement. Physical or occupational therapy should be considered early in the course of the disease. Drugs that may be helpful include nonsteroidal antiinflammatory drugs, disease modifying antirheumatic agents, corticosteroids, and etanercept. Most people who have psoriatic arthritis have a better prognosis than people with RA. 2 figures and 23 references.

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

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

Infliximab can relieve symptoms in refractory psoriatic arthritis Source: Reuters Industry Breifing Date: February 03, 2004

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Fludarabine shows limited potential as treatment for psoriatic arthritis Source: Reuters Industry Breifing Date: November 27, 2003

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Xoma psoriasis drug enters phase II for psoriatic arthritis Source: Reuters Industry Breifing Date: January 30, 2003

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Wyeth's Enbrel approved in Europe for psoriatic arthritis Source: Reuters Industry Breifing Date: December 17, 2002

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deCODE studies locate psoriatic arthritis gene, support schizophrenia gene link Source: Reuters Industry Breifing Date: December 13, 2002

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Amgen submits sNDA for Enbrel in psoriatic arthritis Source: Reuters Industry Breifing Date: October 25, 2002

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Humanized OKT3 monoclonal antibody may be useful for psoriatic arthritis Source: Reuters Industry Breifing Date: October 09, 2002

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AHP, Immunex get FDA approval to market Enbrel for psoriatic arthritis Source: Reuters Industry Breifing Date: January 16, 2002

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Study: Enbrel effective in psoriatic arthritis Source: Reuters Health eLine Date: November 12, 2001

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Immunex releases positive phase III data on Enbrel for psoriatic arthritis Source: Reuters Industry Breifing Date: November 12, 2001

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Cyclosporine well tolerated and highly effective in patients with psoriatic arthritis Source: Reuters Industry Breifing Date: November 09, 2001

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Immunex asks FDA to approve Enbrel for psoriatic arthritis Source: Reuters Industry Breifing Date: July 16, 2001

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Bone mineral density decreased in patients with nonaxial psoriatic arthritis Source: Reuters Medical News Date: February 20, 2001

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Etanercept may benefit patients with HIV-associated psoriatic arthritis Source: Reuters Industry Breifing Date: October 24, 2000

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Prevalence of psoriatic arthritis increasing among HIV-positive black Zambians Source: Reuters Medical News Date: July 24, 2000

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Psoriatic arthritis not associated with increased mortality Source: Reuters Medical News Date: June 13, 2000

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Etanercept effective in psoriatic arthritis Source: Reuters Medical News Date: November 18, 1999

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Enbrel relieves psoriatic arthritis Source: Reuters Health eLine Date: November 17, 1999 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 “psoriatic arthritis” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “psoriatic arthritis” (or synonyms). If you know the name of a company that is relevant to psoriatic arthritis, 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/.

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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 “psoriatic arthritis” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “psoriatic arthritis” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on psoriatic arthritis: •

Etanercept: A New Drug for the Treatment of Psoriatic Arthritis Source: Psoriasis Forum. 8(1): 1,4,5. Spring 2002. Contact: National Psoriasis Foundation. P.O. Box 9009, Portland, OR 97207-9009. (800) 723-9166 ext. 12 or (503) 244-7404. Fax: (503) 245-0626. Email: [email protected]. Website: www.psoriasis.org. Summary: This newsletter article discusses etanercept, the first FDA-approved drug for treating psoriatic arthritis. This drug was approved by the FDA for treating patients with RA in 1998 and has also been used to treat juvenile rheumatoid arthritis. Both topical and systemic therapies are used to treat psoriatic arthritis. Systemic therapies which include UVB and PUVA can cause organ toxicity. Etarnercept works by inhibiting the tumor necrosis factor-alpha (TNF-alpha)that is found in elevated levels in the skin and synovium of patients with psoriatic arthritis. The drug is administered subcutaneously by the patient. The most common side effect of etanercept is injectionsite reactions. Ninety percent of these were resolved without treatment. Other side effects include infections, sepsis, and rarely, tuberculosis, neurologic events, and pancytopenia. Overall, etanercept is well tolerated with an excellent safety profile and provides patients with psoriasis a new treatment option.

•

Know the Symptoms of Psoriatic Arthritis Source: National Psoriasis Foundation Bulletin. 27(5):8; September/October 1996. Contact: National Psoriasis Foundation. 6600 SW 92nd Avenue, Suite 300, Portland, OR 97223-7195. (503)244-7404. Fax (503) 245-0626. Summary: This newsletter article for individuals with psoriasis presents the symptoms of psoriatic arthritis. This form of arthritis affects single or multiple joints, particularly those of the hands and feet. The simultaneous presence of psoriasis and nail malformation are an indication of psoriatic arthritis. Nonpharmacological modalities used to treat psoriatic arthritis are highlighted. Drugs that have been beneficial to individuals with both rheumatoid and psoriatic arthritis are identified, including methotrexate and antimalarials. The co-occurrence of gout in individuals with psoriatic arthritis is also discussed.

Periodicals and News 89

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

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CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for psoriatic arthritis. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with psoriatic arthritis. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.).

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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to psoriatic arthritis: Methotrexate for Noncancerous Conditions •

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

Salicylates •

Systemic - U.S. Brands: Acuprin 81; Amigesic; Anacin Caplets; Anacin Maximum Strength; Anacin Tablets; Anaflex 750; Arthritis Pain Ascriptin; Arthritis Pain Formula; Arthritis Strength Bufferin; Arthropan; Aspergum; Aspirin Regimen Bayer Adult Low Dose http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202515.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/.

PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

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

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

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

•

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

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

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

•

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

11

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

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•

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

•

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

•

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

•

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.12 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:13 •

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

•

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

•

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

•

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

•

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

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

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

•

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

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

•

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

•

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

12

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 13 See http://www.nlm.nih.gov/databases/databases.html.

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•

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

•

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

The NLM Gateway14 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.15 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “psoriatic arthritis” (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 2290 18 447 6 13 2774

HSTAT16 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.17 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.18 Simply search by “psoriatic arthritis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

14

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

15

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 16 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 17 18

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

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

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Coffee Break: Tutorials for Biologists19 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.20 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.21 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

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

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

•

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

The Genome Project and Psoriatic Arthritis In the following section, we will discuss databases and references which relate to the Genome Project and psoriatic arthritis. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).22 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. 19 Adapted 20

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

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 21 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. 22 Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease.

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To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “psoriatic arthritis” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for psoriatic arthritis: •

Psoriatic Arthritis, Susceptibility To, 1 Web site: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=607507 Genes and Disease (NCBI - Map)

The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: •

Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html

•

Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html

•

Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html

•

Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html

•

Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html

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•

Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html

•

Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez

Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: •

3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books

•

Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome

•

NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/

•

Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide

•

OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM

•

PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset

•

ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo

•

Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein

•

PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed

•

Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure

•

Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy

To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then

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select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “psoriatic arthritis” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database23 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. The Genome Database24 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “psoriatic arthritis” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms).

23

Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 24 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission.

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

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Ankylosing Spondylitis http://www.nlm.nih.gov/medlineplus/ankylosingspondylitis.html Arthritis http://www.nlm.nih.gov/medlineplus/arthritis.html Fibromyalgia http://www.nlm.nih.gov/medlineplus/fibromyalgia.html Juvenile Rheumatoid Arthritis http://www.nlm.nih.gov/medlineplus/juvenilerheumatoidarthritis.html Osteoarthritis http://www.nlm.nih.gov/medlineplus/osteoarthritis.html Psoriasis http://www.nlm.nih.gov/medlineplus/psoriasis.html Rheumatoid Arthritis http://www.nlm.nih.gov/medlineplus/rheumatoidarthritis.html

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

General/Overviews Arthritis http://www.nlm.nih.gov/medlineplus/tutorials/arthritisgeneralloader.html Arthritis Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/brochure/thr_report.cfm?Thread_ID=2&topcategory=Ar thritis

•

Diagnosis/Symptoms C-Reactive Protein (CRP) Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/analytes/crp/test.html Glossary of Orthopaedic Diagnostic Tests Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=372&topcategory=Abou t%2520Orthopaedics Guide to Lab Tests Source: Arthritis Foundation http://www.arthritis.org/conditions/lab_tests/labtestmain.asp

•

Treatment 2004 Drug Guide Source: Arthritis Foundation http://www.arthritis.org/conditions/DrugGuide/default.asp Arthritic Disorders and Treatments Source: American College of Foot and Ankle Surgeons http://www.acfas.org/brarthdis.html

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Drug-Drug Interactions Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2003_archives/2003_11_12_mix ing_meds_charts.asp Elbow Surgery for Arthritis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AR00008 Help Your Arthritis Treatment Work http://www.fda.gov/opacom/lowlit/arthrtis.html How Do You Know It's Time for Surgery? Source: Arthritis Foundation http://www.arthritis.org/conditions/surgerycenter/when_surgery.asp Injections Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=PN00046 Make No Mistake: Be Your Own Safety Net Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2003_archives/2003_05_06_ma ke_no_mistake_safetynet.asp Surgery and Arthritis: What You Need to Know Source: Arthritis Foundation http://www.arthritis.org/AFStore/StartRead.asp?idProduct=3354 Total Joint Replacement Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/brochure/thr_report.cfm?Thread_ID=18&topcategory=A bout%2520Orthopaedics&searentry=total%2520joint Total Knee Replacement Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/booklet/thr_report.cfm?thread_id=9&topcategory=knee Types of Surgery Source: Arthritis Foundation http://www.arthritis.org/conditions/surgerycenter/types.asp What Are NSAIDs? Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=398&topcategory=Abou t%2520Orthopaedics What You Need to Know about Arthritis Source: American Physical Therapy Association http://www.apta.org/Consumer/ptandyourbody/arthritis •

Alternative Therapy Acupuncture Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2000_archives/2000_05_06_acu puncture.asp

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Arthritis Today's 2002-2003 Supplement Guide: Herbs and Other Remedies Source: Arthritis Foundation http://www.arthritis.org/conditions/supplementguide/herbs.asp Ayurvedic Herbs Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/1999_archives/1999_05_06expl orations.asp Complementary and Alternative Arthritis Treatments Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01121 Homeopathy Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2000_archives/2000_03_04_ho meopathy.asp Meditation Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2001_archives/2001_01_02_me ditation.asp Tai Chi Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2000_archives/2000_07_08_taic hi.asp •

Nutrition Arthritis Today's 2003 Vitamin and Mineral Guide Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2003_archives/Vitamin_Miner al_Guide/default.asp Diet and Your Arthritis Source: Arthritis Foundation http://www.arthritis.org/resources/nutrition/diet.asp Elimination Diets Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/1999_archives/1999_09_10elim ination_diets.asp

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Coping Arthritis & Courtesy: How to Give It, How to Get It Source: Arthritis Foundation http://www.arthritis.org/resources/tips_courtesy.asp Focus on You Source: Arthritis Foundation http://www.arthritis.org/resources/FocusOnYou/Introduction.asp Managing Your Stress Source: Arthritis Foundation http://www.arthritis.org/AFStore/StartRead.asp?idProduct=3363

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Relationships and Dating Source: Arthritis Foundation http://www.arthritis.org/resources/Relationships/relationships_and_dating.asp Returning to Work: Multiply Your Career Options Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01145 Stuck in the Dumps Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2003_archives/2003_11_12_stu ck_dumps_1.asp •

Specific Conditions/Aspects 52 Ways to Bite Back: Do You Wonder What in the World You'll Do As the Bites Health Care Takes Out of Your Wallet Get Bigger and Bigger and Bigger? Here's Help. Source: Arthritis Foundation http://www.arthritisfoundation.org/resources/arthritistoday/2003_archives/2003 _09_10_52_Ways_Intro.asp Arthritis in the Workplace Source: Arthritis Foundation http://www.arthritis.org/resources/workplace/physical.asp Arthritis of the Elbow Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=239&topcategory=Arm Arthritis of the Foot and Ankle Source: American Orthopaedic Foot and Ankle Society http://www.footcaremd.com/fc_a_arthritis.html Arthritis of the Hand Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=307&topcategory=Arthr itis Arthritis of the Knee Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=177&topcategory=Arthr itis Arthritis of the Shoulder Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=289&topcategory=Arthr itis Arthritis of the Wrist Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=261&topcategory=Arthr itis Financial Plannning: An Introduction Source: Arthritis Foundation http://www.arthritis.org/resources/Financial_Planning/Introduction/financial_in

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tro.asp Get Back at Back Pain Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2002_archives/2002_11_12_bac kpain_p1.asp HIV-Associated Rheumatic Disease Syndromes Source: American College of Rheumatology http://www.rheumatology.org/public/factsheets/hiv.asp?aud=pat Home Barrier-Free Home Source: Arthritis Foundation http://www.arthritis.org/resources/Home_Life/default.asp Inflammatory Arthritis of the Hip Source: American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=288&topcategory=Arthr itis Managing Housework with Arthritis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AR00010 MP Joint Arthritis Source: American Society for Surgery of the Hand http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZCIEQSIPC& sub_cat=404 On the Job with Arthritis: How to Make It Work Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01144 Patient Assistance Programs for Rheumatology-Related Drugs Source: American College of Rheumatology http://www.rheumatology.org/public/acrast.asp?aud=pat Psoriatic Arthritis Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00476 Questions and Answers about Arthritis Pain Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/hi/topics/arthritis/arthpain.htm Questions and Answers about Reactive Arthritis Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/hi/topics/reactive/reactive.htm Reactive Arthritis: What You Should Know Source: American Academy of Family Physicians http://familydoctor.org/448.xml Resources for Good Living: Product & Services Directory Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/bg04listings/default.asp

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Septic Arthritis Source: American Association for Clinical Chemistry http://www.labtestsonline.org/understanding/conditions/septic.html Septic Arthritis Source: Cleveland Clinic Foundation http://www.clevelandclinic.org/ortho/arthritis/septic.htm Traveling with Arthritis: Plan, Pack and Enjoy Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ01554 Wake-Up Call: Sleep Deprivation Can Have Serious Health Consequences Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2004_archives/2004_03_04_Wa ke_Up_Call_1.asp •

Children Juvenile Arthritis - Other Types and Related Conditions Source: Arthritis Foundation http://www.arthritis.org/conditions/DiseaseCenter/ja_other.asp Juvenile Psoriatic Arthritis Source: Arthritis Foundation http://www.arthritis.org/conditions/diseasecenter/juvenilepsoriaticarthritis.asp

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From the National Institutes of Health Arthritis Advice Source: National Institute on Aging http://www.niapublications.org/engagepages/arthritis.asp Do I Have Arthritis? http://www.niams.nih.gov/hi/topics/arthritis/tengo/english.htm NIHSeniorHealth: Arthritis Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://nihseniorhealth.gov/arthritis/toc.html Questions and Answers about Arthritis and Rheumatic Disease Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/hi/topics/arthritis/artrheu.htm

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Latest News Arthritis Raises Risk of Back Problems in Women Source: 03/05/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16421 .html Tiny Fat Droplets May Improve Arthritis Treatment Source: 03/17/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_16615 .html

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Organizations American Academy of Orthopaedic Surgeons http://www.aaos.org/ American College of Rheumatology http://www.rheumatology.org/ Arthritis Foundation http://www.arthritis.org/ National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/

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Research Arthritis Drugs May Help the Heart Source: American Heart Association http://www.americanheart.org/presenter.jhtml%3Bjsessionid=?identifier=3007523 Cost-Effectiveness of Cyclooxygenase-2 Inhibitors for Treating Chronic Arthritis Source: American College of Physicians http://www.annals.org/cgi/content/full/138/10/I-39 Vocational Rehabilitation Improves Job Retention for People with Rheumatic Diseases Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/ne/highlights/spotlight/2004/voc_rehab.htm

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Statistics Arthritis and Chronic Joint Symptoms More Common Than Previously Thought Source: Centers for Disease Control and Prevention http://www.cdc.gov/od/oc/media/pressrel/r021024.htm Targeting Arthritis: The Nation's Leading Cause of Disability Source: Centers for Disease Control and Prevention http://www.cdc.gov/nccdphp/aag/aag_arthritis.htm

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Women Pregnancy Prognosis: Is It Possible to Have Arthritis and a Baby Too? Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/2001_archives/2001_03_04_pre gnancyprognosis.asp

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.

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The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on psoriatic arthritis. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Psoriatic Arthritis Source: Portland, OR: National Psoriasis Foundation. 1999. 12 p. Contact: National Psoriasis Foundation. 6600 SW 92nd Avenue, Suite 300, Portland, OR 97223-7195. (800) 723-9166 or (503) 244-7404. Fax (503) 245-0626. E-mail: [email protected]. Website: www.psoriasis.org. Summary: This booklet for individuals with psoriasis presents an overview of psoriatic arthritis (PA). It lists the symptoms of PA; explains how a diagnosis of PA is made; and describes localized mild PA, generalized disabling PA, symmetric arthritis, asymmetric arthritis, distal interphalangeal predominant arthritis, spondylitis, and arthritis mutilans. The booklet discusses various treatments for PA, including aspirin, nonsteroidal anti-inflammatory drugs, sulfasalazine, gold, methotrexate, azathioprine, steroids, photochemotherapy, antimalarials, cyclosporine, retinoids, diet or climate changes, surgery, exercise, physical therapy, and splints. In addition, it lists educational literature available from the National Psoriasis Foundation.

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Understanding Psoriatic Arthritis Source: National Psoriasis Foundation. 200x. 10 p. Contact: Available from National Psoriasis Foundation. 6600 SW 92nd Avenue, Suite 300, Portland, OR 97223-7195. (800) 723-9166. Website: www.psoriasis.org. Summary: This brochure provides patients with an overview of psoriatic arthritis (PA), a chronic condition that causes pain, swelling, and stiffness in the joints. PA can be mild, involving few joints and minor pain, or severe, involving more joints and severe pain. Most patients that develop PA already have psoriasis. Although PA cannot be cured, it can be effectively managed using medications, exercise, splinting, surgery, other forms of therapy, or a combination of these methods. NSAIDs and DMARDs are used to control pain and swelling. Biologic drugs are used generally when other forms of treatment have not been effective and work by blocking the response of the immune system to prevent the effects of arthritis. The National Guideline Clearinghouse™

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

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

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Knee pain or swelling: acute or chronic Source: University of Michigan Health System - Academic Institution http://www.guideline.gov/summary/summary.aspx?doc_id=3540&nbr=2766&a mp;string=arthropathic+AND+psoriasis

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The diagnosis and treatment of heel pain Source: American College of Foot and Ankle Surgeons - Medical Specialty Society; 2001 Sep-October; 12 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3173&nbr=2399&a mp;string=psoriatic+AND+arthritis 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 psoriatic arthritis. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

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

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

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

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

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

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

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Associations and Psoriatic Arthritis The following is a list of associations that provide information on and resources relating to psoriatic arthritis: •

Psoriatic Arthropathy Alliance Telephone: 0870 7703212 Fax: 0870 7703213 Email: [email protected] Web Site: http://www.paalliance.org Background: The Psoriatic Arthropathic Alliance (PAA) is a non-profit support and informational organization for individuals affected by psoriatic arthropathy (PA) and other related conditions. Psoriatic arthropathy is a rheumatoid-like arthritic condition that is associated with psoriasis of the skin or nails, and a negative rheumatoid arthritis (RA) serology laboratory test. The disorder is more common in females than males. The mission of the PAA is to provide support and information to individuals affected by PA. Established in 1993, the Alliance also monitors medical and health care services and supports research into the causes, prevention, and management of PA and related conditions. In addition, the group acts as a lobbyist for patient rights. Consisting of 1,000 members, the Alliance produces educational materials that are available to medical professionals, medical students, and the general public. PAA publishes a periodic newsletter and a journal and offers a networking service.

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

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To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “psoriatic arthritis” (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 “psoriatic arthritis”. 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 “psoriatic arthritis” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “psoriatic arthritis” (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.25

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

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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)26: •

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

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

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

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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

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California: Gateway Health Library (Sutter Gould Medical Foundation)

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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

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Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

26

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

Finding Medical Libraries 117

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

•

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

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•

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

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

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

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

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

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

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

•

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

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

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

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

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

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

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

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

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

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

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

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

•

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

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•

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

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

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

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

Basic Guidelines for Psoriatic Arthritis Psoriasis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm Psoriatic arthritis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000413.htm

•

Signs & Symptoms for Psoriatic Arthritis Ankle pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003167.htm Elbow pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003172.htm Hip pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003179.htm

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Joint pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003261.htm Joint swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003262.htm Knee pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003187.htm Nail abnormalities Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003247.htm Skin lesion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Skin lesions Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Swelling of joints Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003262.htm Wrist pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003175.htm •

Diagnostics and Tests for Psoriatic Arthritis Joint X-rays Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003810.htm X-ray Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm

•

Background Topics for Psoriatic Arthritis Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Exercise Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001941.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm

Online Glossaries 123

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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PSORIATIC ARTHRITIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abductor: A muscle that draws a part away from the median line. [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] Acne: A disorder of the skin marked by inflammation of oil glands and hair glands. [NIH] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adsorption: The condensation of gases, liquids, or dissolved substances on the surfaces of solids. It includes adsorptive phenomena of bacteria and viruses as well as of tissues treated with exogenous drugs and chemicals. [NIH] Adsorptive: It captures volatile compounds by binding them to agents such as activated carbon or adsorptive resins. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aetiology: Study of the causes of disease. [EU] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agammaglobulinemia: An immunologic deficiency state characterized by an extremely low level of generally all classes of gamma-globulin in the blood. [NIH] 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

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emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [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] 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] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] 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] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH] Alopecia: Absence of hair from areas where it is normally present. [NIH] Alpha 1-Antitrypsin: Plasma glycoprotein member of the serpin superfamily which inhibits trypsin, neutrophil elastase, and other proteolytic enzymes. Commonly referred to as alpha 1-proteinase inhibitor (A1PI), it exists in over 30 different biochemical variant forms known collectively as the PI (protease inhibitor) system. Hereditary A1PI deficiency is associated with pulmonary emphysema. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Alveolitis: Inflammation of an alveolus. Called also odontobothritis. [EU] 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.

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There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Ankylosis: Fixation and immobility of a joint. [NIH] Anthralin: An anti-inflammatory anthracene derivative used for the treatment of dermatoses, especially psoriasis. It may cause folliculitis. [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] Antibody therapy: Treatment with an antibody, a substance that can directly kill specific tumor cells or stimulate the immune system to kill tumor cells. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with

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specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antigen-presenting cell: APC. A cell that shows antigen on its surface to other cells of the immune system. This is an important part of an immune response. [NIH] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] 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] Antirheumatic Agents: Drugs that are used to treat rheumatoid arthritis. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Apheresis: Components plateletpheresis. [NIH]

being

separated

out,

as

leukapheresis,

plasmapheresis,

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 associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Argon: A noble gas with the atomic symbol Ar, atomic number 18, and atomic weight 39.948. It is used in fluorescent tubes and wherever an inert atmosphere is desired and nitrogen cannot be used. [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] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthritis, Gouty: Arthritis, especially of the great toe, as a result of gout. Acute gouty

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arthritis often is precipitated by trauma, infection, surgery, etc. The initial attacks are usually monoarticular but later attacks are often polyarticular. [NIH] Arthritis, Infectious: Arthritis caused by bacteria, rickettsiae, mycoplasmas, viruses, fungi, or parasites. Bacterial arthritis is frequently caused by Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria gonorrhoeae. Viral arthritis is less common than bacterial arthritis and may be a manifestation of such viral diseases as mumps, rubella, hepatitis, etc. [NIH] Arthritis, Psoriatic: Syndrome in which psoriasis is associated with arthritis, often involving inflammation in terminal interphalangeal joints. A rheumatoid factor is not usually present in the sera of affected individuals. [NIH] Arthritis, Reactive: An abacterial form of arthritis developing after infection at a site distant from the affected joint or joints. The causative bacteria cannot be cultured from synovial specimens but bacterial antigens have been demonstrated in cells from the synovial fluid and membrane. It often follows Yersinia infection. [NIH] Arthritis, Rheumatoid: A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated. [NIH] Arthropathy: Any joint disease. [EU] Arthroplasty: Surgical reconstruction of a joint to relieve pain or restore motion. [NIH] Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Aspiration: The act of inhaling. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atopic: Pertaining to an atopen or to atopy; allergic. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Auranofin: An oral chrysotherapeutic agent for the treatment of rheumatoid arthritis. Its exact mechanism of action is unknown, but it is believed to act via immunological mechanisms and alteration of lysosomal enzyme activity. Its efficacy is slightly less than that of injected gold salts, but it is better tolerated, and side effects which occur are potentially less serious. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH]

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Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmunity: Process whereby the immune system reacts against the body's own tissues. Autoimmunity may produce or be caused by autoimmune diseases. [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] Basal cell carcinoma: A type of skin cancer that arises from the basal cells, small round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning

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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 phase: The phase of chronic myelogenous leukemia in which the number of immature, abnormal white blood cells in the bone marrow and blood is extremely high. Also called blast crisis. [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] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Bromocriptine: A semisynthetic ergot alkaloid that is a dopamine D2 agonist. It suppresses prolactin secretion and is used to treat amenorrhea, galactorrhea, and female infertility, and has been proposed for Parkinson disease. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchioles: The tiny branches of air tubes in the lungs. [NIH] Bronchiolitis: Inflammation of the bronchioles. [NIH] Bronchiolitis Obliterans: Inflammation of the bronchioles with obstruction by fibrous granulation tissue or bronchial exudate. It may follow inhalation of irritating gases or foreign bodies and it complicates pneumonia. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bursitis: Inflammation of a bursa, occasionally accompanied by a calcific deposit in the underlying supraspinatus tendon; the most common site is the subdeltoid bursa. [EU] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calculi: An abnormal concretion occurring mostly in the urinary and biliary tracts, usually composed of mineral salts. Also called stones. [NIH]

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Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capillary Permeability: Property of blood capillary walls that allows for the selective exchange of substances. Small lipid-soluble molecules such as carbon dioxide and oxygen move freely by diffusion. Water and water-soluble molecules cannot pass through the endothelial walls and are dependent on microscopic pores. These pores show narrow areas (tight junctions) which may limit large molecule movement. [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] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [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] 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 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] Cellular adhesion: The close adherence (bonding) to adjoining cell surfaces. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH]

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Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] 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] 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 lymphocytic leukemia: A slowly progressing disease in which too many white blood cells (called lymphocytes) are found in the body. [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 phase: Refers to the early stages of chronic myelogenous leukemia or chronic lymphocytic leukemia. The number of mature and immature abnormal white blood cells in the bone marrow and blood is higher than normal, but lower than in the accelerated or blast phase. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] Cleave: A double-stranded cut in DNA with a restriction endonuclease. [NIH]

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Clinical Medicine: The study and practice of medicine by direct examination of the patient. [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] Cluster Analysis: A set of statistical methods used to group variables or observations into strongly inter-related subgroups. In epidemiology, it may be used to analyze a closely grouped series of events or cases of disease or other health-related phenomenon with welldefined distribution patterns in relation to time or place or both. [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] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colchicine: A major alkaloid from Colchicum autumnale L. and found also in other Colchicum species. Its primary therapeutic use is in the treatment of gout, but it has been used also in the therapy of familial Mediterranean fever (periodic disease). [NIH] Colitis: Inflammation of the colon. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Collagen disease: A term previously used to describe chronic diseases of the connective tissue (e.g., rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis), but now is thought to be more appropriate for diseases associated with defects in collagen, which is a component of the connective tissue. [NIH] Collagenases: Enzymes that catalyze the degradation of collagen by acting on the peptide bonds. EC 3.4.24.-. [NIH] Collagenous Colitis: A type of colitis. Caused by an abnormal band of collagen, a threadlike protein. [NIH] Colloidal: Of the nature of a colloid. [EU] 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 Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the

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classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Connective Tissue Diseases: A heterogeneous group of disorders, some hereditary, others acquired, characterized by abnormal structure or function of one or more of the elements of connective tissue, i.e., collagen, elastin, or the mucopolysaccharides. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Contact dermatitis: Inflammation of the skin with varying degrees of erythema, edema and vesinculation resulting from cutaneous contact with a foreign substance or other exposure. [NIH]

Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [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] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or

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groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Cornea: The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [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] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the liver to form the active aldophosphamide. It is used in the treatment of lymphomas, leukemias, etc. Its side effect, alopecia, has been made use of in defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer. [NIH] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH] Cyst: A sac or capsule filled with fluid. [NIH] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH]

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Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Day Care: Institutional health care of patients during the day. The patients return home at night. [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] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dendritic cell: A special type of antigen-presenting cell (APC) that activates T lymphocytes. [NIH]

Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatitis, Allergic Contact: A contact dermatitis due to allergic sensitization to various substances. These substances subsequently produce inflammatory reactions in the skin of those who have acquired hypersensitivity to them as a result of prior exposure. [NIH] Dermatologic Agents: Drugs used to treat or prevent skin disorders or for the routine care of skin. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Desquamation: The shedding of epithelial elements, chiefly of the skin, in scales or small sheets; exfoliation. [EU] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diathermy: The induction of local hyperthermia by either short radio waves or highfrequency sound waves. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dihydroxy: AMPA/Kainate antagonist. [NIH] Dimerization: The process by which two molecules of the same chemical composition form a condensation product or polymer. [NIH]

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Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dominance: In genetics, the full phenotypic expression of a gene in both heterozygotes and homozygotes. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysplasia: Cells that look abnormal under a microscope but are not cancer. [NIH] Dyspnea: Difficult or labored breathing. [NIH] Dystrophy: Any disorder arising from defective or faulty nutrition, especially the muscular dystrophies. [EU] Eczema: A pruritic papulovesicular dermatitis occurring as a reaction to many endogenous and exogenous agents (Dorland, 27th ed). [NIH] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH]

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Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Effusion: The escape of fluid into a part or tissue, as an exudation or a transudation. [EU] Elastin: The protein that gives flexibility to tissues. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emollients: Oleagenous substances used topically to soothe, soften or protect skin or mucous membranes. They are used also as vehicles for other dermatologic agents. [NIH] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Endotoxin: Toxin from cell walls of bacteria. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epidermoid carcinoma: A type of cancer in which the cells are flat and look like fish scales. Also called squamous cell carcinoma. [NIH] Episcleritis: Inflammation of the episclera and/or the outer layers of the sclera itself. [NIH]

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Epistasis: The degree of dominance exerted by one gene on the expression of a non-allelic gene. [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] Epitope: A molecule or portion of a molecule capable of binding to the combining site of an antibody. For every given antigenic determinant, the body can construct a variety of antibody-combining sites, some of which fit almost perfectly, and others which barely fit. [NIH]

Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Essential Tremor: A rhythmic, involuntary, purposeless, oscillating movement resulting from the alternate contraction and relaxation of opposing groups of muscles. [NIH] Etretinate: An oral retinoid used in the treatment of keratotic genodermatosis, lichen planus, and psoriasis. Beneficial effects have also been claimed in the prophylaxis of epithelial neoplasia. The compound may be teratogenic. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Exfoliation: A falling off in scales or layers. [EU] Exocrine: Secreting outwardly, via a duct. [EU] 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] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH]

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Fine-needle aspiration: The removal of tissue or fluid with a needle for examination under a microscope. Also called needle biopsy. [NIH] Flexor: Muscles which flex a joint. [NIH] Fludarabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]

Foetoplacental: Pertaining to the fetus and placenta. [EU] Folliculitis: Inflammation of follicles, primarily hair follicles. [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] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Gadolinium: An element of the rare earth family of metals. It has the atomic symbol Gd, atomic number 64, and atomic weight 157.25. Its oxide is used in the control rods of some nuclear reactors. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [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] 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] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Engineering: Directed modification of the gene complement of a living organism by such techniques as altering the DNA, substituting genetic material by means of a virus, transplanting whole nuclei, transplanting cell hybrids, etc. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genomics: The systematic study of the complete DNA sequences (genome) of organisms. [NIH]

Genotype: The genetic constitution of the individual; the characterization of the genes. [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

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participate in blood production. [NIH] Gliadin: Simple protein, one of the prolamines, derived from the gluten of wheat, rye, etc. May be separated into 4 discrete electrophoretic fractions. It is the toxic factor associated with celiac disease. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]

Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [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] Gluconeogenesis: The process by which glucose is formed from a non-carbohydrate source. [NIH]

Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycogen: A sugar stored in the liver and muscles. It releases glucose into the blood when cells need it for energy. Glycogen is the chief source of stored fuel in the body. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or Nacetylgalactosamine. [NIH] Gold Sodium Thiomalate: A variable mixture of the mono- and disodium salts of gold thiomalic acid used mainly for its anti-inflammatory action in the treatment of rheumatoid arthritis. It is most effective in active progressive rheumatoid arthritis and of little or no value in the presence of extensive deformities or in the treatment of other forms of arthritis. [NIH]

Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH]

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Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Graft Rejection: An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. [NIH] Graft-versus-host disease: GVHD. A reaction of donated bone marrow or peripheral stem cells against a person's tissue. [NIH] Granulation Tissue: A vascular connective tissue formed on the surface of a healing wound, ulcer, or inflamed tissue. It consists of new capillaries and an infiltrate containing lymphoid cells, macrophages, and plasma cells. [NIH] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hemiparesis: The weakness or paralysis affecting one side of the body. [NIH] Hemiplegia: Severe or complete loss of motor function on one side of the body. This condition is usually caused by BRAIN DISEASES that are localized to the cerebral hemisphere opposite to the side of weakness. Less frequently, BRAIN STEM lesions; cervical spinal cord diseases; peripheral nervous system diseases; and other conditions may manifest as hemiplegia. The term hemiparesis (see paresis) refers to mild to moderate weakness involving one side of the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemoglobinuria: The presence of free hemoglobin in the urine. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [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

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cells that are organized into interconnected plates called lobules. [NIH] Hepatotoxicity: How much damage a medicine or other substance does to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

HIV: Human immunodeficiency virus. Species of lentivirus, subgenus primate lentiviruses, formerly designated T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV). It is acknowledged to be the agent responsible for the acute infectious manifestations, neurologic disorders, and immunologic abnormalities linked to the acquired immunodeficiency syndrome. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] 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] Hydroxylysine: A hydroxylated derivative of the amino acid lysine that is present in certain collagens. [NIH] Hydroxyproline: A hydroxylated form of the imino acid proline. A deficiency in ascorbic acid can result in impaired hydroxyproline formation. [NIH] 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] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hyperthermia: A type of treatment in which body tissue is exposed to high temperatures to

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damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperuricemia: A buildup of uric acid (a byproduct of metabolism) in the blood; a side effect of some anticancer drugs. [NIH] Hypodermic: Applied or administered beneath the skin. [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] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] 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] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH]

effects

of

foreign

Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunogenic: Producing immunity; evoking an immune response. [EU] 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] Immunologic Factors: Biologically active substances whose activities affect or play a role in the functioning of the immune system. [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] Immunosuppressive Agents: Agents that suppress immune function by one of several mechanisms of action. Classical cytotoxic immunosuppressants act by inhibiting DNA synthesis. Others may act through activation of suppressor T-cell populations or by inhibiting the activation of helper cells. While immunosuppression has been brought about in the past primarily to prevent rejection of transplanted organs, new applications involving mediation of the effects of interleukins and other cytokines are emerging. [NIH]

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Immunosuppressive therapy: Therapy used to decrease the body's immune response, such as drugs given to prevent transplant rejection. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [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] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] 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]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] 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]

Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inlay: In dentistry, a filling first made to correspond with the form of a dental cavity and then cemented into the cavity. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or

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silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] 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] Interleukins: Soluble factors which stimulate growth-related activities of leukocytes as well as other cell types. They enhance cell proliferation and differentiation, DNA synthesis, secretion of other biologically active molecules and responses to immune and inflammatory stimuli. [NIH] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Islet: Cell producing insulin in pancreas. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Joint Capsule: The sac enclosing a joint. It is composed of an outer fibrous articular capsule and an inner synovial membrane. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Keratolytic Agents: Agents that soften, separate, and cause desquamation of the cornified

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epithelium or horny layer of skin. They are used to expose mycelia of infecting fungi or to treat corns, warts, and certain other skin diseases. [NIH] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lentivirus: A genus of the family Retroviridae consisting of non-oncogenic retroviruses that produce multi-organ diseases characterized by long incubation periods and persistent infection. Lentiviruses are unique in that they contain open reading frames (ORFs) between the pol and env genes and in the 3' env region. Five serogroups are recognized, reflecting the mammalian hosts with which they are associated. HIV-1 is the type species. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukapheresis: The preparation of leukocyte concentrates with the return of red cells and leukocyte-poor plasma to the donor. [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] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] 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] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or

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site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [NIH] Lupus Nephritis: Glomerulonephritis associated with systemic lupus erythematosus. It is classified into four histologic types: mesangial, focal, diffuse, and membranous. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphadenopathy: Disease or swelling of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphedema: Edema due to obstruction of lymph vessels or disorders of the lymph nodes. [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] 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] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Major Histocompatibility Complex: The genetic region which contains the loci of genes which determine the structure of the serologically defined (SD) and lymphocyte-defined (LD) transplantation antigens, genes which control the structure of the immune responseassociated (Ia) antigens, the immune response (Ir) genes which control the ability of an animal to respond immunologically to antigenic stimuli, and genes which determine the structure and/or level of the first four components of complement. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU]

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Malformation: A morphologic developmental process. [EU]

defect

resulting

from

an

intrinsically

abnormal

Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [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] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] 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] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metatarsophalangeal Joint: The articulation between a metatarsal bone and a phalanx. [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] 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] Micronutrients: Essential dietary elements or organic compounds that are required in only

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small quantities for normal physiologic processes to occur. [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] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [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] Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] 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] Mononuclear: A cell with one nucleus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Atrophy: Derangement in size and number of muscle fibers occurring with aging, reduction in blood supply, or following immobilization, prolonged weightlessness, malnutrition, and particularly in denervation. [NIH] Muscular Dystrophies: A general term for a group of inherited disorders which are characterized by progressive degeneration of skeletal muscles. [NIH] Mycophenolate mofetil: A drug that is being studied for its effectiveness in preventing graft-versus-host disease and autoimmune disorders. [NIH] Mycoplasma: A genus of gram-negative, facultatively anaerobic bacteria bounded by a plasma membrane only. Its organisms are parasites and pathogens, found on the mucous membranes of humans, animals, and birds. [NIH]

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Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myotonic Dystrophy: A condition presenting muscle weakness and wasting which may be progressive. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrolysis: Separation or exfoliation of tissue due to necrosis. [EU] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Needle biopsy: The removal of tissue or fluid with a needle for examination under a microscope. Also called fine-needle aspiration. [NIH] Neon: Neon. A noble gas with the atomic symbol Ne, atomic number 10, and atomic weight 20.18. It is found in the earth's crust and atmosphere as an inert, odorless gas and is used in vacuum tubes and incandescent lamps. [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] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephropathy: Disease of the kidneys. [EU] Nephrosis: Descriptive histopathologic term for renal disease without an inflammatory component. [NIH] Nephrotic: Pertaining to, resembling, or caused by nephrosis. [EU] Nephrotic Syndrome: Clinical association of heavy proteinuria, hypoalbuminemia, and generalized edema. [NIH] 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] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are

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unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Neutrophil: A type of white blood cell. [NIH] 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] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Observational study: An epidemiologic study that does not involve any intervention, experimental or otherwise. Such a study may be one in which nature is allowed to take its course, with changes in one characteristic being studied in relation to changes in other characteristics. Analytical epidemiologic methods, such as case-control and cohort study designs, are properly called observational epidemiology because the investigator is observing without intervention other than to record, classify, count, and statistically analyze results. [NIH] Occupational Therapy: The field concerned with utilizing craft or work activities in the rehabilitation of patients. Occupational therapy can also refer to the activities themselves. [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]

Oncogene: A gene that normally directs cell growth. If altered, an oncogene can promote or allow the uncontrolled growth of cancer. Alterations can be inherited or caused by an environmental exposure to carcinogens. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Osteoblasts: Bone-forming cells which secrete an extracellular matrix. Hydroxyapatite crystals are then deposited into the matrix to form bone. [NIH]

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Osteocalcin: Vitamin K-dependent calcium-binding protein synthesized by osteoblasts and found primarily in bone. Serum osteocalcin measurements provide a noninvasive specific marker of bone metabolism. The protein contains three residues of the amino acid gammacarboxyglutamic acid (GLA), which, in the presence of calcium, promotes binding to hydroxyapatite and subsequent accumulation in bone matrix. [NIH] Osteoclasts: A large multinuclear cell associated with the absorption and removal of bone. An odontoclast, also called cementoclast, is cytomorphologically the same as an osteoclast and is involved in cementum resorption. [NIH] Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [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]

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] Pancreatic Insufficiency: Absence of or reduced pancreatic exocrine secretion into the duodenum and resultant poor digestion of lipids, vitamins, nitrogen, and carbohydrates. [NIH]

Pancytopenia: Deficiency of all three cell elements of the blood, erythrocytes, leukocytes and platelets. [NIH] Paralysis: Loss of ability to move all or part of the body. [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] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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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] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Pericarditis: Inflammation of the pericardium. [EU] Pericardium: The fibroserous sac surrounding the heart and the roots of the great vessels. [NIH]

Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Peripheral Neuropathy: Nerve damage, usually affecting the feet and legs; causing pain, numbness, or a tingling feeling. Also called "somatic neuropathy" or "distal sensory polyneuropathy." [NIH] Perivascular: Situated around a vessel. [EU] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phosphodiesterase: Effector enzyme that regulates the levels of a second messenger, the cyclic GMP. [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] Phosphorylated: Attached to a phosphate group. [NIH] Photochemotherapy: Therapy using oral or topical photosensitizing agents with subsequent exposure to light. [NIH] Photosensitizing Agents: Drugs that are pharmacologically inactive but when exposed to ultraviolet radiation or sunlight are converted to their active metabolite to produce a beneficial reaction affecting the diseased tissue. These compounds can be administered topically or systemically and have been used therapeutically to treat psoriasis and various types of neoplasms. [NIH]

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Phototherapy: Treatment of disease by exposure to light, especially by variously concentrated light rays or specific wavelengths. [NIH] Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

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

Pilot study: The initial study examining a new method or treatment. [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 cells: A type of white blood cell that produces antibodies. [NIH] Plasmapheresis: Procedure whereby plasma is separated and extracted from anticoagulated whole blood and the red cells retransfused to the donor. Plasmapheresis is also employed for therapeutic use. [NIH] Plateletpheresis: The preparation of platelet concentrates with the return of red cells and platelet-poor plasma to the donor. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Polyarthritis: An inflammation of several joints together. [EU] Polycystic: An inherited disorder characterized by many grape-like clusters of fluid-filled cysts that make both kidneys larger over time. These cysts take over and destroy working kidney tissue. PKD may cause chronic renal failure and end-stage renal disease. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] 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,

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therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predictive factor: A situation or condition that may increase a person's risk of developing a certain disease or disorder. [NIH] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Primary Biliary Cirrhosis: A chronic liver disease. Slowly destroys the bile ducts in the liver. This prevents release of bile. Long-term irritation of the liver may cause scarring and cirrhosis in later stages of the disease. [NIH] 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] Proline: A non-essential amino acid that is synthesized from glutamic acid. It is an essential component of collagen and is important for proper functioning of joints and tendons. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] 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] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein Conformation: The characteristic 3-dimensional shape of a protein, including the

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secondary, supersecondary (motifs), tertiary (domains) and quaternary structure of the peptide chain. Quaternary protein structure describes the conformation assumed by multimeric proteins (aggregates of more than one polypeptide chain). [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] Protein Subunits: Single chains of amino acids that are the units of a multimeric protein. They can be identical or non-identical subunits. [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] Proteinuria: The presence of protein in the urine, indicating that the kidneys are not working properly. [NIH] Proteoglycan: A molecule that contains both protein and glycosaminoglycans, which are a type of polysaccharide. Proteoglycans are found in cartilage and other connective tissues. [NIH]

Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] 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] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Pruritic: Pertaining to or characterized by pruritus. [EU] Psoralen: A substance that binds to the DNA in cells and stops them from multiplying. It is being studied in the treatment of graft-versus-host disease and is used in the treatment of psoriasis and vitiligo. [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] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Fibrosis: Chronic inflammation and progressive fibrosis of the pulmonary alveolar walls, with steadily progressive dyspnea, resulting finally in death from oxygen lack or right heart failure. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Pustular: Pertaining to or of the nature of a pustule; consisting of pustules (= a visible collection of pus within or beneath the epidermis). [EU]

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Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radio Waves: That portion of the electromagnetic spectrum beyond the microwaves, with wavelengths as high as 30 KM. They are used in communications, including television. Short Wave or HF (high frequency), UHF (ultrahigh frequency) and VHF (very high frequency) waves are used in citizen's band communication. [NIH] Radioactive: Giving off radiation. [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Ramus: Most commonly used for branches of nerves, but applied also to other structures. [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] Rarefaction: The reduction of the density of a substance; the attenuation of a gas. [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] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Reconstitution: 1. A type of regeneration in which a new organ forms by the rearrangement of tissues rather than from new formation at an injured surface. 2. The restoration to original form of a substance previously altered for preservation and storage, as the restoration to a liquid state of blood serum or plasma that has been dried and stored. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refractory: Not readily yielding to treatment. [EU] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time.

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[NIH]

Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Response rate: The percentage of patients whose cancer shrinks or disappears after treatment. [NIH] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinoblastoma: An eye cancer that most often occurs in children younger than 5 years. It occurs in hereditary and nonhereditary (sporadic) forms. [NIH] Retinoid: Vitamin A or a vitamin A-like compound. [NIH] Retrovirus: A member of a group of RNA viruses, the RNA of which is copied during viral replication into DNA by reverse transcriptase. The viral DNA is then able to be integrated into the host chromosomal DNA. [NIH] Rheumatic Diseases: Disorders of connective tissue, especially the joints and related structures, characterized by inflammation, degeneration, or metabolic derangement. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Rheumatology: A subspecialty of internal medicine concerned with the study of inflammatory or degenerative processes and metabolic derangement of connective tissue structures which pertain to a variety of musculoskeletal disorders, such as arthritis. [NIH] Rickettsiae: One of a group of obligate intracellular parasitic microorganisms, once regarded as intermediate in their properties between bacteria and viruses but now classified as bacteria in the order Rickettsiales, which includes 17 genera and 3 families: Rickettsiace. [NIH]

Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rubella: An acute, usually benign, infectious disease caused by a togavirus and most often affecting children and nonimmune young adults, in which the virus enters the respiratory tract via droplet nuclei and spreads to the lymphatic system. It is characterized by a slight cold, sore throat, and fever, followed by enlargement of the postauricular, suboccipital, and cervical lymph nodes, and the appearances of a fine pink rash that begins on the head and spreads to become generalized. Called also German measles, roetln, röteln, and three-day measles, and rubeola in French and Spanish. [EU] Rye: A hardy grain crop, Secale cereale, grown in northern climates. It is the most frequent host to ergot (claviceps), the toxic fungus. Its hybrid with wheat is triticale, another grain.

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[NIH]

Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Sclera: The tough white outer coat of the eyeball, covering approximately the posterior fivesixths of its surface, and continuous anteriorly with the cornea and posteriorly with the external sheath of the optic nerve. [EU] Scleritis: Refers to any inflammation of the sclera including episcleritis, a benign condition affecting only the episclera, which is generally short-lived and easily treated. Classic scleritis, on the other hand, affects deeper tissue and is characterized by higher rates of visual acuity loss and even mortality, particularly in necrotizing form. Its characteristic symptom is severe and general head pain. Scleritis has also been associated with systemic collagen disease. Etiology is unknown but is thought to involve a local immune response. Treatment is difficult and includes administration of anti-inflammatory and immunosuppressive agents such as corticosteroids. Inflammation of the sclera may also be secondary to inflammation of adjacent tissues, such as the conjunctiva. [NIH] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [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] Sediment: A precipitate, especially one that is formed spontaneously. [EU] Sedimentation: The act of causing the deposit of sediment, especially by the use of a centrifugal machine. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Senile: Relating or belonging to old age; characteristic of old age; resulting from infirmity of old age. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sepsis: The presence of bacteria in the bloodstream. [NIH]

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Septic: Produced by or due to decomposition by microorganisms; putrefactive. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serology: The study of serum, especially of antigen-antibody reactions in vitro. [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] Sex Determination: The biological characteristics which distinguish human beings as female or male. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] 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] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somatostatin: A polypeptide hormone produced in the hypothalamus, and other tissues and organs. It inhibits the release of human growth hormone, and also modulates important physiological functions of the kidney, pancreas, and gastrointestinal tract. Somatostatin receptors are widely expressed throughout the body. Somatostatin also acts as a neurotransmitter in the central and peripheral nervous systems. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU]

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Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sperm: The fecundating fluid of the male. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Spondylitis: Inflammation of the vertebrae. [EU] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [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] Squamous cells: Flat cells that look like fish scales under a microscope. These cells cover internal and external surfaces of the body. [NIH] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [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] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH]

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Streptococci: A genus of spherical Gram-positive bacteria occurring in chains or pairs. They are widely distributed in nature, being important pathogens but often found as normal commensals in the mouth, skin, and intestine of humans and other animals. [NIH] 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] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Sunburn: An injury to the skin causing erythema, tenderness, and sometimes blistering and resulting from excessive exposure to the sun. The reaction is produced by the ultraviolet radiation in sunlight. [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] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synovial: Of pertaining to, or secreting synovia. [EU] Synovial Fluid: The clear, viscous fluid secreted by the synovial membrane. It contains mucin, albumin, fat, and mineral salts and serves to lubricate joints. [NIH] Synovial Membrane: The inner membrane of a joint capsule surrounding a freely movable joint. It is loosely attached to the external fibrous capsule and secretes synovial fluid. [NIH] Synovitis: Inflammation of a synovial membrane. It is usually painful, particularly on motion, and is characterized by a fluctuating swelling due to effusion within a synovial sac. Synovitis is qualified as fibrinous, gonorrhoeal, hyperplastic, lipomatous, metritic, puerperal, rheumatic, scarlatinal, syphilitic, tuberculous, urethral, etc. [EU] Synthetic retinoid: A substance related to vitamin A that is produced in a laboratory. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Systemic lupus erythematosus: SLE. A chronic inflammatory connective tissue disease marked by skin rashes, joint pain and swelling, inflammation of the kidneys, inflammation of the fibrous tissue surrounding the heart (i.e., the pericardium), as well as other problems. Not all affected individuals display all of these problems. May be referred to as lupus. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or

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mucous membranes. [NIH] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Tendonitis: Inflammation of tendons attached to the biceps muscle, i. e. the main flexor muscle of the upper arm. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [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] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thymus: An organ that is part of the lymphatic system, in which T lymphocytes grow and multiply. The thymus is in the chest behind the breastbone. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyroid Hormones: Hormones secreted by the thyroid gland. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Topical: On the surface of the body. [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

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pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transcription Factors: Endogenous substances, usually proteins, which are effective in the initiation, stimulation, or termination of the genetic transcription process. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translational: The cleavage of signal sequence that directs the passage of the protein through a cell or organelle membrane. [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] 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] Trypsin: A serine endopeptidase that is formed from trypsinogen in the pancreas. It is converted into its active form by enteropeptidase in the small intestine. It catalyzes hydrolysis of the carboxyl group of either arginine or lysine. EC 3.4.21.4. [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] Tuberous Sclerosis: A rare congenital disease in which the essential pathology is the appearance of multiple tumors in the cerebrum and in other organs, such as the heart or kidneys. [NIH] Tumor Necrosis Factor: Serum glycoprotein produced by activated macrophages and other mammalian mononuclear leukocytes which has necrotizing activity against tumor cell lines and increases ability to reject tumor transplants. It mimics the action of endotoxin but differs from it. It has a molecular weight of less than 70,000 kDa. [NIH] Tumor suppressor gene: Genes in the body that can suppress or block the development of cancer. [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] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of

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ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Ultraviolet Therapy: The use of ultraviolet electromagnetic radiation in the treatment of disease, usually of the skin. This is the part of the sun's spectrum that causes sunburn and tanning. Ultraviolet A, used in PUVA, is closer to visible light and less damaging than Ultraviolet B, which is ionizing. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Uric: A kidney stone that may result from a diet high in animal protein. When the body breaks down this protein, uric acid levels rise and can form stones. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Uvea: The middle coat of the eyeball, consisting of the choroid in the back of the eye and the ciliary body and iris in the front of the eye. [NIH] Uveitis: An inflammation of part or all of the uvea, the middle (vascular) tunic of the eye, and commonly involving the other tunics (the sclera and cornea, and the retina). [EU] Vaccination: Administration of vaccines to stimulate the host's immune response. This includes any preparation intended for active immunological prophylaxis. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] 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] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] 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] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is

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dependent mainly on the sharpness of the retinal focus. [NIH] Vitiligo: A disorder consisting of areas of macular depigmentation, commonly on extensor aspects of extremities, on the face or neck, and in skin folds. Age of onset is often in young adulthood and the condition tends to progress gradually with lesions enlarging and extending until a quiescent state is reached. [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] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [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] 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]

169

INDEX A Abdominal, 125, 154, 166 Abdominal Pain, 125, 166 Abductor, 34, 125 Abortion, 125, 153 Acne, 125 Adjuvant, 75, 125 Adrenal Cortex, 125, 153 Adrenal Glands, 125, 127 Adsorption, 54, 125 Adsorptive, 125 Adverse Effect, 125, 162 Aetiology, 77, 125 Affinity, 11, 125, 126, 162 Agammaglobulinemia, 36, 125 Agar, 125, 156 Age of Onset, 32, 126 Agonist, 126, 131, 138 Albumin, 126, 164 Algorithms, 10, 126, 131 Alimentary, 126, 154 Alkaloid, 126, 131, 134 Alleles, 9, 21, 33, 126 Alopecia, 75, 126, 136 Alpha 1-Antitrypsin, 21, 126 Alpha Particles, 126, 159 Alternative medicine, 87, 126 Alveolar Process, 126, 160 Alveolitis, 53, 126 Amenorrhea, 126, 131 Amino acid, 22, 73, 78, 126, 127, 141, 142, 144, 154, 155, 157, 158, 164, 166 Amino Acid Sequence, 73, 127, 141 Amyloidosis, 29, 53, 127 Anaesthesia, 127, 146 Analgesic, 30, 127, 145 Analog, 64, 76, 127 Analytes, 104, 127 Anaphylatoxins, 127, 135 Anastomosis, 50, 127 Anatomical, 127, 133, 146, 161 Anemia, 101, 127 Ankylosis, 27, 127 Anthralin, 81, 83, 127 Antibiotic, 70, 127, 163, 165 Antibodies, 25, 33, 71, 73, 74, 75, 76, 127, 129, 143, 149, 156 Antibody therapy, 36, 127

Antigen, 5, 33, 47, 50, 58, 59, 70, 71, 74, 125, 127, 128, 135, 137, 144, 145, 146, 161, 162 Antigen-Antibody Complex, 128, 135 Antigen-presenting cell, 128, 137 Anti-inflammatory, 41, 68, 70, 111, 127, 128, 129, 142, 145, 157, 161 Anti-Inflammatory Agents, 128, 129 Antimetabolite, 128, 150 Antineoplastic, 128, 136, 150 Antioxidant, 27, 128 Antirheumatic Agents, 83, 128 Anus, 128, 131, 134 Apheresis, 54, 128 Apolipoproteins, 128, 148 Apoptosis, 77, 128 Aqueous, 73, 128, 130, 137 Argon, 70, 128 Arterial, 128, 133, 136, 158 Arteries, 128, 131, 136, 149, 150 Arterioles, 128, 131, 132 Arteritis, 30, 128 Artery, 128, 131, 136, 158, 167 Arthritis, Gouty, 68, 128 Arthritis, Infectious, 68, 129 Arthritis, Psoriatic, 18, 26, 42, 52, 63, 64, 68, 71, 129 Arthritis, Reactive, 76, 129 Arthritis, Rheumatoid, 12, 44, 71, 73, 74, 129 Arthropathy, 4, 36, 58, 59, 113, 129 Arthroplasty, 27, 129 Articular, 50, 51, 129, 147, 153 Articulation, 129, 150 Aspiration, 64, 129 Aspirin, 92, 111, 129 Ataxia, 100, 101, 129, 165 Atopic, 75, 129 Atrophy, 100, 129 Auranofin, 58, 60, 129 Autoantibodies, 7, 129 Autoantigens, 7, 129 Autoimmune disease, 6, 7, 8, 11, 73, 74, 76, 130, 151 Autoimmunity, 8, 11, 12, 130 B Bacteria, 125, 127, 128, 129, 130, 139, 150, 151, 160, 161, 163, 164, 166, 167

Psoriatic arthritis

Bacteriophage, 130, 156 Basal cell carcinoma, 75, 130 Basal cells, 130 Basal Ganglia, 129, 130 Basal Ganglia Diseases, 129, 130 Base, 130, 137, 141, 147 Basophils, 130, 143, 148 Benign, 130, 152, 160, 161, 168 Bile, 130, 141, 148, 157, 163 Bile duct, 130, 157 Biliary, 6, 130, 131 Biochemical, 22, 126, 128, 130, 153 Biological response modifier, 130, 147 Biopsy, 64, 130 Biotechnology, 13, 87, 97, 99, 100, 101, 130 Bladder, 131, 151, 157, 167 Blast phase, 131, 133 Blood pressure, 131, 151, 162 Blood vessel, 131, 133, 136, 139, 140, 142, 147, 149, 150, 164, 165, 167 Bone Marrow, 131, 133, 136, 143, 145, 149 Bone Resorption, 10, 13, 16, 41, 131 Bowel, 42, 73, 131, 137, 146, 147, 163, 166 Bowel Movement, 131, 137, 163 Branch, 119, 131, 149, 155, 162, 165 Bromocriptine, 59, 131 Bronchial, 131 Bronchioles, 131 Bronchiolitis, 58, 131 Bronchiolitis Obliterans, 58, 131 Bronchitis, 131, 133 Buccal, 131, 149 Bursitis, 52, 131 C Calcium, 131, 135, 154 Calculi, 131, 142 Capillary, 44, 132, 167 Capillary Permeability, 44, 132 Carbohydrate, 18, 132, 142, 156 Carbon Dioxide, 132 Carcinogenic, 132, 146, 157, 163 Carcinogens, 132, 153 Carcinoma, 132 Case report, 17, 69, 132 Celiac Disease, 132, 142 Cell Adhesion, 73, 74, 132 Cell Death, 128, 132 Cell Division, 100, 130, 132, 151, 156 Cell proliferation, 74, 77, 132, 147 Cellular adhesion, 74, 132 Central Nervous System, 132, 141, 151 Cerebellar, 129, 132, 159

170

Cerebral, 129, 130, 132, 143 Cerebral Cortex, 129, 132 Cerebrum, 132, 166 Cervical, 53, 133, 143, 160 Cervix, 125, 133 Character, 133, 137, 142 Chemotactic Factors, 133, 135 Chemotherapy, 81, 133 Chin, 133, 150 Cholesterol, 31, 36, 130, 133, 148, 149, 163 Cholesterol Esters, 133, 148 Chromatin, 128, 133, 139 Chromosomal, 133, 160 Chromosome, 15, 133, 148 Chronic lymphocytic leukemia, 133 Chronic myelogenous leukemia, 131, 133 Chronic Obstructive Pulmonary Disease, 73, 133 Chronic phase, 4, 133 Chronic renal, 133, 156 Chylomicrons, 133, 148 Cirrhosis, 6, 133, 157 Cleave, 68, 133 Clinical Medicine, 134, 157 Clinical trial, 5, 7, 8, 11, 43, 63, 65, 97, 134, 135, 136, 138, 158, 159 Cloning, 72, 130, 134 Cluster Analysis, 52, 134 Coenzyme, 7, 134 Cofactor, 134, 158 Colchicine, 59, 134 Colitis, 30, 134 Collagen, 69, 71, 126, 129, 134, 135, 157, 161 Collagen disease, 134, 161 Collagenases, 69, 134 Collagenous Colitis, 20, 134 Colloidal, 126, 134, 139 Colon, 42, 100, 134, 146, 148, 166 Combination Therapy, 25, 134 Complement, 34, 127, 134, 141, 149, 161 Complete remission, 135, 160 Computational Biology, 97, 99, 135 Concomitant, 17, 135 Conjunctiva, 135, 161 Connective Tissue, 71, 131, 134, 135, 140, 141, 143, 149, 150, 158, 160, 161, 164, 165 Connective Tissue Cells, 135 Connective Tissue Diseases, 71, 135 Consciousness, 127, 135, 138 Contact dermatitis, 135, 137 Continuum, 33, 135

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Contraindications, ii, 135 Controlled study, 4, 29, 64, 135 Coordination, 8, 135, 151 Cor, 136 Cornea, 136, 161, 167 Coronary, 136, 150 Coronary Thrombosis, 136, 150 Cortex, 136, 159 Cortical, 10, 136, 161, 165 Corticosteroids, 5, 78, 82, 83, 136, 142, 157, 161 Cortisone, 136, 157 Curative, 136, 165 Cutaneous, 36, 44, 53, 58, 59, 135, 136, 149 Cyclic, 136, 155 Cyclophosphamide, 7, 136 Cyclosporine, 4, 14, 40, 81, 86, 111, 136 Cyst, 17, 136 Cytokine, 12, 21, 40, 55, 73, 75, 136 Cytoplasm, 128, 130, 137, 139 Cytotoxic, 6, 8, 137, 145 Cytotoxicity, 74, 137 D Day Care, 81, 137 Degenerative, 68, 137, 143, 153, 160 Deletion, 128, 137 Dendrites, 137 Dendritic, 6, 137, 150 Dendritic cell, 6, 137 Density, 16, 18, 31, 70, 74, 86, 137, 148, 153, 159, 162 Dermatitis, 73, 75, 137, 138 Dermatitis, Allergic Contact, 75, 137 Dermatologic Agents, 137, 139 Dermatology, 4, 8, 16, 17, 24, 25, 26, 28, 31, 34, 36, 38, 44, 45, 46, 47, 53, 54, 58, 59, 60, 137 Desquamation, 137, 147 Diabetes Mellitus, 6, 137, 142, 143, 147 Diagnostic procedure, 67, 87, 137 Diathermy, 70, 137 Digestion, 126, 130, 131, 137, 147, 148, 154, 163 Digestive system, 66, 137 Digestive tract, 137, 163 Dihydrotestosterone, 137, 159 Dihydroxy, 69, 137 Dimerization, 78, 137 Direct, iii, 11, 53, 70, 74, 91, 134, 138, 159 Discrete, 69, 138, 142, 165 Disease Progression, 19, 68, 70, 138 Dissociation, 125, 138

Distal, 4, 22, 23, 111, 138, 155, 158 Dominance, 138, 140 Dopamine, 131, 138, 152 Double-blind, 14, 29, 49, 58, 138 Drug Interactions, 92, 105, 138 Drug Tolerance, 138, 165 Duodenum, 130, 138, 154, 163 Dysplasia, 101, 138 Dyspnea, 138, 158 Dystrophy, 100, 138 E Eczema, 73, 138 Edema, 23, 135, 138, 149, 152 Effector, 6, 16, 33, 74, 134, 139, 155 Efficacy, 3, 4, 6, 24, 26, 39, 63, 65, 129, 139 Effusion, 139, 164 Elastin, 134, 135, 139 Electrocardiogram, 64, 139 Electrophoresis, 18, 139 Embryo, 125, 139, 146, 153 Emollients, 81, 83, 139 Emphysema, 126, 133, 139 Endocrine Glands, 139 Endogenous, 42, 129, 138, 139, 166 Endothelial cell, 35, 73, 139 Endotoxin, 76, 139, 166 End-stage renal, 133, 139, 156 Environmental Exposure, 139, 153 Environmental Health, 96, 98, 139 Enzymatic, 69, 126, 131, 135, 139 Enzyme, 129, 134, 139, 150, 155, 157, 158, 159, 166, 168 Eosinophils, 139, 143, 148 Epidermal, 59, 139, 150, 168 Epidermis, 130, 139, 144, 158 Epidermoid carcinoma, 139, 163 Episcleritis, 139, 161 Epistasis, 9, 140 Epithelial, 137, 140, 143 Epithelium, 140, 148 Epitope, 53, 140 Ergot, 131, 140, 160 Erythrocytes, 28, 127, 131, 140, 154, 161 Esophagus, 137, 140, 163 Essential Tremor, 100, 140 Etretinate, 5, 58, 59, 82, 140 Excitation, 10, 140, 152 Exfoliation, 137, 140, 152 Exocrine, 140, 154 Exogenous, 125, 138, 139, 140 Extensor, 140, 158, 168 Extracellular, 135, 140, 153, 162

Psoriatic arthritis

Extracellular Matrix, 135, 140, 153 Extremity, 23, 140, 154 Exudate, 131, 140 F Family Planning, 97, 140 Fat, 10, 109, 131, 136, 140, 148, 151, 160, 164, 166 Fatigue, 4, 140, 143 Fibrosis, 68, 101, 140, 158, 161 Fine-needle aspiration, 141, 152 Flexor, 140, 141, 165 Fludarabine, 40, 64, 86, 141 Foetoplacental, 141, 153 Folliculitis, 127, 141 Free Radicals, 128, 138, 141 Fungi, 129, 141, 148, 150, 151, 168 G Gadolinium, 11, 141 Gallbladder, 125, 130, 137, 141 Ganglia, 130, 141, 152, 155 Gas, 128, 132, 141, 144, 152, 153, 159 Gastrointestinal, 29, 141, 162, 164 Gastrointestinal tract, 141, 162 Gene Expression, 9, 12, 77, 78, 101, 141 Genetic Code, 141, 153 Genetic Engineering, 130, 134, 141 Genetics, 9, 12, 15, 18, 30, 47, 138, 141 Genomics, 72, 141 Genotype, 141, 155 Gland, 125, 136, 141, 149, 154, 157, 161, 163, 165 Gliadin, 33, 142 Glomerular, 142 Glomeruli, 142 Glomerulonephritis, 33, 43, 142, 149 Glomerulus, 142, 152 Glucocorticoid, 142, 157 Gluconeogenesis, 142 Glucose, 100, 137, 142, 143, 147 Glucose Intolerance, 137, 142 Gluten, 132, 142 Glycine, 126, 142, 152 Glycogen, 142 Glycoprotein, 126, 142, 166 Glycosaminoglycans, 142, 158 Gold Sodium Thiomalate, 60, 142 Gout, 88, 128, 134, 142 Governing Board, 142, 157 Grade, 63, 143 Graft, 143, 144, 146, 151, 158 Graft Rejection, 143, 146 Graft-versus-host disease, 143, 151, 158

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Granulation Tissue, 131, 143 Granulocyte, 28, 54, 143 Growth, 27, 28, 100, 128, 132, 143, 147, 150, 152, 153, 156, 162, 165, 166 H Hair follicles, 141, 143, 168 Haptens, 125, 143 Health Status, 51, 63, 143 Heart failure, 143, 158 Hemiparesis, 143 Hemiplegia, 41, 143 Hemoglobin, 127, 140, 143 Hemoglobinuria, 100, 143 Hemorrhage, 143, 164 Hepatitis, 30, 31, 129, 143 Hepatocytes, 143 Hepatotoxicity, 40, 144 Hereditary, 126, 135, 142, 144, 160 Heredity, 141, 144 Heterogeneity, 9, 125, 144 HIV, 60, 86, 97, 98, 108, 144, 148 Homeostasis, 78, 144 Homogeneous, 135, 144 Homologous, 126, 144, 161 Hormonal, 129, 144 Hormone, 136, 144, 147, 157, 160, 162, 165 Horny layer, 139, 144, 148 Host, 14, 68, 130, 144, 145, 146, 160, 167 Hydrogen, 130, 132, 144, 151, 152, 154, 158 Hydrolysis, 144, 158, 166 Hydrophobic, 144, 148 Hydroxylysine, 134, 144 Hydroxyproline, 126, 134, 144 Hyperplasia, 49, 144 Hypersensitivity, 137, 144, 160, 161 Hyperthermia, 70, 137, 144 Hypertrophy, 136, 144, 145 Hyperuricemia, 29, 142, 145 Hypodermic, 70, 145 Hypothalamus, 145, 162 I Ibuprofen, 58, 145 Id, 61, 100, 105, 106, 107, 108, 109, 112, 118, 120, 145 Immune function, 145 Immune system, 111, 127, 128, 130, 145, 146, 149, 151, 167, 168 Immunity, 11, 145 Immunization, 145, 146, 161 Immunodeficiency, 26, 33, 100, 144, 145 Immunodeficiency syndrome, 144, 145 Immunogenic, 71, 145

173

Immunoglobulin, 127, 145, 151 Immunologic, 82, 125, 133, 144, 145 Immunologic Factors, 82, 145 Immunology, 11, 21, 23, 33, 35, 46, 47, 76, 77, 125, 145 Immunosuppressant, 145, 150 Immunosuppressive, 3, 136, 142, 145, 146, 161 Immunosuppressive Agents, 3, 145, 161 Immunosuppressive therapy, 146 Immunotherapy, 75, 146 Impairment, 129, 146, 150 Implantation, 146, 153 In vitro, 72, 73, 146, 162 In vivo, 72, 73, 75, 146 Incision, 146, 147 Indicative, 82, 146, 155, 167 Induction, 73, 77, 137, 146, 157 Infarction, 136, 146, 150 Infection, 30, 38, 129, 130, 133, 143, 145, 146, 148, 149, 152, 160, 164, 168 Infertility, 131, 146 Infiltration, 39, 142, 146 Inflammatory bowel disease, 74, 146 Inhalation, 131, 146 Initiation, 146, 166 Inlay, 146, 160 Insight, 6, 146 Insulator, 146, 151 Insulin, 147 Interferon, 47, 147 Interferon-alpha, 147 Interleukins, 145, 147 Internal Medicine, 12, 58, 59, 147, 160 Interstitial, 147, 152 Intestinal, 132, 147, 149 Intestine, 131, 138, 144, 147, 148, 164, 166 Intracellular, 146, 147, 160 Intramuscular, 39, 58, 147, 154 Intravenous, 36, 147, 154 Intrinsic, 6, 125, 147 Invasive, 70, 145, 147, 149 Involuntary, 130, 140, 147, 152 Ionizing, 126, 139, 147, 167 Ischemia, 129, 147 Islet, 8, 147 J Joint Capsule, 147, 164 K Kb, 46, 96, 147 Keratolytic, 73, 83, 147 Keratolytic Agents, 83, 147

Kidney Disease, 66, 96, 101, 148 Kinetics, 27, 148 L Labile, 134, 148 Lactation, 148, 153, 157 Large Intestine, 137, 147, 148, 159 Latent, 31, 148 Lentivirus, 144, 148 Leucocyte, 42, 148 Leukapheresis, 64, 128, 148 Leukemia, 100, 133, 148 Leukocytes, 130, 131, 133, 139, 147, 148, 154, 166 Library Services, 118, 148 Ligament, 148, 157 Ligands, 78, 148 Linkage, 9, 148 Lipid, 128, 132, 147, 148, 151, 166 Lipoprotein, 31, 148, 149 Liver, 3, 125, 126, 127, 130, 133, 136, 137, 141, 142, 143, 144, 148, 157 Localization, 6, 9, 78, 148 Localized, 39, 111, 127, 143, 146, 149, 156, 161 Low-density lipoprotein, 148, 149 Lupus, 7, 11, 12, 73, 76, 149, 164 Lupus Nephritis, 7, 149 Lymph, 133, 139, 144, 149, 160 Lymph node, 133, 149, 160 Lymphadenopathy, 144, 149 Lymphatic, 146, 149, 150, 160, 163, 165 Lymphatic system, 149, 160, 163, 165 Lymphedema, 40, 55, 149 Lymphocyte, 40, 50, 58, 59, 128, 149 Lymphoid, 127, 136, 143, 148, 149 Lymphoma, 100, 149 M Macrophage, 40, 49, 149 Magnetic Resonance Imaging, 14, 19, 45, 149 Maintenance therapy, 7, 149 Major Histocompatibility Complex, 42, 71, 74, 149 Malabsorption, 100, 132, 149 Malformation, 88, 150 Malignant, 100, 128, 150, 152, 161 Malnutrition, 126, 129, 150, 151 Mandible, 126, 133, 150, 160 Manifest, 143, 150 Mediate, 10, 138, 150 MEDLINE, 97, 99, 101, 150 Melanocytes, 150

Psoriatic arthritis

Melanoma, 75, 100, 150 Membrane, 34, 76, 129, 135, 140, 150, 151, 155, 160, 164, 166 Memory, 7, 74, 150 Menopause, 150, 153, 156 Menstrual Cycle, 150, 153 Mental, iv, 5, 66, 96, 98, 102, 132, 133, 138, 140, 150, 158, 161 Mental Disorders, 66, 150 Mesenchymal, 129, 150 Metabolic disorder, 142, 150 Metatarsophalangeal Joint, 5, 150 Methotrexate, 3, 5, 6, 15, 28, 31, 39, 40, 41, 42, 49, 51, 52, 82, 88, 92, 111, 150 MI, 43, 51, 123, 150 Microbe, 150, 165 Micronutrients, 27, 150 Microorganism, 134, 151, 168 Migration, 7, 151 Mitosis, 128, 151 Mobility, 4, 151 Modification, 43, 126, 141, 151, 159 Molecular, 55, 71, 78, 97, 99, 130, 135, 151, 157, 166 Molecule, 15, 73, 128, 130, 132, 134, 135, 138, 139, 140, 144, 151, 154, 158, 159, 166 Monitor, 151, 153 Monoclonal, 65, 86, 151 Monocyte, 39, 54, 151 Mononuclear, 151, 166 Mucosa, 132, 149, 151, 157 Mucus, 151, 166 Multiple sclerosis, 6, 73, 74, 151 Muscle Fibers, 151 Muscular Atrophy, 100, 151 Muscular Dystrophies, 138, 151 Mycophenolate mofetil, 60, 151 Mycoplasma, 129, 151 Myelin, 151, 152 Myocardium, 150, 152 Myotonic Dystrophy, 100, 152 N NCI, 1, 66, 95, 152 Necrolysis, 59, 152 Need, 3, 4, 7, 78, 81, 82, 88, 105, 114, 133, 142, 152, 165 Needle biopsy, 64, 141, 152 Neon, 70, 152 Neoplasia, 100, 140, 152 Neoplasm, 152, 161 Neoplastic, 149, 152 Nephritis, 7, 152

174

Nephropathy, 41, 148, 152 Nephrosis, 152 Nephrotic, 29, 152 Nephrotic Syndrome, 29, 152 Nerve, 129, 133, 137, 151, 152, 155, 160, 161, 163 Nervous System, 52, 100, 132, 152, 155 Neurologic, 88, 144, 152 Neuropathy, 152, 155 Neurotransmitter, 127, 138, 142, 152, 162, 164 Neutrons, 126, 152, 159 Neutrophil, 44, 126, 153 Nitrogen, 126, 128, 136, 153, 154, 166 Nuclear, 9, 27, 31, 40, 77, 78, 130, 141, 153 Nuclei, 126, 141, 149, 151, 152, 153, 158, 160 Nucleic acid, 68, 76, 141, 153 Nucleus, 128, 130, 133, 136, 137, 139, 151, 153, 158, 165 O Observational study, 54, 153 Occupational Therapy, 83, 153 Oestrogen, 58, 153 Oncogene, 100, 153 Opacity, 137, 153 Osteoarthritis, 12, 42, 52, 68, 72, 73, 104, 153 Osteoblasts, 153, 154 Osteocalcin, 52, 154 Osteoclasts, 10, 154 Osteoporosis, 5, 55, 153, 154 Outpatient, 5, 43, 154 Ovary, 153, 154 Oxidation, 128, 154 P Palliative, 70, 153, 154, 165 Pancreas, 125, 137, 147, 154, 162, 166 Pancreatic, 30, 100, 154 Pancreatic cancer, 100, 154 Pancreatic Insufficiency, 30, 154 Pancytopenia, 88, 154 Paralysis, 7, 143, 154 Parenteral, 58, 154 Paresis, 143, 154 Paroxysmal, 100, 154 Partial remission, 154, 160 Pathogenesis, 12, 44, 45, 48, 59, 82, 154 Pathologic, 128, 130, 136, 144, 155, 158, 160, 163 Pathologic Processes, 128, 155 Pathologies, 75, 76, 155

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Patient Education, 63, 111, 116, 118, 123, 155 Pelvic, 155, 157 Peptide, 71, 74, 126, 134, 155, 157, 158 Pericarditis, 30, 155 Pericardium, 155, 164 Peripheral blood, 11, 16, 55, 147, 155 Peripheral Nervous System, 143, 152, 155, 162, 164 Peripheral Nervous System Diseases, 143, 155 Peripheral Neuropathy, 24, 155 Perivascular, 34, 155 Pharmacologic, 155, 166 Phenotype, 6, 72, 75, 155 Phosphodiesterase, 73, 155 Phospholipids, 140, 148, 155 Phosphorylated, 134, 155 Photochemotherapy, 5, 111, 155 Photosensitizing Agents, 155 Phototherapy, 81, 156 Physical Examination, 5, 64, 156 Physical Therapy, 68, 105, 111, 156 Physiologic, 126, 150, 151, 156, 159, 160 Pilot study, 24, 41, 59, 156 Plants, 126, 132, 142, 156, 166 Plaque, 60, 73, 83, 156 Plasma, 64, 126, 127, 133, 142, 143, 148, 151, 156, 159, 161 Plasma cells, 127, 143, 156 Plasmapheresis, 128, 156 Plateletpheresis, 128, 156 Platelets, 154, 156 Pneumonia, 131, 135, 156 Polyarthritis, 5, 63, 82, 156 Polycystic, 101, 156 Polymorphic, 9, 156 Polymorphism, 38, 46, 54, 156 Polysaccharide, 128, 156, 158 Posterior, 46, 129, 154, 156, 161 Postmenopausal, 154, 156 Practice Guidelines, 98, 111, 156 Precursor, 11, 76, 136, 138, 139, 157, 166 Predictive factor, 19, 157 Prednisolone, 157 Prednisone, 4, 31, 157 Prevalence, 30, 77, 86, 157 Primary Biliary Cirrhosis, 50, 157 Progression, 7, 32, 39, 46, 70, 157 Progressive, 133, 138, 142, 143, 151, 152, 153, 157, 158 Prolactin, 131, 157

Proline, 134, 144, 157 Promoter, 38, 157 Prophylaxis, 140, 157, 167 Prospective study, 46, 157 Prostate, 100, 153, 157 Protease, 126, 134, 157 Protein C, 126, 127, 128, 130, 148, 154, 157 Protein Conformation, 127, 157 Protein S, 12, 76, 101, 131, 141, 154, 158, 165 Protein Subunits, 76, 158 Proteins, 11, 31, 34, 69, 73, 126, 127, 128, 133, 134, 151, 153, 155, 156, 158, 162, 166 Proteinuria, 152, 158 Proteoglycan, 69, 158 Proteolytic, 69, 71, 126, 135, 158 Protocol, 7, 158 Protons, 126, 144, 147, 158, 159 Proximal, 55, 138, 158 Pruritic, 138, 158 Psoralen, 81, 158 Psychic, 150, 158, 161 Public Policy, 97, 158 Pulmonary, 15, 68, 126, 131, 136, 158, 167 Pulmonary Fibrosis, 15, 158 Pulse, 10, 49, 151, 158 Pustular, 29, 38, 73, 81, 158 Q Quality of Life, 19, 21, 30, 159 R Race, 151, 159 Radiation, 68, 70, 139, 141, 145, 147, 155, 159, 164, 167, 168 Radio Waves, 137, 159 Radioactive, 144, 146, 153, 159 Radiological, 15, 19, 39, 49, 53, 70, 159 Radiology, 9, 34, 159 Ramus, 56, 159 Randomized, 4, 29, 49, 139, 159 Rarefaction, 129, 159 Receptor, 8, 11, 21, 32, 35, 59, 74, 77, 78, 128, 138, 159 Recombinant, 72, 159 Reconstitution, 11, 159 Rectum, 128, 131, 134, 137, 141, 146, 148, 157, 159 Recurrence, 73, 159 Red Nucleus, 129, 159 Reductase, 7, 150, 159 Refer, 1, 131, 134, 141, 148, 153, 159, 166 Refractory, 40, 54, 68, 85, 159 Regeneration, 159

Psoriatic arthritis

Regimen, 73, 92, 139, 159 Relapse, 73, 159 Reliability, 45, 50, 159 Remission, 50, 70, 149, 159, 160 Resorption, 10, 154, 160 Response rate, 4, 160 Restoration, 11, 156, 159, 160 Retina, 46, 160, 167 Retinoblastoma, 100, 160 Retinoid, 140, 160 Retrovirus, 73, 74, 160 Rheumatism, 16, 19, 21, 23, 24, 27, 30, 31, 33, 34, 36, 40, 42, 43, 45, 49, 52, 55, 145, 160 Rickettsiae, 129, 160 Risk factor, 9, 51, 157, 160 Rubella, 129, 160 Rye, 140, 142, 160 S Salivary, 137, 154, 161 Salivary glands, 137, 161 Sarcoma, 37, 161 Schizophrenia, 86, 161 Sclera, 135, 139, 161, 167 Scleritis, 46, 161 Scleroderma, 6, 8, 73, 76, 161 Sclerosis, 31, 100, 134, 151, 161 Screening, 68, 72, 134, 161 Sebaceous, 161, 168 Secretion, 75, 131, 147, 148, 151, 154, 161 Sediment, 161 Sedimentation, 4, 161 Seizures, 154, 161 Semen, 157, 161 Semisynthetic, 131, 161 Senile, 154, 161 Sensitization, 137, 161 Sepsis, 88, 161 Septic, 109, 162 Sequencing, 7, 9, 12, 162 Serology, 113, 162 Serum, 28, 31, 35, 40, 51, 52, 69, 126, 127, 134, 149, 154, 159, 162, 166 Sex Characteristics, 153, 162, 165 Sex Determination, 101, 162 Shock, 162, 166 Side effect, 3, 73, 88, 91, 125, 129, 136, 145, 162, 165 Signs and Symptoms, 159, 160, 162 Skeleton, 147, 162 Social Environment, 159, 162 Sodium, 142, 162

176

Somatic, 151, 155, 162 Somatostatin, 30, 59, 162 Sound wave, 137, 162 Specialist, 113, 162 Species, 55, 134, 144, 148, 151, 159, 162, 164, 166, 167 Specificity, 125, 163 Spectrum, 159, 163, 167 Sperm, 133, 163 Spinal cord, 132, 133, 143, 152, 155, 163 Spinal Cord Diseases, 143, 163 Spleen, 127, 149, 163 Spondylitis, 4, 8, 16, 18, 22, 23, 30, 51, 68, 104, 111, 163 Sporadic, 160, 163 Squamous, 75, 139, 163 Squamous cell carcinoma, 75, 139, 163 Squamous cells, 163 Statistically significant, 4, 163 Sterility, 136, 146, 163 Steroid, 136, 153, 163 Stimulus, 140, 163 Stomach, 125, 137, 140, 141, 144, 163 Stool, 134, 148, 163 Streptococci, 55, 164 Stress, 5, 52, 106, 160, 164 Stroke, 66, 96, 164 Subacute, 146, 164 Subclinical, 146, 161, 164 Subcutaneous, 138, 154, 164 Subspecies, 162, 164 Substance P, 159, 161, 164 Sunburn, 164, 167 Supplementation, 58, 164 Suppression, 10, 77, 164 Symphysis, 133, 157, 164 Symptomatic, 4, 14, 16, 164 Synovial, 6, 10, 15, 16, 17, 21, 31, 33, 34, 35, 40, 42, 49, 50, 55, 64, 77, 129, 147, 164 Synovial Fluid, 17, 21, 31, 35, 50, 55, 64, 129, 164 Synovial Membrane, 15, 34, 40, 49, 129, 147, 164 Synovitis, 6, 15, 164 Synthetic retinoid, 81, 164 Systemic, 6, 8, 12, 29, 31, 53, 73, 74, 76, 81, 88, 92, 127, 129, 131, 134, 146, 149, 157, 161, 164 Systemic disease, 129, 164 Systemic lupus erythematosus, 6, 8, 74, 134, 149, 164

177

T Telangiectasia, 101, 164 Tendon, 34, 48, 54, 55, 131, 165 Tendonitis, 35, 165 Teratogenic, 140, 165 Testis, 153, 165 Testosterone, 159, 165 Tetracycline, 70, 165 Thalamic, 129, 165 Thalamic Diseases, 129, 165 Therapeutics, 12, 77, 92, 165 Thrombosis, 158, 164, 165 Thymus, 75, 145, 149, 165 Thyroid, 78, 165 Thyroid Gland, 165 Thyroid Hormones, 78, 165 Tin, 155, 165 Tolerance, 7, 11, 142, 165 Topical, 5, 81, 83, 88, 155, 165 Toxic, iv, 59, 73, 137, 139, 142, 145, 152, 160, 165, 166 Toxicity, 3, 88, 138, 165 Toxicology, 98, 165 Toxin, 139, 165, 166 Trachea, 165, 166 Transcriptase, 160, 166 Transcription Factors, 77, 78, 166 Transfection, 130, 166 Translation, 126, 166 Translational, 8, 11, 166 Transplantation, 8, 43, 133, 145, 149, 166 Trauma, 68, 83, 129, 130, 165, 166 Triglyceride, 36, 166 Trypsin, 126, 166 Tryptophan, 134, 166 Tuberous Sclerosis, 101, 166 Tumor Necrosis Factor, 16, 31, 38, 46, 52, 54, 75, 76, 88, 166 Tumor suppressor gene, 77, 166

U Ulcerative colitis, 76, 146, 166 Ultrasonography, 14, 35, 54, 166 Ultraviolet Therapy, 82, 167 Unconscious, 145, 167 Urethra, 157, 167 Uric, 142, 145, 167 Urine, 131, 143, 158, 167 Uterus, 125, 133, 167 Uvea, 167 Uveitis, 19, 167 V Vaccination, 75, 167 Vaccine, 125, 158, 167 Vascular, 41, 143, 146, 163, 165, 167 Vasculitis, 43, 56, 167 Vein, 64, 147, 153, 167 Venous, 158, 167 Ventricle, 136, 145, 158, 167 Venules, 131, 132, 167 Vertebrae, 163, 167 Veterinary Medicine, 97, 167 Viral, 129, 160, 167, 168 Virulence, 165, 167 Virus, 26, 30, 33, 130, 141, 144, 147, 156, 160, 167 Visual Acuity, 161, 167 Vitiligo, 158, 168 Vitro, 73, 168 Vivo, 73, 168 Vulgaris, 38, 44, 46, 54, 168 W Warts, 148, 168 White blood cell, 64, 127, 131, 133, 143, 148, 149, 151, 153, 156, 168 Windpipe, 165, 168 X X-ray, 10, 64, 122, 153, 159, 168 Y Yeasts, 141, 155, 168

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