Raynaud's Disease - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

RAYNAUD’S DISEASE 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., 1960Raynaud’s Disease: 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: 0-597-84602-2 1. Raynaud’s Disease-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 Raynaud’s disease. 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 RAYNAUD’S DISEASE ................................................................................ 3 Overview........................................................................................................................................ 3 Federally Funded Research on Raynaud’s Disease ........................................................................ 3 The National Library of Medicine: PubMed .................................................................................. 6 CHAPTER 2. NUTRITION AND RAYNAUD’S DISEASE ...................................................................... 31 Overview...................................................................................................................................... 31 Finding Nutrition Studies on Raynaud’s Disease....................................................................... 31 Federal Resources on Nutrition ................................................................................................... 37 Additional Web Resources ........................................................................................................... 38 CHAPTER 3. CLINICAL TRIALS AND RAYNAUD’S DISEASE ............................................................ 41 Overview...................................................................................................................................... 41 Recent Trials on Raynaud’s Disease............................................................................................ 41 Keeping Current on Clinical Trials ............................................................................................. 43 CHAPTER 4. BOOKS ON RAYNAUD’S DISEASE ................................................................................ 45 Overview...................................................................................................................................... 45 Book Summaries: Online Booksellers........................................................................................... 45 Chapters on Raynaud’s Disease ................................................................................................... 45 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 49 Overview...................................................................................................................................... 49 NIH Guidelines............................................................................................................................ 49 NIH Databases............................................................................................................................. 51 Other Commercial Databases....................................................................................................... 53 APPENDIX B. PATIENT RESOURCES ................................................................................................. 55 Overview...................................................................................................................................... 55 Patient Guideline Sources............................................................................................................ 55 Finding Associations.................................................................................................................... 60 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 63 Overview...................................................................................................................................... 63 Preparation................................................................................................................................... 63 Finding a Local Medical Library.................................................................................................. 63 Medical Libraries in the U.S. and Canada ................................................................................... 63 ONLINE GLOSSARIES.................................................................................................................. 69 Online Dictionary Directories ..................................................................................................... 70 RAYNAUD’S DISEASE DICTIONARY...................................................................................... 71 INDEX ................................................................................................................................................ 95

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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 Raynaud’s disease 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 Raynaud’s disease, 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 Raynaud’s disease, 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 Raynaud’s disease. 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 Raynaud’s disease, 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 Raynaud’s disease. 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 RAYNAUD’S DISEASE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Raynaud’s disease.

Federally Funded Research on Raynaud’s Disease The U.S. Government supports a variety of research studies relating to Raynaud’s disease. 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 Raynaud’s disease. 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 Raynaud’s disease. The following is typical of the type of information found when searching the CRISP database for Raynaud’s disease: •

Project Title: FINE SPECIFICITY OF SCLERODERMA AUTOANTIBODIES Principal Investigator & Institution: James, Judith A.; Associate Professor; Oklahoma Medical Research Foundation Oklahoma City, Ok 731045005 Timing: Fiscal Year 2002; Project Start 26-SEP-2001; Project End 31-MAY-2006 Summary: (provided by applicant): Systemic sclerosis (scleroderma) is a disfiguring, multi-system disease of unknown etiology, which is characterized by a broad spectrum

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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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of disease manifestations with varying organ involvement. Raynaud's phenomenon, the dysregulated vascular contraction of the terminal arteries of the circulatory system, is present in almost every case. Vascular insufficiency in these patients is associated with a vasculopathy causing tissue ischemia, which is directly linked to progressive fibrosis of specific target organs, such as the skin, lung, heart, gastrointestinal tract, and kidney. Although the underlying pathophysiology of this disorder remains an enigma, the presence of anti-nuclear antibodies in scleroderma patients is nearly universal. Targets of these autoantibodies include topoisomerase 1 (Scl-70), nuclear ribonucleoproteins (nRNP), centromere, PM-Scl, and Ku. Anti-topoisomerase-1 (topo-1) autoantibodies are quite specific for scleroderma. and are present in precipitating levels in 20-40% of patients. Anti-topo 1 is associated with diffuse skin thickening, lung involvement, and the development of lung, colon, and brain cancer. Scleroderma patients with anti-nRNP autoantibodies may have a more cutaneous form of the disease and universally suffer from Raynaud's phenomenon. Over the past decade we have extensively characterized the immunochemistry of lupus autoantigens. These previous studies provide the technical background for this proposal. Epitope mapping experiments of the lupus spliceosomal autoantigens have led to a peptide induced model of lupus autoimmunity. These studies have identified a potential etiological trigger and pathogenic mechanisms. We will now apply these well-honed techniques, as well as a similar scientific strategy, to analyze the humoral fine specificity of the anti-nRNP and anti-topoisomerase autoantibodies found in scleroderma. Preliminary data suggest a dramatic difference in the anti-nRNP response of SLE patients and scleroderma patients with nRNP autoantibodies. This project seeks to identify the common humoral epitopes of nRNP and topoisomerase-1 in scleroderma and primary Raynaud's, to describe the development of these humoral autoimmune responses over time (and with therapy), to establish potential etiological triggers of these rheumatic diseases, and to understand the role of these specific autoantibodies in scleroderma, disease pathogenesis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MECHANISMS SCLERODERMA

OF

ALTERED

VASOREACTIVITY

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Principal Investigator & Institution: Flavahan, Nicholas A.; Professor of Medicine & Physiology; Internal Medicine; Ohio State University 1960 Kenny Road Columbus, Oh 43210 Timing: Fiscal Year 2002; Project Start 01-SEP-1998; Project End 30-JUN-2004 Summary: Scleroderma (SSc) is a disease of unknown etiology associated with high mortality and morbidity. An early feature of SSc is reversible vasospasm occurring in peripheral, myocardial, renal and pulmonary circulations - Raynaud's phenomenon is present in 95 percent of cases. Small arteries/arterioles subsequently develop concentric intimal thickening and adventitial fibrosis. In preliminary studies, small dermal arteries (100-300 mu diameter) were isolated from skin biopsies of SSc patients and from age/sex-matched controls and mounted in a microperfusion system. Vascular smooth muscle of SSc arteries (clinically-uninvolved skin) demonstrated a dramatic and selective increase (300-fold) in contractile reactivity to stimulation of alpha2adenoceptors (alpha2-ARs). Endothelial function, as assessed by NO- mediated, endothelium-dependent relaxation to acetylcholine or bradykinin, was normal. In SSc arteries from involved skin, endothelium-dependent response to bradykinin was impaired suggesting the presence of endothelial dysfunction. The hypothesis of this proposal is that an early feature of SSc is an increased reactivity of microvascular smooth muscle alpha2-ARs. This causes inappropriate and exaggerated vasoconstriction

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in response to physiologic stimuli (e.g. nerve stimulation, cold). The resulting cycles of ischemia and reperfusion, characteristic of SSc, leads to dysfunction of microvascular endothelial cells, promoting vascular lesion development and the extravascular complications of the disease process. To test this hypothesis, experiments will be performed on isolated dermal arteries from subjects with SSc or primary Raynaud's disease, and from age/sex matched controls. Pharmacological, biochemical and molecular techniques will be used to address 3 specific aims: 1) to determine the mechanisms(s) underlying increased responsiveness to alpha-AR stimulation in SSc, 2) to determine whether the neural regulation of SSc microvascular contraction is dysfunctional, and 3) to analyze endothelial function, and the mechanisms underlying development of endothelial dysfunction in SSc. These studies should increase our understanding of the SSc disease process and may provide a scientific basis for therapeutic intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROSPECTIVE STUDY OF PATIENTS WITH RAYNAUD'S DISEASE Principal Investigator & Institution: Rothfield, Naomi; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 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: STUDY OF PERSISTENT INFECTION IN SSC SKIN AND VESSELS Principal Investigator & Institution: Mayes, Maureen D.; Professor; Internal Medicine; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 26-SEP-2001; Project End 31-MAY-2004 Summary: (provided by applicant): The overall objective of this proposal is to study the possibility that in some systemic sclerosis patients, a persistent bacterial infection involving dermal microvascular endothelium or other cells that are resident in skin results in the obliterative microvasculopathy and/or the fibrosing features of this disease. As a first step in addressing this issue, we will test the following hypothesis: persistent bacterial infection of skin or microvasculature occurs more commonly in systemic sclerosis cases than in matched controls and participates in the disease process. Specific aims are: (1) to test skin biopsies from 60 systemic scleroderma patients and 30 matched normal controls for evidence of bacterial persistence by pan-bacterial and chlamydia-specific molecular screening; (2) to microdissect dermal vessels from these same cases and controls and test this tissue by panbacterial and chlamydia-specific molecular probes; (3) to prepare PBMC'S from these individuals and screen with these probes; and (4) depending on positive results, to perform immunohistochemistry studies for these organisms on skin biopsies/vessels from selected patients and appropriate controls. Scleroderma small vessel vasculopathy shares some key features with large vessel atherosclerosis, a condition also characterized by intimal proliferation and luminal narrowing among multiple other abnormalities. Inflammation may play an important role in the pathogenesis of atherosclerosis raising the possibility of infectious agents as mediators in this process. There are several examples of infection resulting in chronic inflammatory autoimmune diseases including Lyme disease (Borrelia burgdorferii), and reactive arthritis (ReA), an inflammatory joint disease associated with prior infection by a number of specific bacterial pathogens, including Chlamydia trachomatis and various species of the Genera Salmonella, Yersinia, Campylobacter, and

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others. This research team is comprised of individuals with expertise in clinical scleroderma, the vascular abnormalities of primary and secondary Raynaud's disease, and autoimmunity related to persistent bacterial infections with relevant pathogens. If positive results are obtained in at least a subset of scleroderma cases, intervention trials could be devised with therapy targeted to specific organisms. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with Raynaud’s disease, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “Raynaud’s disease” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for Raynaud’s disease (hyperlinks lead to article summaries): •

“Raynaud's disease” in migraineurs: one entity or two? Author(s): Kaiser RS. Source: Headache. 1992 October; 32(9): 463-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1446993

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A case of Raynaud's disease with uterine cancer producing interleukin-6. Author(s): Murashima A, Takasaki Y, Hashimoto H, Hirano T, Hirose S. Source: Clinical Rheumatology. 1992 September; 11(3): 410-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1458793

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A double blind randomised placebo controlled trial of hexopal in primary Raynaud's disease. Author(s): Sunderland GT, Belch JJ, Sturrock RD, Forbes CD, McKay AJ. Source: Clinical Rheumatology. 1988 March; 7(1): 46-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3044673

3 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 novel anti-microfilament antibody, anti-135 kD, is associated with Raynaud's disease, undifferentiated connective tissue disease and systemic autoimmune diseases. Author(s): Girard D, Senecal JL. Source: Autoimmunity. 1996; 24(3): 167-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9020409

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Acupuncture treatment of Raynaud's disease--a report of 43 cases. Author(s): Bao JZ. Source: J Tradit Chin Med. 1988 December; 8(4): 257-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3246885

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Acute vasospastic attack after extradural block in a patient with Raynaud's disease. Author(s): Nay PG, O'Brien K. Source: Anesthesia and Analgesia. 2000 June; 90(6): 1417-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10825332

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Adrenoceptors in Raynaud's disease. Author(s): Lindblad LE, Ekenvall L, Etzell BM, Bevegard S. Source: Journal of Cardiovascular Pharmacology. 1989 December; 14(6): 881-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2481777

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Adventitial stripping of the radial and ulnar arteries in Raynaud's disease. Author(s): Balogh B, Mayer W, Vesely M, Mayer S, Partsch H, Piza-Katzer H. Source: The Journal of Hand Surgery. 2002 November; 27(6): 1073-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12457360

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Aimed pharmacological treatment of Raynaud's disease. Author(s): Allegra C, Pollari G. Source: Bibl Anat. 1979; (18): 141-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=40542

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Alpha 2-adrenergic function in Raynaud's disease. Author(s): Freedman RR. Source: Archives of Internal Medicine. 1992 September; 152(9): 1929, 1933. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1325763

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Altered regulator mechanisms of presynaptic adrenergic nerve: a new physiopathological hypothesis in Raynaud's disease. Author(s): Giovanni B, Giuseppina CM, Susanna F, Roberto M. Source: Microvascular Research. 1984 January; 27(1): 110-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6323930

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Anticentromere autoantibodies in patients without Raynaud's disease or systemic sclerosis. Author(s): Vazquez-Abad D, Grodzicky T, Senecal JL. Source: Clinical Immunology (Orlando, Fla.). 1999 February; 90(2): 182-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10080829

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Behavioral approaches to Raynaud's disease. Author(s): Surwit RS. Source: Psychotherapy and Psychosomatics. 1981; 36(3-4): 224-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7345469

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Behavioral treatment for Raynaud's disease: a comparative study with long-term follow-up. Author(s): Jacobson AM, Manschreck TC, Silverberg E. Source: The American Journal of Psychiatry. 1979 June; 136(6): 844-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=375758

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Behavioral treatment of Raynaud's disease. Author(s): Freedman RR, Ianni P, Wenig P. Source: Journal of Consulting and Clinical Psychology. 1983 August; 51(4): 539-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6619361

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Behavioral treatment of Raynaud's disease. Author(s): Surwit RS, Pilon RN, Fenton CH. Source: Journal of Behavioral Medicine. 1978 September; 1(3): 323-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=755865

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Behavioral treatment of Raynaud's disease: long-term follow-up. Author(s): Freedman RR, Ianni P, Wenig P. Source: Journal of Consulting and Clinical Psychology. 1985 February; 53(1): 136. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3980820

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Beta-blockers: a new therapeutic approach to Raynaud's disease. Author(s): Brotzu G, Susanna F, Roberto M, Palmina P. Source: Microvascular Research. 1987 March; 33(2): 283-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2884554

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Bilateral total occlusion of the ulnar and radial arteries at the wrist presenting as Raynaud's disease. Author(s): MacPeek DM, Wilson AR, Weiss AA, DeHoratius RJ. Source: The Journal of Rheumatology. 1987 April; 14(2): 394-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3599014

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Biofeedback as therapy in Raynaud's disease. Author(s): Sappington JT, Fiorito EM, Brehony KA. Source: Biofeedback Self Regul. 1979 June; 4(2): 155-69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=476191

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Biofeedback for Raynaud's disease. Author(s): Sedlacek K. Source: Psychosomatics. 1979 August; 20(8): 535, 538-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=493478

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Biofeedback treatment for headaches, Raynaud's disease, essential hypertension, and irritable bowel syndrome: a review of the long-term follow-up literature. Author(s): Ford MR. Source: Biofeedback Self Regul. 1982 December; 7(4): 521-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7165783

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Biofeedback treatment of Raynaud's disease and phenomenon. Author(s): Freedman RR, Lynn SJ, Ianni P, Hale PA. Source: Biofeedback Self Regul. 1981 September; 6(3): 355-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7326270

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Biofeedback, autogenic training, and progressive relaxation in the treatment of Raynaud's disease: a comparative study. Author(s): Keefe FJ, Surwit RS, Pilon RN. Source: J Appl Behav Anal. 1980 Spring; 13(1): 3-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6988380

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Biofeedback: a possible treatment for Raynaud's disease. Author(s): Surwit RS. Source: Semin Psychiatry. 1973 November; 5(4): 483-90. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4770576

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Blockade of vasospastic attacks by alpha 2-adrenergic but not alpha 1-adrenergic antagonists in idiopathic Raynaud's disease. Author(s): Freedman RR, Baer RP, Mayes MD. Source: Circulation. 1995 September 15; 92(6): 1448-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7664425

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Blood viscosity and Raynaud's disease. Author(s): Walder DN. Source: Journal of the Royal College of Surgeons of Edinburgh. 1973 September; 18(5): 277-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4746829

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Calcium channel blockers and Raynaud's disease. Author(s): Vayssairat M, Capron L, Fiessinger JN, Mathieu JF, Housset E. Source: Annals of Internal Medicine. 1981 August; 95(2): 243. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6266305

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Carbamazepine in Raynaud's disease. Author(s): Merikangas JR, Auchenbach R. Source: Lancet. 1977 December 3; 2(8049): 1186. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=73104

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Cardiovascular responses evoked by mild cool stimuli in primary Raynaud's disease: the role of endothelin. Author(s): Edwards CM, Marshall JM, Pugh M. Source: Clinical Science (London, England : 1979). 1999 June; 96(6): 577-88. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10334963

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Cold hypersensitivity after sympathectomy for Raynaud's disease. Author(s): Nielsen SL, Olsen N, Henriksen O. Source: Scand J Thorac Cardiovasc Surg. 1980; 14(1): 109-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7375882

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Cold-induced potentiation of alpha 2-adrenergic vasoconstriction in primary Raynaud's disease. Author(s): Freedman RR, Moten M, Migaly P, Mayes M. Source: Arthritis and Rheumatism. 1993 May; 36(5): 685-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8387786

Studies

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Comparison of behavioral treatments for Raynaud's disease. Author(s): Jobe JB, Sampson JB, Roberts DE, Kelly JA. Source: Journal of Behavioral Medicine. 1986 February; 9(1): 89-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3701861

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Comparison of the hunting reaction in normals and individuals with Raynaud's disease. Author(s): Jobe JB, Goldman RF, Beetham WP Jr. Source: Aviation, Space, and Environmental Medicine. 1985 June; 56(6): 568-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4015569

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CRST syndrome (calcinosis, Raynaud's disease, sclerodactyly, and telangiectasias). Author(s): Abrahams I. Source: Archives of Dermatology. 1965 August; 92(2): 209-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11873727

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Cryoglobulinemia and hepatitis B markers in North African Jews with Raynaud's disease. Author(s): Horowitz J, Klein M, Sukenik S. Source: Arthritis and Rheumatism. 1986 August; 29(8): 1026-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3741513

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Differences in red cell behaviour between patients with Raynaud's phenomenon and systemic sclerosis and patients with Raynaud's disease. Author(s): Rustin MH, Kovacs IB, Sowemimo-Coker SO, Maddison PJ, Kirby JD. Source: The British Journal of Dermatology. 1985 September; 113(3): 265-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3877518

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Differentiation of primary and secondary Raynaud's disease by carotid arterial stiffness. Author(s): Cheng KS, Tiwari A, Boutin A, Denton CP, Black CM, Morris R, Seifalian AM, Hamilton G. Source: European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery. 2003 April; 25(4): 336-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12651172

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Digital nerve blockade in Raynaud's disease. Author(s): Freedman RR, Mayes MD, Sabharwal SC. Source: Circulation. 1989 December; 80(6): 1923-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2598451

12

Raynaud's Disease

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Digital pressure and flow measurement upon local cooling in Raynaud's disease. Effect of naftidrofuryl. Author(s): Bounameaux HM, Hellemans H, Verhaege R. Source: International Angiology : a Journal of the International Union of Angiology. 1986 January-March; 5(1): 39-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3734514

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Digital vasodilatation during mental stress in patients with Raynaud's disease. Author(s): Halperin JL, Cohen RA, Coffman JD. Source: Cardiovascular Research. 1983 November; 17(11): 671-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6652643

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Effect of nifedipine in Raynaud's disease: a case report. Author(s): Maguire FW. Source: Del Med J. 1984 July; 56(7): 393-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6479385

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Effect of the cold pressor test on diffusing capacity. Comparison of normal subjects and those with Raynaud's disease and progressive systemic sclerosis. Author(s): Miller MJ. Source: Chest. 1983 September; 84(3): 264-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6884100

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Effects of general and thematically relevant stressors in Raynaud's disease. Author(s): Freedman RR, Ianni P. Source: Journal of Psychosomatic Research. 1985; 29(3): 275-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4032326

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Effects of low-dose nifedipine on a cold provocation test in patients with Raynaud's disease. Author(s): Weber A, Bounameaux H. Source: Journal of Cardiovascular Pharmacology. 1990 May; 15(5): 853-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1692948

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Epoprostenol in patients with Raynaud's disease. Author(s): Fitscha P, Kaliman J, Weidinger F, Sinzinger H, O'Grady J. Source: Prostaglandins, Leukotrienes, and Essential Fatty Acids. 1988 July; 33(1): 23-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3141936

Studies

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Evolution of primary Raynaud's phenomenon (Raynaud's disease) to connective tissue disease. Author(s): Gerbracht DD, Steen VD, Ziegler GL, Medsger TA Jr, Rodnan GP. Source: Arthritis and Rheumatism. 1985 January; 28(1): 87-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3871330

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Familial aggregation of primary Raynaud's disease. Author(s): Freedman RR, Mayes MD. Source: Arthritis and Rheumatism. 1996 July; 39(7): 1189-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8670329

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Familial Raynaud's disease. Author(s): Greenwood RD. Source: J Kans Med Soc. 1976 September; 77(9): 403-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=965798

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Fine structural capillary changes and basal lamina thickening in scleroderma (progressive systemic sclerosis) and Raynaud's disease. Author(s): Camilleri JP, Fiessinger JN, Debure C, Bruneval P, Tricottet V, Kazandjian S, Housset E. Source: Pathology, Research and Practice. 1984 January; 178(3): 230-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6718273

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Finger blood flow in healthy subjects of different age and sex and in patients with primary Raynaud's disease. Author(s): Bollinger A, Schlumpf M. Source: Acta Chir Scand Suppl. 1976; 465: 42-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1069432

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Functional studies in small arteries do not support a primary role for endothelin in the pathogenesis of Raynaud's disease. Author(s): Smith PJ, Ferro CJ, McQueen DS, Webb DJ. Source: Journal of Cardiovascular Pharmacology. 1998; 31 Suppl 1: S473-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9595516

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Griseofulvin in Raynaud's disease. Author(s): Hasker WE. Source: Lancet. 1970 November 28; 2(7683): 1136. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4097937

14

Raynaud's Disease

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Hexopal in Raynaud's disease. Author(s): Aylward M. Source: J Int Med Res. 1979; 7(6): 484-91. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=520652

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Hyperventilation and Raynaud's disease. Author(s): Williams H, Freeman LJ, Nixon PG. Source: Postgraduate Medical Journal. 1987 May; 63(739): 377-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3671272

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Images in clinical medicine. Acute episode of Raynaud's disease. Author(s): Bluto MJ, Norman DA. Source: The New England Journal of Medicine. 2002 September 26; 347(13): 992. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12324555

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Impaired cholinergic dilator response of resistance arteries isolated from patients with Raynaud's disease. Author(s): Smith PJ, Ferro CJ, McQueen DS, Webb DJ. Source: British Journal of Clinical Pharmacology. 1999 May; 47(5): 507-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10336574

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In search of mediators of skin vasodilation induced by transcutaneous nerve stimulation: III. Increase in plasma VIP in normal subjects and in Raynaud's disease. Author(s): Kaada B, Olsen E, Eielsen O. Source: General Pharmacology. 1984; 15(2): 107-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6714637

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Increased alpha-adrenergic responsiveness in idiopathic Raynaud's disease. Author(s): Freedman RR, Sabharal SC, Desai N, Wenig P, Mayes M. Source: Arthritis and Rheumatism. 1989 January; 32(1): 61-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2536282

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Individual differences in response to the behavioral treatment of Raynaud's disease. Author(s): Surwit RS, Bradner MN, Fenton CH, Pilon RN. Source: Journal of Consulting and Clinical Psychology. 1979 April; 47(2): 363-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=469084

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Induced temperature transients in Raynaud's disease measured by thermography. A preliminary report. Author(s): Chucker F, Fowler RC, Motomiya T, Singh B, Hurley W. Source: Angiology. 1971 November; 22(10): 580-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5121559

Studies

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Induced vasodilation as a home treatment for Raynaud's disease. Author(s): Jobe JB, Beetham WP Jr, Roberts DE, Silver GR, Larsen RF, Hamlet MP, Sampson JB. Source: The Journal of Rheumatology. 1985 October; 12(5): 953-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4087271

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Induced vasodilation as treatment for Raynaud's disease. Author(s): Jobe JB, Sampson JB, Roberts DE, Beetham WP Jr. Source: Annals of Internal Medicine. 1982 November; 97(5): 706-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7137735

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Induction of vasospastic attacks despite digital nerve block in Raynaud's disease and phenomenon. Author(s): Freedman RR, Mayes MD, Sabharwal SC. Source: Circulation. 1989 October; 80(4): 859-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2791249

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Interstitial calcinosis and scleroderma associated with rheumatoid arthritis and Raynaud's disease.5A case report. Author(s): Sherman BD. Source: J Am Podiatry Assoc. 1968 February; 58(2): 68-71. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5636488

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Intra-arterial administration of reserpine. Its use in patients with Raynaud's disease or Raynaud's phenomenon. Author(s): Romeo SG, Whalen RE, Tindall JP. Source: Archives of Internal Medicine. 1970 May; 125(5): 825-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5444311

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Invariability of blood viscosity after cold testing in patients suffering for Raynaud's disease. Author(s): Pola P, Savi L, Dal Lago A, Flore R, Shami J. Source: The Journal of Cardiovascular Surgery. 1980 March-April; 21(2): 211-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7364865

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Is cryotherapy an occupational “contact” hazard for physicians with Raynaud's disease? Author(s): Hashem CJ, Christina B, Sheretz EF. Source: American Journal of Contact Dermatitis : Official Journal of the American Contact Dermatitis Society. 1997 March; 8(1): 56-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9066854

16

Raynaud's Disease

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Isosorbide dinitrate ointment in Raynaud's disease. Author(s): Diehm C, Muller-Buhl U, Morl H. Source: Zeitschrift Fur Kardiologie. 1983; 72 Suppl 3: 185-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6364591

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Lack of habituation of the pattern of cardiovascular response evoked by sound in subjects with primary Raynaud's disease. Author(s): Edwards CM, Marshall JM, Pugh M. Source: Clinical Science (London, England : 1979). 1998 September; 95(3): 249-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9730843

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Laterality of body focus and digital skin temperature in patients with Raynaud's disease. Author(s): Surwit RS, Bradner MN, Fenton CH, Pilon RN. Source: Psychophysiology. 1978 July; 15(4): 320-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=693739

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Letter: Raynaud's disease and systemic sclerosis. Author(s): Rowell NR. Source: British Medical Journal. 1973 November 24; 4(5890): 493. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4758478

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Letter: Raynaud's disease and the oral contraceptive pill. Author(s): Eastcott HH. Source: British Medical Journal. 1976 August 21; 2(6033): 477. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=953634

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Long-term monitoring of the effects of thymoxamine hydrochloride tablets in the management of patients with Raynaud's disease. Author(s): Aylward M, Bater PA, Davies DE, Dewland PM, Lewis PA, Maddock J. Source: Current Medical Research and Opinion. 1982; 8(3): 158-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6215212

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Lower plasma levels of some gastrointestinal peptides in Raynaud's disease. Influence of transcutaneous nerve stimulation. Author(s): Kaada B, Lygren I. Source: General Pharmacology. 1985; 16(2): 153-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3873378

Studies

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Manometric assessment of oesophageal involvement in progressive systemic sclerosis, morphoea and Raynaud's disease. Author(s): Weihrauch TR, Korting GW. Source: The British Journal of Dermatology. 1982 September; 107(3): 325-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7115611

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Medical treatment in Raynaud's disease. Author(s): Hansteen V. Source: Acta Chir Scand Suppl. 1976; 465: 87-91. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=793268

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Minipress treatment of primary Raynaud's disease. Author(s): Bodolay E, Hatvani I, Szegedi G. Source: Ther Hung. 1986; 34(2): 96-101. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3449974

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Modification of the terminal circulation in Raynaud's disease and acrocyanosis. Author(s): Piovella C, Fratti L, Fontana S. Source: Bibl Anat. 1965; 7: 552-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5860790

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Nifedipine in the treatment of Raynaud's disease in childhood. Author(s): Kaya IS, Senses DA, Dilmen U. Source: Lancet. 1989 May 20; 1(8647): 1136. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2566072

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Non drug treatment for migraine headache with associated Raynaud's disease. Author(s): Giacovazzo M, Romiti A, Martelletti P, Gallo MF, Iuvara Romiti E, Megale G. Source: Headache. 1985 November; 25(8): 441-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4086296

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Observations on the Raynaud's disease. Author(s): Agrifoglio G, Agus GB. Source: The Journal of Cardiovascular Surgery. 1976 November-December; 17(6): 513-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=993253

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Occupational aspects of Raynaud's disease. Author(s): Grounds M. Source: The Medical Journal of Australia. 1972 October 14; 2(16): 910. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4647297

18

Raynaud's Disease

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Pathophysiology of capillary circulation: Raynaud's disease. Author(s): Arnot RS, Boroda C, Peacock JH. Source: Angiology. 1978 January; 29(1): 48-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=343651

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Pathophysiology of Raynaud's disease. Author(s): Halperin JL, Coffman JD. Source: Archives of Internal Medicine. 1979 January; 139(1): 89-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=760690

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Peculiarities in dermatology. A case of the Thiebierge-Weissen-bach type of systemic scleroderma associated with circumscribed calcinosis and Raynaud's disease. Author(s): Kingsley HJ. Source: Cent Afr J Med. 1968 March; 14(3): 59-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5649072

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Phenformin and ethyloestrenol for Raynaud's disease. Author(s): Fearnley GR, Chakrabarti R. Source: Lancet. 1969 November 29; 2(7631): 1203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4187238

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Phenformin and ethyloestrenol for Raynaud's disease. Author(s): Fearnley GR, Chakrabarti R. Source: Lancet. 1969 October 25; 2(7626): 906-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4186475

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Plasma catecholamines during behavioral treatments for Raynaud's disease. Author(s): Freedman RR, Keegan D, Migaly P, Galloway MP, Mayes M. Source: Psychosomatic Medicine. 1991 July-August; 53(4): 433-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1924655

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Plasmapheresis in Raynaud's disease. Author(s): Cotton LT. Source: Lancet. 1978 July 8; 2(8080): 108. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=78277

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Plasmapheresis in Raynaud's disease. Author(s): Klinenberg JR, Wallace D. Source: Lancet. 1978 June 17; 1(8077): 1310-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=78071

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Plasmapheresis in Raynaud's disease. Author(s): Acheson ED. Source: Lancet. 1978 March 25; 1(8065): 672. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=76217

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Plasmapheresis in Raynaud's disease. Author(s): Talpos G, Horrocks M, White JM, Cotton LT. Source: Lancet. 1978 February 25; 1(8061): 416-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=75444

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Plethysmographic demonstration of rapid vasodilation by direct suggestion: a case of Raynaud's disease treated by hypnosis. Author(s): Conn L, Mott T Jr. Source: Am J Clin Hypn. 1984 January; 26(3): 166-70. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6486072

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Pregnancy in a patient with Raynaud's disease. Author(s): Babenerd J, Flenker H. Source: Arch Gynecol. 1979 August; 227(2): 119-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=485219

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Primary Raynaud's disease associated with sclerodactyly and digital osteosclerosis. Author(s): Golding DN, Baker H. Source: Postgraduate Medical Journal. 1968 July; 44(513): 553-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5662197

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Prognostic significance of anticentromere antibodies and anti-topoisomerase I antibodies in Raynaud's disease. A prospective study. Author(s): Weiner ES, Hildebrandt S, Senecal JL, Daniels L, Noell S, Joyal F, Roussin A, Earnshaw W, Rothfield NF. Source: Arthritis and Rheumatism. 1991 January; 34(1): 68-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1845841

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Pulmonary hypertension. Raynaud's disease, telangiectasias. Author(s): Curth HO. Source: Archives of Dermatology. 1965 August; 92(2): 208-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11850933

20

Raynaud's Disease

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Quantitative measurements of finger blood flow during behavioral treatments for Raynaud's disease. Author(s): Freedman RR. Source: Psychophysiology. 1989 July; 26(4): 437-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2798693

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Rapid effect of oral limaprost in Raynaud's disease in childhood. Author(s): Shono T, Ikeda K. Source: Lancet. 1989 April 22; 1(8643): 908. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2564996

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Raynaud's disease and cooling of the fingers. Author(s): Miller IA, Walder DN. Source: The British Journal of Surgery. 1972 April; 59(4): 312. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5020774

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Raynaud's disease and extraction-wound healing. Author(s): Bonnette GH, Arentz RE. Source: J Oral Surg. 1968 March; 26(3): 185-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5237179

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Raynaud's disease and nifedipine. Author(s): Pierce EH, Valle RD, Wielenga J. Source: Annals of Internal Medicine. 1983 January; 98(1): 111. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6848031

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Raynaud's disease and oral contraceptives. Author(s): Jarrett PE. Source: British Medical Journal. 1976 September 18; 2(6037): 699. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=974553

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Raynaud's disease and phenomenon, a medical approach. Author(s): Willerson JT, Decker JL. Source: American Heart Journal. 1971 October; 82(4): 572-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5111239

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Raynaud's disease and phenomenon. Author(s): Hoffman GS. Source: American Family Physician. 1980 January; 21(1): 91-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7350741

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Raynaud's disease and prostacyclin. Author(s): Kennerly D. Source: Annals of Internal Medicine. 1983 February; 98(2): 258. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6337542

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Raynaud's disease and scleroderma. Author(s): Horwitz O. Source: Jama : the Journal of the American Medical Association. 1979 April 27; 241(17): 1794. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=430746

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Raynaud's disease in childhood with radiological features. Author(s): Shono T, Okadome K, Naritomi G, Suita S. Source: The British Journal of Radiology. 1990 May; 63(749): 364-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2379063

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Raynaud's disease in children. Author(s): Guntheroth WG, Morgan BC, Harbinson JA, Mullins GL. Source: Circulation. 1967 November; 36(5): 724-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6050929

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Raynaud's disease in patients with mitral valvular prolapse. Author(s): Meyer FH, Richter MA, Glancy DL, Akman D, Mahajan R. Source: J La State Med Soc. 1983 May; 135(5): 16-7, 19. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6553067

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Raynaud's disease presenting in a 5-month-old-male infant. Author(s): Sayre JW. Source: Pediatrics. 1973 September; 52(3): 412-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4730398

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Raynaud's disease treated with griseofulvin. Author(s): Creery RD, Voyce MA, Preece AW, Evason AR. Source: Archives of Disease in Childhood. 1968 June; 43(229): 344-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5652712

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Raynaud's disease. Author(s): Bowling JC, Dowd PM. Source: Lancet. 2003 June 14; 361(9374): 2078-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12814733

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Raynaud's disease. Author(s): Burns EC, Dunger DB, Dillon MJ. Source: Archives of Disease in Childhood. 1985 June; 60(6): 537-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3160308

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Raynaud's disease. Author(s): Hyland F. Source: Nurs Times. 1985 April 24-30; 81(17): 36. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3846936

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Raynaud's disease. Author(s): Neuenschwander JR. Source: J Kans Med Soc. 1973 June; 74(6): 228-32. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4707742

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Raynaud's disease. Author(s): Peacck JH. Source: Nurs Times. 1969 June 5; 65(23): 720-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5783683

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Raynaud's disease. Author(s): Birnstingl M. Source: Proc R Soc Med. 1968 August; 61(8): 790-1. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5673408

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Raynaud's disease: a new therapeutic approach with a 5-HT2 receptors blocker. Author(s): Allegra C, Tonelli V, Bonifacio M, Mari A, Assogna G. Source: Boll Chim Farm. 1985 October; 124(10): 121S-124S. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2935173

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Raynaud's disease: an update. Author(s): Varon J, Gasman JD. Source: Hosp Pract (Off Ed). 1991 January 15; 26(1): 157-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1898940

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Raynaud's disease: pathophysiology, diagnosis, and treatment. Author(s): Hodges H. Source: Journal of the American Academy of Nurse Practitioners. 1995 April; 7(4): 15964. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7756043

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Raynaud's disease: patient education as a primary nursing intervention. Author(s): Kaufman MW, All AC. Source: Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing. 1996 June; 14(2): 34-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8900768

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Raynaud's disease: reduced hand blood flows with normal blood viscosity. Author(s): McGrath MA, Peek R, Penny R. Source: Aust N Z J Med. 1978 April; 8(2): 126-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=277163

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Raynaud's disease--a work-related phenomenon? Author(s): Marmor D. Source: Med Trial Tech Q. 1974 Fall; 21(2): 179-86. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4444466

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Raynaud's phenomenon and celiac disease. Author(s): Gabrielli M, Candelli M, Santarelli L, Nista EC, Santoliquido A, Gasbarrini G, Pola P, Gasbarrini A. Source: The American Journal of Gastroenterology. 2003 November; 98(11): 2578-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14638377

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Raynaud's phenomenon and Raynaud's disease definition of Raynaud's phenomenon. Author(s): Pratesi F, Corsi C, Deidda C, Nuti A. Source: Schweiz Rundsch Med Prax. 1976 November 2; 65(44): 1368-70. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1005332

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Reflex vasodilatation and Raynaud's disease. Author(s): Burch GE. Source: American Heart Journal. 1972 August; 84(2): 277-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5075079

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Relationship between nailfold capillary microscopy and salivary capillary basement membrane width in Raynaud's disease and progressive systemic sclerosis. Author(s): DeBure C, Fiessinger JN, Priollet P, Camilleri JP, Vayssairat M, Kazandjian S, Housset E. Source: The Journal of Rheumatology. 1985 April; 12(2): 279-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4032402

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Reserpine in Raynaud's disease and phenomenon. Short-term response to intraarterial injection. Author(s): Willerson JT, Thompson RH, Hookman P, Herdt J, Decker JL. Source: Annals of Internal Medicine. 1970 January; 72(1): 17-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5410395

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Reserpine treatment of Raynaud's disease. Author(s): Nobin BA, Nielsen SL, Eklov B, Lassen NA. Source: Annals of Surgery. 1978 January; 187(1): 12-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=619795

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Responses to nifedipine by patients with Raynaud's disease and Raynaud's phenomenon secondary to another disease. Author(s): Riccio A, Del Puente A, Farinaro C, Scarpa R, Oriente P, Rocco P, Gioia M. Source: Clinical Therapeutics. 1987; 9(2): 232-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3568066

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Rhytidectomy flap necrosis in Raynaud's disease. Author(s): Vecchione TR. Source: Plastic and Reconstructive Surgery. 1983 November; 72(5): 713-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6622579

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Role of cold and emotional stress in Raynaud's disease and scleroderma. Author(s): Freedman RR, Ianni P. Source: British Medical Journal (Clinical Research Ed.). 1983 November 19; 287(6404): 1499-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6416474

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Role of digital artery adrenoceptors in Raynaud's disease. Author(s): Cooke JP, Creager SJ, Scales KM, Ren C, Tsapatsaris NP, Beetham WP Jr, Creager MA. Source: Vascular Medicine (London, England). 1997; 2(1): 1-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9546943

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Scleroderma associated with Raynaud's disease. Author(s): Lantz H. Source: J Oral Med. 1967 July; 22(3): 103-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5235027

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Skin temperature biofeedback for Raynaud's disease: a double-blind study. Author(s): Guglielmi RS, Roberts AH, Patterson R. Source: Biofeedback Self Regul. 1982 March; 7(1): 99-120. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7093357

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Skin temperature changes in Raynaud's disease after griseofulvin. Author(s): Charles CR, Carmick ES. Source: Archives of Dermatology. 1970 March; 101(3): 331-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5414890

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State of the mechanisms of autonomous regulation in Raynaud's disease. Author(s): Tabeeva GR. Source: Neuroscience and Behavioral Physiology. 1992 July-August; 22(4): 346-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1528427

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Subclavian vein thrombosis in a patient with Raynaud's disease. Author(s): Laguna P, Sanchez MA, Moya M. Source: Postgraduate Medical Journal. 1994 April; 70(822): 312. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8183785

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Systemic connective tissue diseases in India, VI. Raynaud's disease and preprogressive systemic sclerosis (Pre-PSS). Author(s): Malaviya AN, Narayanan K, Tiwari SC, Khan KM, Raina V, Pande JN. Source: J Assoc Physicians India. 1983 October; 31(10): 625-8. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6671930

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Ten year follow-up of a case of Raynaud's disease treated by pallidotomy. Author(s): Narabayashi H, Nagao T. Source: Confin Neurol. 1972; 34(2): 152-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4666058

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Ten year follow-up of a case of Raynaud's disease treated by pallidotomy. Author(s): Narabayashi H, Nagao T. Source: Confin Neurol. 1972; 34(1): 152-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4563545

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The behavioral treatment of Raynaud's disease: a review. Author(s): Rose GD, Carlson JG. Source: Biofeedback Self Regul. 1987 December; 12(4): 257-72. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3331296

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The cutaneous vasoconstrictor response to venous stasis is normal in subjects with primary Raynaud's disease. Author(s): Edwards CM, Marshall JM, Pugh M. Source: Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society. 1999 October; 9(5): 255-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10580877

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The effect of parenteral indoramin on peripheral blood flow in patients with Raynaud's disease or atherosclerosis associated with intermittent claudication. Author(s): Fares CM, Milliken JC. Source: Current Medical Research and Opinion. 1974; 2(2): 57-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4151332

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The effects of vasodilator agents and of indirect heating in Raynaud's disease. Author(s): Hansteen V. Source: Scand J Clin Lab Invest Suppl. 1973; 128: 211-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4764583

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The enigma of primary Raynaud's disease. Author(s): Coffman JD. Source: Circulation. 1989 October; 80(4): 1089-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2551536

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The importance of presynaptic beta receptors in Raynaud's disease. Author(s): Brotzu G, Falchi S, Mannu B, Montisci R, Petruzzo P, Staico R. Source: Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter. 1989 June; 9(6): 767-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2542629

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The pathogenesis of esophageal dysfunction in scleroderma and Raynaud's disease. Author(s): Cohen S, Fisher R, Lipshutz W, Turner R, Myers A, Schumacher R. Source: The Journal of Clinical Investigation. 1972 October; 51(10): 2663-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5056661

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The role of phenformin and ethyloestrenol or stanozolol in the treatment of decreased fibrinolytic states. (Cutaneous vasculitis, Raynaud's disease, Behcet's syndrome, recurrent deep vein thrombosis and post myocardial infarction). Author(s): Menon IS. Source: Acta Univ Carol Med Monogr. 1972; 52: 19-23. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4669824

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The role of presynaptic beta-receptors in Raynaud's disease. Author(s): Brotzu G, Carboni MG, Falchi S, Montisci R, Petruzzo P. Source: Artery. 1985; 13(2): 77-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3002305

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The use of digital artery sympathectomy as a salvage procedure for severe ischemia of Raynaud's disease and phenomenon. Author(s): McCall TE, Petersen DP, Wong LB. Source: The Journal of Hand Surgery. 1999 January; 24(1): 173-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10048533

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The use of Ginkgo biloba in Raynaud's disease: a double-blind placebo-controlled trial. Author(s): Muir AH, Robb R, McLaren M, Daly F, Belch JJ. Source: Vascular Medicine (London, England). 2002; 7(4): 265-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12710841

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The yellow nail syndrome, bronchiectasis and Raynaud's disease--a relationship. Author(s): Awerbuch MS. Source: The Medical Journal of Australia. 1976 November 27; 2(22): 829-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1012130

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Thermosensitivity of cutaneous vessels and Raynaud's disease. Author(s): Vanhoutte PM, Janssens WJ. Source: American Heart Journal. 1980 August; 100(2): 263-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7405793

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Thymoxamine for Raynaud's disease and chilblains. Author(s): Jaffe GV, Grimshaw JJ. Source: Br J Clin Pract. 1980 November-December; 34(11-12): 343-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6450602

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Topical glyceryl trinitrate as adjunctive treatment in Raynaud's disease. Author(s): Franks AG Jr. Source: Lancet. 1982 January 9; 1(8263): 76-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6119495

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Transient corneal opacification induced by cold in Raynaud's disease. Author(s): McWhae JA, Andrews DM. Source: Ophthalmology. 1991 May; 98(5): 666-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2062499

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Treatment of childhood Raynaud's disease by transdermal prostaglandin E2 analogue. Author(s): Dunger DB, Dillon MJ, Daman-Willems C, Cooke ED, Bowcock SA. Source: Lancet. 1985 July 6; 2(8445): 50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2861505

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Treatment of Raynaud's disease with temperature biofeedback. Author(s): Sundermann RH, Delk JL. Source: Southern Medical Journal. 1978 March; 71(3): 340-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=628858

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Treatment of Raynaud's disease: evaluation of a behavioral approach. Author(s): Jacobson AM, Silverberg E, Hackett T, Manschreck T. Source: Psychiatr Clin (Basel). 1978; 11(3): 125-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=368891

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Use of biofeedback training in treatment of Raynaud's disease and phenomenon. Author(s): Yocum DE, Hodes R, Sundstrom WR, Cleeland CS. Source: The Journal of Rheumatology. 1985 February; 12(1): 90-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3981523

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Vasomotor tone and vascular responses to local cold in primary Raynaud's disease. Author(s): Lottenbach K. Source: Angiology. 1971 January; 22(1): 4-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5101049

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Velocity patterns in nailfold capillaries of normal subjects and patients with Raynaud's disease and acrocyanosis. Author(s): Bollinger A, Mahler F, Meier B. Source: Bibl Anat. 1977; (16 Pt 2): 142-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=603500

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Venodilation in Raynaud's disease. Author(s): Freedman RR, Moten M. Source: Lancet. 1994 March 12; 343(8898): 678-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7906847

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Venodilation in Raynaud's disease. Author(s): Bedarida G, Kim D, Blaschke TF, Hoffman BB. Source: Lancet. 1993 December 11; 342(8885): 1451-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7902481

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CHAPTER 2. NUTRITION AND RAYNAUD’S DISEASE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and Raynaud’s disease.

Finding Nutrition Studies on Raynaud’s Disease The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “Raynaud’s disease” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4

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

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

A double blind, randomised, multicentre comparison of two doses of intravenous iloprost in the treatment of Raynaud's phenomenon secondary to connective tissue diseases. Author(s): Royal Infirmary, Glasgow. Source: Torley, H I Madhok, R Capell, H A Brouwer, R M Maddison, P J Black, C M Englert, H Dormandy, J A Watson, H R Ann-Rheum-Dis. 1991 November; 50(11): 800-4 0003-4967

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A randomised, double-blind study of cicaprost, an oral prostacyclin analogue, in the treatment of Raynaud's phenomenon secondary to systemic sclerosis. Author(s): University Department of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland. Source: Lau, C S Belch, J J Madhok, R Cappell, H Herrick, A Jayson, M Thompson, J M Clin-Exp-Rheumatol. 1993 Jan-February; 11(1): 35-40 0392-856X

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Acute estrogen administration can reverse cold-induced coronary Raynaud's phenomenon in systemic sclerosis. Author(s): Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece. Source: Lekakis, J Mavrikakis, M Emmanuel, M Prassopoulos, V Papamichael, C Moulopoulou, D Ziaga, A Kostamis, P Moulopoulos, S Clin-Exp-Rheumatol. 1996 JulAugust; 14(4): 421-4 0392-856X

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Calcium-channel blockers for Raynaud's phenomenon in systemic sclerosis. Author(s): University of Western Ontario, London, Canada. Source: Thompson, A E Shea, B Welch, V Fenlon, D Pope, J E Arthritis-Rheum. 2001 August; 44(8): 1841-7 0004-3591

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Cocaine-Induced raynaud's phenomenon and ischaemic finger necrosis. Author(s): B. Shine Department of Rheumatology, Rambam Medical Center, The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa. [email protected] Source: Balbir Gurman, A Braun Moscovici, Y Nahir, A M Clin-Rheumatol. 2001; 20(5): 376-8 0770-3198

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Comparison of intravenous infusions of iloprost and oral nifedipine in treatment of Raynaud's phenomenon in patients with systemic sclerosis: a double blind randomised study. Author(s): Department of Dermatology, St Bartholomew's Hospital, London. Source: Rademaker, M Cooke, E D Almond, N E Beacham, J A Smith, R E Mant, T G Kirby, J D BMJ. 1989 March 4; 298(6673): 561-4 0959-8138

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Current management of Raynaud's syndrome. Author(s): Division of Vascular Surgery, Oregon Health Sciences University, Portland, USA. Source: Landry, G J Edwards, J M Porter, J M Adv-Surg. 1996; 30333-47 0065-3411

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Effect of ceramic-impregnated “thermoflow” gloves on patients with Raynaud's syndrome: randomized, placebo-controlled study. Author(s): Alternative Medicine Research, Department of Rehabilitation Medicine, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Ontario, Canada. [email protected] Source: Ko, G D Berbrayer, D Altern-Med-Revolume 2002 August; 7(4): 328-35 1089-5159

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Effect of long-term estrogen therapy on brachial arterial endothelium-dependent vasodilation in women with Raynaud's phenomenon secondary to systemic sclerosis. Author(s): Department of Clinical Therapeutics, Athens University, Alexandra Hospital, Greece. Source: Lekakis, J Papamichael, C Mavrikakis, M Voutsas, A Stamatelopoulos, S Am-JCardiol. 1998 December 15; 82(12): 1555-7, A8 0002-9149

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Effect of nitric-oxide-generating system on microcirculatory blood flow in skin of patients with severe Raynaud's syndrome: a randomised trial. Author(s): Clinical Microvascular Unit, St Bartholomew's Hospital, London, UK. Source: Tucker, A T Pearson, R M Cooke, E D Benjamin, N Lancet. 1999 November 13; 354(9191): 1670-5 0140-6736

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Effect of temperature and modulators of protein tyrosine kinase activity on the reactivity of isolated venules in secondary Raynaud's phenomenon. Author(s): Department of Psychiatry, Internal Medicine, Wayne State University Detroit, Michigan 48201, USA. [email protected] Source: Furspan, P B Mayes, M D Freedman, R R J-Rheumatol. 2001 October; 28(10): 2263-8 0315-162X

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Effects of long-term cyclic iloprost therapy in systemic sclerosis with Raynaud's phenomenon. A randomized, controlled study. Author(s): Clinical Immunology and Allergy, University of Milan, IRCCS Ospedale Maggiore, Milan, Italy. [email protected] Source: Scorza, R Caronni, M Mascagni, B Berruti, V Bazzi, S Micallef, E Arpaia, G Sardina, M Origgi, L Vanoli, M Clin-Exp-Rheumatol. 2001 Sep-October; 19(5): 503-8 0392-856X

•

Efficacy evaluation of prostaglandin E1 against placebo in patients with progressive systemic sclerosis and significant Raynaud's phenomenon. Author(s): Department of Internal Medicine, University of Messina. Source: Bartolone, S Trifiletti, A De Nuzzo, G Scamardi, R Larosa, D Sottilotta, G Raffa, A Barbera, N Minerva-Cardioangiol. 1999 May; 47(5): 137-43 0026-4725

•

Elevated homocysteine levels in patients with Raynaud's syndrome. Author(s): Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel. Source: Levy, Y George, J Langevitz, P Harats, D Doolman, R Sela, B A Shoenfeld, Y JRheumatol. 1999 November; 26(11): 2383-5 0315-162X

•

Esophageal scintigraphy with a semisolid meal to evaluate esophageal dysmotility in systemic sclerosis and Raynaud's phenomenon. Author(s): Department of Nuclear Medicine and Institute of Radiology and Biomedical Science, San Paolo Hospital, University of Milan, Italy. Source: Bestetti, A Carola, F Conciato, L Marasini, B Tarolo, G L J-Nucl-Med. 1999 January; 40(1): 77-84 0161-5505

•

Homocysteine levels in patients with Raynaud's phenomenon. Author(s): Department of Medical Angiology, Clinical Institute for Medical Laboratory Diagnostics, University of Vienna, Austria. [email protected] Source: al Awami, M Schillinger, M Maca, T Gschwandtner, M Bieglmayer, C Wagner, O Minar, E Vasa. 2002 May; 31(2): 87-90 0301-1526

•

Iloprost and cisaprost for Raynaud's phenomenon in progressive systemic sclerosis. Author(s): Medicine (Division of Rheumatology), University of Western Ontario, LHSCSouth Campus, 375 South Street Room 309;Colborne Bldg., London, Ontario, Canada, N6A 4G5. [email protected]

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Source: Pope, J Fenlon, D Thompson, A Shea, B Furst, D Wells, G Silman, A CochraneDatabase-Syst-Revolume 2000; (2): CD000953 1469-493X •

Iloprost treatment of finger gangrene in a patient with Raynaud's syndrome. Author(s): Department of Medicine B, and Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Israel. Source: Levy, Y Sherer, Y Shoenfeld, Y Isr-Med-Assoc-J. 2000 December; 2(12): 960-1 1565-1088

•

Infusion of iloprost, a prostacyclin analogue, for treatment of Raynaud's phenomenon in systemic sclerosis. Author(s): Royal National Hospital for Rheumatic Diseases, Bath, UK. Source: McHugh, N J Csuka, M Watson, H Belcher, G Amadi, A Ring, E F Black, C M Maddison, P J Ann-Rheum-Dis. 1988 January; 47(1): 43-7 0003-4967

•

Intravenous iloprost treatment of Raynaud's phenomenon and ischemic ulcers secondary to systemic sclerosis. Author(s): Department of Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ. Source: Wigley, F M Seibold, J R Wise, R A McCloskey, D A Dole, W P J-Rheumatol. 1992 September; 19(9): 1407-14 0315-162X

•

Intravenous N-acetylcysteine for treatment of Raynaud's phenomenon secondary to systemic sclerosis: a pilot study. Author(s): Istituto di Clinica Medica Generale, Ematologia ed Immunologia Clinica, University of Ancona, Italy. Source: Sambo, P Amico, D Giacomelli, R Matucci Cerinic, M Salsano, F Valentini, G Gabrielli, A J-Rheumatol. 2001 October; 28(10): 2257-62 0315-162X

•

L-arginine therapy in Raynaud's phenomenon? Author(s): Department of Clinical Medicine, University of Milan, S. Paolo Hospital, Italy. Source: Agostoni, A Marasini, B Biondi, M L Bassani, C Cazzaniga, A Bottasso, B Cugno, M Int-J-Clin-Lab-Res. 1991; 21(2): 202-3 0940-5437

•

Oral iloprost in Raynaud's phenomenon secondary to systemic sclerosis: a multicentre, placebo-controlled, dose-comparison study. Author(s): Royal Free Hospital, London. Source: Black, C M Halkier Sorensen, L Belch, J J Ullman, S Madhok, R Smit, A J Banga, J D Watson, H R Br-J-Rheumatol. 1998 September; 37(9): 952-60 0263-7103

•

Oral iloprost treatment in patients with Raynaud's phenomenon secondary to systemic sclerosis: a multicenter, placebo-controlled, double-blind study. Author(s): The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Source: Wigley, F M Korn, J H Csuka, M E Medsger, T A Rothfield, N F Ellman, M Martin, R Collier, D H Weinstein, A Furst, D E Jimenez, S A Mayes, M D Merkel, P A Gruber, B Kaufman, L Varga, J Bell, P Kern, J Marrott, P White, B Simms, R W Phillips, A C Seibold, J R Arthritis-Rheum. 1998 April; 41(4): 670-7 0004-3591

•

Pharmacokinetics of oral iloprost in patients with Raynaud's phenomenon secondary to systemic sclerosis. Author(s): Department of Medicine, Division of General Internal Medicine, University Hospital Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.

Nutrition 35

Source: Janssena, M C Wollersheim, H Kraus, C Hildebrand, M Watson, H R Thien, T Prostaglandins-Other-Lipid-Mediat. 2000 March; 60(4-6): 153-60 1098-8823 •

Placebo controlled study showing therapeutic benefit of iloprost in the treatment of Raynaud's phenomenon. Author(s): Rheumatology Research Unit, Addenbrooke's Hospital, Cambridge, UK. Source: Kyle, M V Belcher, G Hazleman, B L J-Rheumatol. 1992 September; 19(9): 1403-6 0315-162X

•

Prevalence of Raynaud's phenomenon in a healthy Greek population. Author(s): Department of Internal Medicine, Medical School, University of Ioannina, 451 10 Ioannina, Greece. Source: Voulgari, P V Alamanos, Y Papazisi, D Christou, K Papanikolaou, C Drosos, A A Ann-Rheum-Dis. 2000 March; 59(3): 206-10 0003-4967

•

Probucol improves symptoms and reduces lipoprotein oxidation susceptibility in patients with Raynaud's phenomenon. Author(s): Academic Unit of Rheumatology, Royal Free Hospital School of Medicine, London, UK. Source: Denton, C P Bunce, T D Darado, M B Roberts, Z Wilson, H Howell, K Bruckdorfer, K R Black, C M Rheumatology-(Oxford). 1999 April; 38(4): 309-15 14620324

•

Raynaud's phenomenon and acral necrosis after chemotherapy for AIDS-related Kaposi's sarcoma. Author(s): Medizinische Klinik I, University Hospital, Cologne, Germany. Source: Reiser, M Bruns, C Hartmann, P Salzberger, B Diehl, V Fatkenheuer, G Eur-JClin-Microbiol-Infect-Dis. 1998 January; 17(1): 58-60 0934-9723

•

Raynaud's syndrome. Author(s): Department of Medical Electronics, St Bartholomew's Hospital, London. Source: Cooke, E D Nicolaides, A N BMJ. 1990 March 3; 300(6724): 553-5 0959-8138

•

Remission of Raynaud's phenomenon after L-thyroxine therapy in a patient with hypothyroidism. Author(s): Second Department of Medicine, Semmelweis University Medical School, Budapest, Hungary. Source: Lateiwish, A M Feher, J Baraczka, K Racz, K Kiss, R Glaz, E J-Endocrinol-Invest. 1992 January; 15(1): 49-51 0391-4097

•

Retrospective comparison of iloprost with other treatments for secondary Raynaud's phenomenon. Author(s): Cardiovascular Clinical Research Unit, Schering Health Care Limited, Burgess Hill, West Sussex. Source: Watson, H R Belcher, G Ann-Rheum-Dis. 1991 June; 50(6): 359-61 0003-4967

•

Selective suprasensitivity to calcitonin-gene-related peptide in the hands in Raynaud's phenomenon. Author(s): Clinical Pharmacology Unit, Addenbrooke's Hospital, Cambridge. Source: Shawket, S Dickerson, C Hazleman, B Brown, M J Lancet. 1989 December 9; 2(8676): 1354-7 0140-6736

•

Short-term estrogen administration improves abnormal endothelial function in women with systemic sclerosis and Raynaud's phenomenon. Author(s): Department of Clinical Therapeutics, Alexandra University Hospital, Athens, Greece.

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Source: Lekakis, J Mavrikakis, M Papamichael, C Papazoglou, S Economou, O Scotiniotis, I Stamatelopoulos, K Vemmos, C Stamatelopoulos, S Moulopoulos, S AmHeart-J. 1998 November; 136(5): 905-12 0002-8703 •

Skin blood flow in patients with systemic sclerosis and Raynaud's phenomenon: effects of oral L-arginine supplementation. Author(s): University Department of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK. Source: Khan, F Belch, J J J-Rheumatol. 1999 November; 26(11): 2389-94 0315-162X

•

Successful treatment of Raynaud's syndrome with Iloprost, a chemically stable prostacyclin analogue. Author(s): Department of Haematology, University College, London, UK. Source: Yardumian, D A Isenberg, D A Rustin, M Belcher, G Snaith, M L Dowd, P M Machin, S J Br-J-Rheumatol. 1988 June; 27(3): 220-6 0263-7103

•

Systemic sclerosis-related Raynaud's phenomenon: effects of iloprost infusion therapy on serum cytokine, growth factor and soluble adhesion molecule levels. Author(s): Department of Dermatology, University of Leipzig, Germany. Source: Mittag, M Beckheinrich, P Haustein, U F Acta-Derm-Venereol. 2001 AugSeptember; 81(4): 294-7 0001-5555

•

The effects of single oral doses of 17 beta-oestradiol and progesterone on finger skin circulation in healthy women and in women with primary Raynaud's phenomenon. Author(s): Department of Medicine, University Hospital Nijmegen, The Netherlands. Source: Bartelink, M L Wollersheim, H Vemer, H Thomas, C M de Boo, T Thien, T Eur-JClin-Pharmacol. 1994; 46(6): 557-60 0031-6970

•

The pharmacological effects of cicaprost, an oral prostacyclin analogue, in patients with Raynaud's syndrome secondary to systemic sclerosis--a preliminary study. Author(s): University Department of Medicine, Ninewells Hospital and Medical School, Dundee, Scotland, UK. Source: Lau, C S McLaren, M Saniabadi, A Scott, N Belch, J J Clin-Exp-Rheumatol. 1991 May-June; 9(3): 271-3 0392-856X

•

The treatment of Raynaud's phenomenon. Author(s): Clinical Pharmacology Unit, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903-0019. Source: Seibold, J R Allegar, N E Clin-Dermatol. 1994 Apr-June; 12(2): 317-21 0738-081X

•

Thromboangiitis obliterans: a rare cause of a reversible Raynaud's phenomenon. Author(s): Department of Dermatology, DHURDV, CHUV, Lausanne, Switzerland. [email protected] Source: Noel, B Krayenbuhl, B Cerottini, J P Guggisberg, D Buxtorf, K Pires, A Panizzon, R G Dermatology. 2000; 200(4): 363-5 1018-8665

•

Thromboxane does not play a significant role in acute, cold-induced vasoconstriction in Raynaud's phenomenon. Studies with combined thromboxane synthase inhibition and thromboxane receptor antagonism. Author(s): Istituto di Semeiotica Medica, University of Perugia, Italy. Source: Gresele, P Volpato, R Migliacci, R Vezza, R Boschetti, E Nenci, G G Thromb-Res. 1992 May 1; 66(2-3): 259-64 0049-3848

•

Treatment of Raynaud's phenomenon with captopril. Source: Tosi, S Marchesoni, A Messina, K Bellintani, C Sironi, G Faravelli, C Drugs-ExpClin-Res. 1987; 13(1): 37-42 0378-6501

Nutrition 37

•

Treatment of refractory ischemic skin ulcers in patients with Raynaud's phenomenon with PGE1 infusions. Author(s): Rheumatic Disease Unit, Wellesley Hospital, Toronto, Ontario, Canada. Source: Langevitz, P Buskila, D Lee, P Urowitz, M B J-Rheumatol. 1989 November; 16(11): 1433-5 0315-162X

•

Use of prostaglandin E1 (lipo-PGE1) to treat Raynaud's phenomenon associated with connective tissue disease: thermographic and subjective assessment. Author(s): First Department of Internal Medicine, Yokohama City University School of Medicine, Japan. Source: Katoh, K Kawai, T Narita, M Uemura, J Tani, K Okubo, T J-Pharm-Pharmacol. 1992 May; 44(5): 442-4 0022-3573

•

Vascular toxicity and the mechanism underlying Raynaud's phenomenon in patients treated with cisplatin, vinblastine and bleomycin. Author(s): Department of Oncology, Rigshospitalet, Copenhagen, Denmark. Source: Hansen, S W Olsen, N Rossing, N Rorth, M Ann-Oncol. 1990 July; 1(4): 289-92 0923-7534

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

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

•

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

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

Vitamins Niacin Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,892,00.html Vitamin B3 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B3 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin E Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,906,00.html

•

Minerals Calcium-Channel Blockers Source: Healthnotes, Inc.; www.healthnotes.com L-carnitine Source: Healthnotes, Inc.; www.healthnotes.com Magnesium Source: Healthnotes, Inc.; www.healthnotes.com

Nutrition 39

Magnesium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html •

Food and Diet Omega-3 Fatty Acids Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,992,00.html

41

CHAPTER 3. CLINICAL TRIALS AND RAYNAUD’S DISEASE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning Raynaud’s disease.

Recent Trials on Raynaud’s Disease The following is a list of recent trials dedicated to Raynaud’s disease.5 Further information on a trial is available at the Web site indicated. •

Safety and efficacy of Pletal(cilostazol) for the treatment of juvenile primary and secondary Raynaud's phenomenon Condition(s): Raynaud's Disease Study Status: This study is currently recruiting patients. Sponsor(s): Otsuka America Pharmaceutical Purpose - Excerpt: Juvenile primary Raynaud's (ray-knows) Phenomenon is a disorder of the blood vessels in the fingers and sometimes can affect the toes, nose, or ears. When children with primary Raynaud's Phenomenon are exposed to chilly or cold conditions from weather, cold temperatures, or even holding cold items from the refrigerator, their fingers may become cold, numb, hurt, and/or turn purple or white. Children with primary Raynaud's Phenomenon have no underlying systemic disease. The cause for their symptoms is unknown. The investigational drug, Pletal(cilostazol), which has been approved for other conditions, inhibits the ability of one type of blood cell, platelets, to form blood clots, and also widens narrowed blood vessels. It has been used in a variety of other conditions in which blood flow is decreased. This study will test the safety and effectiveness Pletal(cilostazol) to lessen the severity of the symptoms and decrease the number of primary Raynaud's episodes in juvenile patients. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below

5

These are listed at www.ClinicalTrials.gov.

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Raynaud's Disease

Web Site: http://clinicaltrials.gov/ct/show/NCT00048763 •

Safety and efficacy of Pletal(cilostazol) for the treatment of juvenile primary and secondary Raynaud's phenomenon Condition(s): Secondary Raynaud's Study Status: This study is currently recruiting patients. Sponsor(s): Otsuka America Pharmaceutical Purpose - Excerpt: Juvenile secondary Raynaud's (ray-knows) Phenomenon is a disorder of the blood vessels in the fingers and sometimes can affect the toes, nose, or ears. Children with secondary Raynaud's Phenomenon have an underlying condition such as systemic lupus, scleroderma, or mixed connective tissue disease. When children with secondary Raynaud's are exposed to chilly or cold conditions from weather, cold temperatures, or even holding cold items from the refrigerator, their fingers may become cold, numb, hurt, and/or turn purple or white. The investigational drug, Pletal(cilostazol), which has been approved for other conditions, inhibits the ability of one type of blood cell, platelets, to form blood clots, and also widens narrowed blood vessels. It has been used in a variety of other conditions in which blood flow is decreased. This study will test the safety and effectiveness Pletal(cilostazol) to lessen the severity of the symptoms and decrease the number of secondary Raynaud's episodes in juvenile patients. Phase(s): Phase IV; MedlinePlus consumer health information Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00048776

•

Phase III Randomized, Double-Blind, Placebo-Controlled Study of Oral Iloprost for Raynaud's Phenomenon Secondary to Systemic Sclerosis Condition(s): Systemic Sclerosis; Raynaud Disease Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); University of Pittsburgh Purpose - Excerpt: Objectives: I. Evaluate the safety and efficacy of oral iloprost, a prostacyclin analog, in patients with Raynaud's phenomenon secondary to systemic sclerosis. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004786

•

Raynaud's Treatment Study (RTS) Condition(s): Cardiovascular Diseases; Heart Diseases; Raynaud's Disease; Vascular Diseases Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI)

Clinical Trials

43

Purpose - Excerpt: To determine the relative efficacy of usual medical care and a course of treatment by thermal biofeedback in reducing vasospastic attacks characteristic of Raynaud's syndrome. Also, to confirm the frequency and severity of attacks, examine the role of psychophysiological factors in precipitating attacks, and assess the influence of treatment on health quality of life. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000530

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 “Raynaud’s disease” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •

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

•

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

•

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

•

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

•

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

•

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

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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

•

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

•

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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Raynaud's Disease

•

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

•

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

•

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

•

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

•

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

•

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

45

CHAPTER 4. BOOKS ON RAYNAUD’S DISEASE Overview This chapter provides bibliographic book references relating to Raynaud’s disease. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on Raynaud’s disease include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

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

Raynaud's Phenomenon by Jay D. Coffman; ISBN: 0195057562; http://www.amazon.com/exec/obidos/ASIN/0195057562/icongroupinterna

•

The Official Patient's Sourcebook on Raynaud's Phenomenon: A Revised and Updated Directory for the Internet Age by Icon Health Publications; ISBN: 0597835349; http://www.amazon.com/exec/obidos/ASIN/0597835349/icongroupinterna

Chapters on Raynaud’s Disease In order to find chapters that specifically relate to Raynaud’s disease, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and Raynaud’s disease using the “Detailed Search” option. Go to the

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Raynaud's Disease

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 “Raynaud’s disease” (or synonyms) into the “For these words:” box.

47

APPENDICES

49

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 Institute6: •

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

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

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

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

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

•

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

6

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

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Raynaud's Disease

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources 51

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 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:8 •

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

7 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). 8 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 Gateway9 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.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Raynaud’s disease” (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 5023 47 782 0 15 5867

HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 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.13 Simply search by “Raynaud’s disease” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

9

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

10

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

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.

Physician Resources 53

Coffee Break: Tutorials for Biologists14 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.15 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.16 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/.

14 Adapted 15

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. 16 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.

55

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 Raynaud’s disease can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased 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 Raynaud’s disease. 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 Raynaud’s disease. 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 “Raynaud’s disease”:

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Arthritis http://www.nlm.nih.gov/medlineplus/arthritis.html Autoimmune Diseases http://www.nlm.nih.gov/medlineplus/autoimmunediseases.html Bacterial Infections http://www.nlm.nih.gov/medlineplus/bacterialinfections.html Behcet's Syndrome http://www.nlm.nih.gov/medlineplus/behcetssyndrome.html Cerebral Palsy http://www.nlm.nih.gov/medlineplus/cerebralpalsy.html Connective Tissue Disorders http://www.nlm.nih.gov/medlineplus/connectivetissuedisorders.html Lupus http://www.nlm.nih.gov/medlineplus/lupus.html Movement Disorders http://www.nlm.nih.gov/medlineplus/movementdisorders.html Neuromuscular Disorders http://www.nlm.nih.gov/medlineplus/neuromusculardisorders.html Raynaud's Disease http://www.nlm.nih.gov/medlineplus/raynaudsdisease.html Rheumatoid Arthritis http://www.nlm.nih.gov/medlineplus/rheumatoidarthritis.html Scleroderma http://www.nlm.nih.gov/medlineplus/scleroderma.html Sjogren's Syndrome http://www.nlm.nih.gov/medlineplus/sjogrenssyndrome.html Vasculitis http://www.nlm.nih.gov/medlineplus/vasculitis.html Wegener's Granulomatosis http://www.nlm.nih.gov/medlineplus/wegenersgranulomatosis.html

Within the health topic page dedicated to Raynaud’s disease, the following was listed: •

General/Overviews Raynaud's Disease Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00433

•

Alternative Therapy Medical Oils Source: Arthritis Foundation http://www.arthritis.org/resources/arthritistoday/1999_archives/1999_07_08expl orations.asp

Patient Resources 57

•

Specific Conditions/Aspects Cold Hemagglutinins Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00400 CREST Syndrome Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00495 Raynaud's Disease and Intermittent Claudication Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=AN00218

•

From the National Institutes of Health Facts about Raynaud's Phenomenon Source: National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health/public/blood/other/raynaud.htm Threat of Raynaud's Source: National Institutes of Health http://www.nih.gov/news/WordonHealth/apr2001/story02.htm

•

Organizations National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/ National Institute of Arthritis and Musculoskeletal and Skin Diseases http://www.niams.nih.gov/

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

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•

Questions and Answers About Raynaud's Phenomenon Source: Bethesda, MD: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 2001. 24 p. Contact: Available from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Information Clearinghouse. 1 AMS Circle, Bethesda, MD 20892-3675. (877) 226-4267 or (301) 495-4484. Fax (301) 718-6366. TTY (301) 565-2966. E-mail: [email protected]. Website: www.niams.nih.gov. PRICE: 1 to 25 copies free. Order Number: AR-125QA (booklet), or AR-125L QA (large print). Summary: This fact sheet for people with Raynaud's disease uses a question and answer format to provide information. The disorder is characterized by vasospastic attacks that cause the blood vessels in the fingers and toes to constrict; blood vessels in the nose, lips, and ear lobes may also be affected, and attacks are usually triggered by exposure to cold or emotional stress. The fact sheet explains both the primary and secondary forms of the disease and what tests are useful for distinguishing between these two forms. Several nondrug treatments and self-help measures are discussed including keeping warm, quitting smoking, controlling stress, exercising, and consulting a doctor about concerns. Some drugs may decrease the frequency and severity of attacks. The fact sheet also discusses current research on the causes and treatments for Raynaud's disease. It then refers the reader to another organization for additional information. A large print version of this fact sheet is also available. 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 “Raynaud’s disease” (or synonyms). The following was recently posted: •

AACE medical guidelines for clinical practice for management of menopause Source: American Association of Clinical Endocrinologists - Medical Specialty Society; 1999 Nov-December; 13 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2138&nbr=1364&a mp;string=Raynaud''s+AND+disease

•

Management of primary biliary cirrhosis Source: American Association for the Study of Liver Diseases - Private Nonprofit Research Organization; 2000 April; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3445&nbr=2671&a mp;string=Raynaud''s+AND+disease

•

Migraine headache Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1998 November (revised 2002 Jul); 74 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3441&nbr=2667&a mp;string=Raynaud''s+AND+disease

Patient Resources 59

•

Practice parameter: evidence-based guidelines for migraine headache (an evidencebased review). Report of the Quality Standards Subcommittee of the American Academy of Neurology Source: American Academy of Neurology - Medical Specialty Society; 2000 September; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2820&nbr=2046&a mp;string=Raynaud''s+AND+disease

•

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Source: National Heart, Lung, and Blood Institute (U.S.) - Federal Government Agency [U.S.]; 1997 (revised 2003 May 21); 22 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3744&nbr=2970&a mp;string=Raynaud''s+AND+disease Healthfinder™

Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Questions and Answers about Raynaud's Phenomenon Summary: Raynaud's phenomenon is a disorder that affects the blood vessels in the fingers, toes, ears, and nose. Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6730 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 Raynaud’s disease. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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Raynaud's Disease

Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to Raynaud’s disease. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with Raynaud’s disease. 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 Raynaud’s disease. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “Raynaud’s disease” (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

Patient Resources 61

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 “Raynaud’s disease”. 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 “Raynaud’s disease” (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 “Raynaud’s disease” (or a synonym) into the search box, and click “Submit Query.”

63

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.17

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

17

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)18: •

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

•

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

•

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

•

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

•

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

•

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

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

18

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

Finding Medical Libraries 65

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

Finding Medical Libraries 67

•

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/

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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

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

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

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

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

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

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

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

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

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

•

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/

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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 Raynaud’s disease: •

Basic Guidelines for Raynaud’s Disease Raynaud's phenomenon Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000412.htm

•

Signs & Symptoms for Raynaud’s Disease Fingers that change color Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003249.htm Fingers that change color upon pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003249.htm Paleness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003244.htm Skin discoloration, bluish Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003215.htm

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Skin redness or inflammation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003220.htm Spasms Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Swelling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003103.htm Tingling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm •

Diagnostics and Tests for Raynaud’s Disease Blood flow studies Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003442.htm

•

Background Topics for Raynaud’s Disease Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.htm

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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RAYNAUD’S DISEASE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylcysteine: The N-acetyl derivative of cysteine. It is used as a mucolytic agent to reduce the viscosity of mucous secretions. It has also been shown to have antiviral effects in patients with HIV due to inhibition of viral stimulation by reactive oxygen intermediates. [NIH] Acrocyanosis: A condition marked by symmetrical cyanosis of the extremities, with persistent, uneven, mottled blue or red discoloration of the skin of the digits, wrists, and ankles and with profuse sweating and coldness of the digits. Called also Raynaud's sign. [EU] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenergic Antagonists: Drugs that bind to but do not activate adrenergic receptors. Adrenergic antagonists block the actions of the endogenous adrenergic transmitters epinephrine and norepinephrine. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] 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] 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] 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] Analog: In chemistry, a substance that is similar, but not identical, to another. [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] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Anginal: Pertaining to or characteristic of angina. [EU] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihypertensive: An agent that reduces high blood pressure. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic

Dictionary 73

and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arginine: An essential amino acid that is physiologically active in the L-form. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arteriolar: Pertaining to or resembling arterioles. [EU] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] 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] Autogenic: A type of succession when the developing vegetation itself is the cause for the succession. [NIH] Autogenic Training: Technique based on muscle relaxation during self-hypnotic exercises. It is used in conjunction with psychotherapy. [NIH] 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] Autonomic: Self-controlling; functionally independent. [EU] 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] Bacterial Infections: Infections by bacteria, general or unspecified. [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] Basement Membrane: Ubiquitous supportive tissue adjacent to epithelium and around smooth and striated muscle cells. This tissue contains intrinsic macromolecular components such as collagen, laminin, and sulfated proteoglycans. As seen by light microscopy one of its

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subdivisions is the basal (basement) lamina. [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] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bleomycin: A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Viscosity: The internal resistance of the blood to shear forces. The in vitro measure of whole blood viscosity is of limited clinical utility because it bears little relationship to the actual viscosity within the circulation, but an increase in the viscosity of circulating blood can contribute to morbidity in patients suffering from disorders such as sickle cell anemia and polycythemia. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Bradykinin: A nonapeptide messenger that is enzymatically produced from kallidin in the blood where it is a potent but short-lived agent of arteriolar dilation and increased capillary permeability. Bradykinin is also released from mast cells during asthma attacks, from gut walls as a gastrointestinal vasodilator, from damaged tissues as a pain signal, and may be a neurotransmitter. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchiectasis: Persistent abnormal dilatation 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] Calcinosis: Pathologic deposition of calcium salts in tissues. [NIH]

Dictionary 75

Calcitonin: A peptide hormone that lowers calcium concentration in the blood. In humans, it is released by thyroid cells and acts to decrease the formation and absorptive activity of osteoclasts. Its role in regulating plasma calcium is much greater in children and in certain diseases than in normal adults. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] 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] Captopril: A potent and specific inhibitor of peptidyl-dipeptidase A. It blocks the conversion of angiotensin I to angiotensin II, a vasoconstrictor and important regulator of arterial blood pressure. Captopril acts to suppress the renin-angiotensin system and inhibits pressure responses to exogenous angiotensin. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] 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] Catecholamines: A general class of ortho-dihydroxyphenylalkylamines derived from tyrosine. [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 Division: The fission of a cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Centromere: The clear constricted portion of the chromosome at which the chromatids are joined and by which the chromosome is attached to the spindle during cell division. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH]

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Chilblains: Recurrent localized itching, swelling and painful erythema on the fingers, toes or ears, produced by exposure to cold. It is also called pernio. [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] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [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] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Cirrhosis: A type of chronic, progressive liver disease. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] 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] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Computational Biology: A field of biology concerned with the development of techniques

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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] Concentric: Having a common center of curvature or symmetry. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] 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] Constrict: Tighten; narrow. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [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]

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] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Cryotherapy: Any method that uses cold temperature to treat disease. [NIH] Cutaneous: Having to do with the skin. [NIH] Cyanosis: A bluish or purplish discoloration of the skin and mucous membranes due to an increase in the amount of deoxygenated hemoglobin in the blood or a structural defect in the hemoglobin molecule. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types,

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including T and B cells. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Dermatology: A medical specialty concerned with the skin, its structure, functions, diseases, and treatment. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilatation, Pathologic: The condition of an anatomical structure's being dilated beyond normal dimensions. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Dilator: A device used to stretch or enlarge an opening. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] 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] Duct: A tube through which body fluids pass. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elastin: The protein that gives flexibility to tissues. [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] Endothelium: A layer of epithelium that lines the heart, blood vessels (endothelium, vascular), lymph vessels (endothelium, lymphatic), and the serous cavities of the body. [NIH] Endothelium, Lymphatic: Unbroken cellular lining (intima) of the lymph vessels (e.g., the

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high endothelial lymphatic venules). It is more permeable than vascular endothelium, lacking selective absorption and functioning mainly to remove plasma proteins that have filtered through the capillaries into the tissue spaces. [NIH] Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components from interstitium to lumen; this function has been most intensively studied in the blood capillaries. [NIH] 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] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Epitopes: Sites on an antigen that interact with specific antibodies. [NIH] Epoprostenol: A prostaglandin that is biosynthesized enzymatically from prostaglandin endoperoxides in human vascular tissue. It is a potent inhibitor of platelet aggregation. The sodium salt has been also used to treat primary pulmonary hypertension. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogen: One of the two female sex hormones. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraction: The process or act of pulling or drawing out. [EU] Extravascular: Situated or occurring outside a vessel or the vessels. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Fibrin: A protein derived from fibrinogen in the presence of thrombin, which forms part of the blood clot. [NIH]

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Fibrinolytic: Pertaining to, characterized by, or causing the dissolution of fibrin by enzymatic action [EU] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fold: A plication or doubling of various parts of the body. [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] Gangrene: Death and putrefaction of tissue usually due to a loss of blood supply. [NIH] Gastric: Having to do with the stomach. [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]

Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habituation: Decline in response of an organism to environmental or other stimuli with repeated or maintained exposure. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] 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 cells that are organized into interconnected plates called lobules. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one

Dictionary 81

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] 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] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hybridization: The genetic process of crossbreeding to produce a hybrid. Hybrid nucleic acids can be formed by nucleic acid hybridization of DNA and RNA molecules. Protein hybridization allows for hybrid proteins to be formed from polypeptide chains. [NIH] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 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] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [EU] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Iloprost: An eicosanoid, derived from the cyclooxygenase pathway of arachidonic acid metabolism. It is a stable and synthetic analog of epoprostenol, but with a longer half-life

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than the parent compound. Its actions are similar to prostacyclin. Iloprost produces vasodilation and inhibits platelet aggregation. [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] Immunochemistry: Field of chemistry that pertains to immunological phenomena and the study of chemical reactions related to antigen stimulation of tissues. It includes physicochemical interactions between antigens and antibodies. [NIH] Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indoramin: A hypotensive agent with some anti-arrhythmic effects. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Interleukin-6: Factor that stimulates the growth and differentiation of human B-cells and is also a growth factor for hybridomas and plasmacytomas. It is produced by many different cells including T-cells, monocytes, and fibroblasts. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intermittent Claudication: A symptom complex characterized by leg pain and weakness brought on by walking, with the disappearance of the symptoms following a brief rest. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH]

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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] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] Kallidin: A decapeptide bradykinin homolog produced by the action of tissue and glandular kallikreins on low-molecular-weight kininogen. It is a smooth-muscle stimulant and hypotensive agent that functions through vasodilatation. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Laminin: Large, noncollagenous glycoprotein with antigenic properties. It is localized in the basement membrane lamina lucida and functions to bind epithelial cells to the basement membrane. Evidence suggests that the protein plays a role in tumor invasion. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [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 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] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH]

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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] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [NIH] Membranes: Thin layers of tissue which cover parts of the body, separate adjacent cavities, or connect adjacent structures. [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] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] 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] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Mixed Connective Tissue Disease: A syndrome with overlapping clinical features of systemic lupus erythematosus, scleroderma, polymyositis, and Raynaud's phenomenon. The disease is differentially characterized by high serum titers of antibodies to ribonucleasesensitive extractable (saline soluble) nuclear antigen and a "speckled" epidermal nuclear staining pattern on direct immunofluorescence. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Probes: A group of atoms or molecules attached to other molecules or cellular structures and used in studying the properties of these molecules and structures. Radioactive DNA or RNA sequences are used in molecular genetics to detect the presence of a complementary sequence by molecular hybridization. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA,

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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] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mucolytic: Destroying or dissolving mucin; an agent that so acts : a mucopolysaccharide or glycoprotein, the chief constituent of mucus. [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [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] 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] Neoplasm: A new growth of benign or malignant tissue. [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] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [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] Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful antianginal agent that also lowers blood pressure. The use of nifedipine as a tocolytic is being investigated. [NIH] Noel: The highest dose level of a chemical that, in a given toxicity test, causes no observable adverse effect in the test animals. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal

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transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Oestradiol: Growth hormone. [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] Osteosclerosis: An abnormal hardening or increased density of bone tissue. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

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] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

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

Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH]

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

Pilot study: The initial study examining a new method or treatment. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] 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] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Platelets: A type of blood cell that helps prevent bleeding by causing blood clots to form. Also called thrombocytes. [NIH] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Pneumonia: Inflammation of the lungs. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] 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] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or

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severity. [EU] Prolapse: The protrusion of an organ or part of an organ into a natural or artificial orifice. [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] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteoglycans: Glycoproteins which have a very high polysaccharide content. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Circulation: The circulation of blood through the lungs. [NIH]

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Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] 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] 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] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Renin: An enzyme which is secreted by the kidney and is formed from prorenin in plasma and kidney. The enzyme cleaves the Leu-Leu bond in angiotensinogen to generate angiotensin I. EC 3.4.23.15. (Formerly EC 3.4.99.19). [NIH] Renin-Angiotensin System: A system consisting of renin, angiotensin-converting enzyme, and angiotensin II. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming angiotensin I. The converting enzyme contained in the lung acts on angiotensin I in the plasma converting it to angiotensin II, the most powerful directly pressor substance known. It causes contraction of the arteriolar smooth muscle and has other indirect actions mediated through the adrenal cortex. [NIH] Reperfusion: Restoration of blood supply to tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. It is primarily a procedure for treating infarction or other ischemia, by enabling viable ischemic tissue to recover, thus limiting further necrosis. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing reperfusion injury. [NIH] Reperfusion Injury: Functional, metabolic, or structural changes, including necrosis, in ischemic tissues thought to result from reperfusion to ischemic areas of the tissue. The most common instance is myocardial reperfusion injury. [NIH] Reserpine: An alkaloid found in the roots of Rauwolfia serpentina and R. vomitoria. Reserpine inhibits the uptake of norepinephrine into storage vesicles resulting in depletion of catecholamines and serotonin from central and peripheral axon terminals. It has been used as an antihypertensive and an antipsychotic as well as a research tool, but its adverse effects limit its clinical use. [NIH]

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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] Ribonuclease: RNA-digesting enzyme. [NIH] Ribonucleic acid: RNA. One of the two nucleic acids found in all cells. The other is deoxyribonucleic acid (DNA). Ribonucleic acid transfers genetic information from DNA to proteins produced by the cell. [NIH] Ribonucleoproteins: Proteins conjugated with ribonucleic acids (RNA) or specific RNA. Many viruses are ribonucleoproteins. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] 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] 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] 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] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serous: Having to do with serum, the clear liquid part of blood. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] 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] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and

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processes that influence the life of an individual or community. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] 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] 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] Stanozolol: Anabolic agent. [NIH] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] 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] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Sympathectomy: The removal or interruption of some part of the sympathetic nervous system for therapeutic or research purposes. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral

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column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] 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] Systolic: Indicating the maximum arterial pressure during contraction of the left ventricle of the heart. [EU] Thermal: Pertaining to or characterized by heat. [EU] Thermography: Measurement of the regional temperature of the body or an organ by infrared sensing devices, based on self-emanating infrared radiation. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombocytes: Blood cells that help prevent bleeding by causing blood clots to form. Also called platelets. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [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] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU]

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Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transcutaneous: Transdermal. [EU] Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [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] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilatation: A state of increased calibre of the blood vessels. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vasodilator Agents: Drugs used to cause dilation of the blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Villous: Of a surface, covered with villi. [NIH] Vinblastine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. It is a mitotic inhibitor. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] 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]

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Viruses: Minute infectious agents whose genomes are composed of DNA or RNA, but not both. They are characterized by a lack of independent metabolism and the inability to replicate outside living host cells. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Wound Healing: Restoration of integrity to traumatized tissue. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

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INDEX A Abdomen, 71, 74, 82, 83, 91 Acceptor, 71, 86 Acetylcholine, 4, 71, 76, 85 Acetylcysteine, 34, 71 Acrocyanosis, 17, 28, 71 Adrenal Cortex, 71, 87, 89 Adrenergic, 7, 10, 14, 71, 72, 79 Adrenergic Antagonists, 10, 71 Adverse Effect, 71, 85, 89 Algorithms, 71, 74 Alimentary, 71, 86 Alkaloid, 71, 89 Alternative medicine, 71 Amino acid, 71, 72, 73, 86, 88, 90, 92, 93 Amino Acid Sequence, 72 Analog, 42, 72, 81 Anatomical, 72, 76, 77, 78, 82, 90 Anemia, 72, 74 Aneurysm, 72, 93 Anginal, 72, 85 Antagonism, 36, 72 Antibacterial, 72, 91 Antibiotic, 72, 86, 91 Antibodies, 4, 19, 72, 73, 79, 81, 82, 84, 87 Antibody, 7, 72, 82, 91 Antigen, 72, 79, 81, 82, 84 Antihypertensive, 72, 89 Antineoplastic, 72, 74, 93 Antipsychotic, 72, 89 Antiviral, 71, 73 Anus, 73, 74, 76 Apolipoproteins, 73, 83 Arachidonic Acid, 73, 81, 88 Arginine, 34, 36, 73 Arterial, 11, 15, 24, 33, 73, 75, 76, 81, 88, 92 Arteries, 4, 7, 9, 13, 14, 73, 74, 77, 83, 84, 85 Arteriolar, 73, 74, 89 Arterioles, 4, 73, 74, 75 Artery, 24, 27, 72, 73, 74, 77, 89 Autoantibodies, 4, 8, 73 Autoantigens, 4, 73 Autogenic, 9, 73 Autogenic Training, 9, 73 Autoimmune disease, 5, 7, 73 Autoimmunity, 4, 6, 7, 73 Autonomic, 26, 71, 73, 85, 91

B Bacteria, 72, 73, 84, 91 Bacterial Infections, 6, 56, 73, 75 Base, 73, 78, 83 Basement Membrane, 23, 73, 79, 83 Benign, 74, 80, 85 Bile, 74, 80, 81, 83, 87 Bile duct, 74, 87 Biochemical, 5, 74, 90 Biotechnology, 6, 51, 74 Bleomycin, 37, 74 Blood pressure, 72, 74, 75, 81, 85 Blood vessel, 41, 42, 58, 59, 74, 75, 76, 78, 83, 90, 91, 92, 93 Blood Viscosity, 15, 23, 74 Bowel, 9, 74, 78, 82, 91 Bowel Movement, 74, 78, 91 Brachial, 33, 74 Bradykinin, 4, 74, 83 Branch, 67, 74, 86, 91 Bronchi, 74, 79 Bronchiectasis, 27, 74 Buccal, 74, 83 C Calcinosis, 11, 15, 18, 74 Calcitonin, 35, 75 Calcium, 10, 32, 38, 74, 75, 85 Capillary, 13, 18, 23, 74, 75, 93 Capillary Permeability, 74, 75 Captopril, 36, 75 Cardiovascular, 7, 10, 12, 13, 15, 16, 17, 26, 35, 42, 75, 90 Carnitine, 38, 75 Case report, 12, 15, 75 Catecholamines, 18, 75, 89 Celiac Disease, 23, 75 Cell, 11, 41, 42, 73, 74, 75, 76, 77, 78, 79, 81, 83, 84, 85, 86, 87, 88, 89, 90, 93, 94 Cell Division, 73, 75 Central Nervous System, 71, 75, 80, 90 Central Nervous System Infections, 75, 80 Centromere, 4, 75 Chemotherapy, 35, 75 Chilblains, 27, 76 Chin, 7, 76, 84 Cholesterol, 74, 76, 83 Cholesterol Esters, 76, 83 Cholinergic, 14, 72, 76

Raynaud's disease

Chromosome, 75, 76 Chronic, 5, 76, 82, 87, 90, 91, 92 Chylomicrons, 76, 83 Circulatory system, 4, 76 Cirrhosis, 76, 87 Cisplatin, 37, 76 Clinical Medicine, 14, 34, 76, 87 Clinical trial, 3, 41, 43, 51, 76, 77, 78, 89 Cloning, 74, 76 Collagen, 71, 73, 76, 77, 80, 87 Colon, 4, 76, 83 Computational Biology, 51, 76 Concentric, 4, 77 Conjugated, 77, 90 Connective Tissue, 7, 13, 25, 32, 37, 56, 76, 77, 78, 80, 90, 92 Connective Tissue Cells, 77 Connective Tissue Diseases, 25, 32, 77 Constrict, 58, 77 Constriction, 77, 83, 93 Constriction, Pathologic, 77, 93 Contraindications, ii, 77 Controlled study, 32, 33, 35, 77 Coronary, 32, 77, 84, 85 Coronary Thrombosis, 77, 84, 85 Corpus, 77, 87 Corpus Luteum, 77, 87 Cranial, 77, 80 Craniocerebral Trauma, 77, 80 Cryotherapy, 15, 77 Cutaneous, 4, 26, 27, 77, 83 Cyanosis, 71, 77 Cyclic, 33, 77, 88 Cytokine, 36, 77 Cytotoxicity, 76, 78 D Degenerative, 78, 80 Density, 78, 83, 86 Dermal, 4, 5, 78 Dermatology, 11, 17, 18, 19, 25, 32, 36, 78 Dermis, 78, 93 Diagnostic procedure, 78 Diastolic, 78, 81 Digestion, 71, 74, 78, 82, 83, 91 Digestive system, 44, 78 Dilatation, 72, 74, 78, 93 Dilatation, Pathologic, 78, 93 Dilation, 74, 78, 93 Dilator, 14, 78 Direct, iii, 19, 76, 78, 84, 89, 92 Double-blind, 25, 27, 32, 34, 78 Duct, 78, 90

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E Effector, 71, 78 Efficacy, 33, 41, 42, 43, 78 Elastin, 76, 77, 78 Endogenous, 71, 73, 78 Endothelial cell, 5, 78 Endothelium, 4, 5, 33, 78, 79 Endothelium, Lymphatic, 78 Endothelium, Vascular, 78, 79 Environmental Health, 50, 52, 79 Enzymatic, 71, 75, 79, 80 Epidermal, 79, 84 Epinephrine, 71, 79, 85, 93 Epithelium, 73, 78, 79 Epitopes, 4, 79 Epoprostenol, 12, 79, 81 Erythema, 76, 79 Esophageal, 26, 33, 79 Esophagus, 78, 79, 91 Estrogen, 32, 33, 35, 79 Exhaustion, 72, 79 Exogenous, 75, 78, 79 Extracellular, 77, 79, 80 Extracellular Matrix, 77, 79, 80 Extraction, 20, 79 Extravascular, 5, 79 F Family Planning, 51, 79 Fatty acids, 79, 88 Fibrin, 79, 80 Fibrinolytic, 26, 80 Fibroblasts, 77, 80, 82 Fibrosis, 4, 80, 90 Fold, 4, 80 G Gallbladder, 78, 80 Ganglia, 71, 73, 80, 85, 92 Gangrene, 34, 80 Gastric, 75, 80 Gastrointestinal, 4, 16, 74, 79, 80, 90 Gastrointestinal tract, 4, 80, 90 Gene, 35, 74, 80 Genetics, 80, 84 Gluten, 75, 80 Governing Board, 80, 87 Growth, 36, 72, 80, 82, 84, 85, 86, 92 H Habituation, 16, 80 Half-Life, 80, 81 Headache, 6, 17, 58, 59, 80 Headache Disorders, 80 Hemorrhage, 77, 80, 91

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Hepatitis, 11, 80 Hepatocytes, 80 Hereditary, 77, 80 Heredity, 80, 81 Hormone, 75, 79, 81, 86, 87, 90, 92 Humoral, 4, 81 Humour, 81 Hybridization, 81, 84 Hybridomas, 81, 82 Hydrogen, 71, 73, 81, 84, 86 Hydrolysis, 76, 81 Hydrophobic, 81, 83 Hypersensitivity, 10, 81, 90 Hypertension, 9, 19, 79, 80, 81 Hypnotic, 73, 81 Hypotensive, 81, 82, 83 Hypothyroidism, 35, 81 I Id, 38, 56, 57, 58, 59, 60, 66, 68, 81 Idiopathic, 10, 14, 81 Iloprost, 32, 33, 34, 35, 36, 42, 81 Immune response, 72, 73, 82 Immune system, 73, 82, 94 Immunochemistry, 4, 82 Immunofluorescence, 82, 84 Immunohistochemistry, 5, 82 Impairment, 82, 84 In vitro, 74, 82 Indicative, 45, 82, 86, 93 Indoramin, 26, 82 Infarction, 82, 89 Infection, 5, 82, 83, 84, 86, 90, 91, 94 Inflammation, 5, 70, 80, 82, 87, 90, 92, 93 Infusion, 34, 36, 82 Inorganic, 76, 82 Interleukin-6, 6, 82 Intermittent, 26, 57, 82 Intermittent Claudication, 26, 57, 82 Intestinal, 75, 82, 84 Intestinal Mucosa, 75, 82 Intestine, 74, 81, 82, 83 Intracellular, 82, 83, 88 Intramuscular, 83, 86 Intravenous, 32, 34, 82, 83, 86 Intrinsic, 73, 83 Ischemia, 4, 5, 27, 83, 89 J Joint, 5, 59, 83, 92 K Kallidin, 74, 83 Kb, 50, 83

L Laminin, 73, 83 Large Intestine, 78, 82, 83, 89 Lethargy, 81, 83 Library Services, 66, 83 Ligaments, 77, 83 Lipid, 35, 73, 75, 83 Lipoprotein, 35, 83 Liver, 58, 73, 74, 75, 76, 78, 80, 83, 87, 89 Localization, 82, 83 Localized, 76, 82, 83, 90 Low-density lipoprotein, 83 Lupus, 4, 42, 56, 83, 92 Lymph, 76, 78, 81, 83, 84 Lymphatic, 79, 82, 83, 84, 91 Lymphoid, 72, 84 M Malabsorption, 75, 84 Malignant, 72, 84, 85, 90 MEDLINE, 51, 84 Melanin, 84, 86, 93 Membranes, 75, 77, 84, 87 Menopause, 58, 84 Menstrual Cycle, 84, 87 Menstruation, 84 Mental, iv, 3, 12, 44, 50, 52, 76, 81, 84, 88 Mental Disorders, 44, 84 MI, 70, 84 Microbe, 84, 92 Microscopy, 23, 73, 84 Mitotic, 84, 93 Mixed Connective Tissue Disease, 42, 84 Modification, 17, 71, 84, 89 Molecular, 5, 51, 53, 74, 77, 83, 84 Molecular Probes, 5, 84 Molecule, 36, 72, 73, 75, 77, 78, 81, 84, 86, 89 Monitor, 85, 86 Monocytes, 82, 85 Mucolytic, 71, 85 Mucosa, 83, 85 Muscle Relaxation, 73, 85 Myocardial infarction, 26, 77, 84, 85 Myocardium, 84, 85 N NCI, 1, 43, 49, 85 Need, 45, 61, 85 Neoplasm, 85, 90 Nerve, 5, 7, 11, 14, 15, 16, 71, 76, 85, 90, 93 Nervous System, 75, 85, 91 Neural, 5, 81, 85 Neuromuscular, 56, 71, 85

Raynaud's disease

Neuromuscular Junction, 71, 85 Neurotransmitter, 71, 72, 74, 85 Nifedipine, 12, 17, 20, 24, 32, 85 Noel, 36, 85 Norepinephrine, 71, 85, 89 Nuclear, 4, 33, 84, 86 Nucleus, 77, 85, 86 O Oestradiol, 36, 86 Osteoclasts, 75, 86 Osteosclerosis, 19, 86 Ovum, 77, 86, 87 Oxidation, 35, 71, 86 P Pancreas, 78, 86 Pancreatic, 75, 86 Parenteral, 26, 86 Patch, 86, 93 Pathogenesis, 4, 5, 13, 26, 86 Pathologic, 74, 77, 81, 86 Pathophysiology, 4, 18, 22, 86 Patient Education, 23, 57, 64, 66, 70, 86 Penicillin, 72, 86 Peptide, 4, 35, 71, 75, 86, 88, 92 Peripheral blood, 26, 86 Pharmacologic, 80, 86, 93 Phenylalanine, 86, 93 Phospholipids, 83, 87 Physicochemical, 82, 87 Physiologic, 5, 80, 84, 87, 88, 89 Pilot study, 34, 87 Placenta, 87 Plasma, 14, 16, 18, 72, 75, 76, 79, 87, 89 Plasma cells, 72, 87 Platelet Aggregation, 79, 82, 87 Platelets, 41, 42, 87, 90, 92 Platinum, 76, 87 Pneumonia, 77, 87 Potentiation, 10, 87 Practice Guidelines, 52, 58, 87 Precursor, 73, 78, 79, 85, 86, 87, 93 Presynaptic, 7, 26, 27, 85, 87 Primary Biliary Cirrhosis, 58, 87 Progesterone, 36, 87 Progressive, 4, 9, 12, 13, 17, 23, 25, 33, 76, 80, 87 Prolapse, 21, 88 Prospective study, 19, 88 Prostaglandin, 28, 33, 37, 79, 88 Prostaglandins A, 88 Protein C, 72, 73, 83, 88 Protein S, 74, 88

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Proteins, 71, 72, 73, 76, 79, 81, 84, 86, 87, 88, 90, 93 Proteoglycans, 73, 88 Proximal, 87, 88 Psychic, 84, 88 Psychotherapy, 8, 73, 88 Public Policy, 51, 88 Pulmonary, 4, 19, 74, 79, 88 Pulmonary Circulation, 4, 88 Putrefaction, 80, 89 Q Quality of Life, 43, 89 R Radiation, 89, 92, 94 Radioactive, 80, 81, 84, 86, 89 Radiological, 21, 89 Radiology, 21, 33, 89 Randomized, 32, 33, 42, 78, 89 Receptor, 36, 72, 89, 90 Rectum, 73, 74, 76, 78, 83, 89 Refer, 1, 74, 83, 89 Refraction, 89, 91 Refractory, 37, 89 Regimen, 78, 89 Renin, 75, 89 Renin-Angiotensin System, 75, 89 Reperfusion, 5, 89 Reperfusion Injury, 89 Reserpine, 15, 24, 89 Rheumatic Diseases, 4, 34, 90 Rheumatism, 10, 11, 13, 14, 19, 90 Rheumatoid, 15, 56, 90 Rheumatoid arthritis, 15, 90 Ribonuclease, 84, 90 Ribonucleic acid, 90 Ribonucleoproteins, 4, 90 Risk factor, 88, 90 S Saliva, 90 Salivary, 23, 78, 90 Salivary glands, 78, 90 Sarcoma, 35, 90 Scleroderma, 3, 4, 5, 13, 15, 18, 21, 24, 26, 42, 56, 84, 90 Sclerosis, 3, 5, 8, 11, 12, 13, 16, 17, 23, 25, 32, 33, 34, 35, 36, 42, 90 Screening, 5, 76, 90 Secretion, 81, 90 Serotonin, 72, 85, 89, 90 Serous, 78, 90 Serum, 36, 83, 84, 90 Skeleton, 83, 88, 90

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Smooth muscle, 4, 77, 89, 90 Social Environment, 89, 90 Solid tumor, 74, 91 Somatic, 81, 91 Specialist, 60, 78, 91 Species, 5, 79, 91, 93 Specificity, 4, 91 Spectrum, 3, 91 Spinal cord, 74, 75, 76, 85, 91, 92 Stanozolol, 26, 91 Stasis, 26, 91 Stomach, 78, 79, 80, 81, 91 Stool, 76, 83, 91 Stress, 12, 24, 58, 90, 91 Stroke, 44, 50, 91 Subacute, 82, 91 Subarachnoid, 80, 91 Subclinical, 82, 91 Subcutaneous, 86, 91 Subspecies, 91 Supplementation, 36, 91 Sympathectomy, 10, 27, 91 Sympathetic Nervous System, 91 Synapse, 71, 85, 87, 92, 93 Systemic, 3, 5, 7, 8, 11, 12, 13, 16, 17, 18, 23, 25, 32, 33, 34, 35, 36, 41, 42, 74, 79, 82, 84, 90, 92 Systemic disease, 41, 92 Systemic lupus erythematosus, 84, 92 Systolic, 81, 92 T Thermal, 43, 92 Thermography, 14, 92 Threshold, 81, 92 Thrombocytes, 87, 92 Thrombosis, 25, 26, 88, 91, 92 Thyroid, 75, 81, 92, 93 Thyroid Gland, 92 Thyrotropin, 81, 92 Thyroxine, 35, 86, 92

Tissue, 4, 5, 72, 73, 74, 75, 77, 79, 80, 83, 84, 85, 86, 89, 92, 94 Tone, 28, 92 Tonus, 92 Toxic, iv, 78, 92, 93 Toxicity, 37, 85, 92 Toxicology, 52, 93 Toxins, 72, 82, 93 Transcutaneous, 14, 16, 93 Transdermal, 28, 93 Transfection, 74, 93 Transmitter, 71, 86, 93 Tyrosine, 33, 75, 93 U Unconscious, 81, 93 Uterus, 77, 84, 87, 93 V Vascular, 4, 6, 11, 23, 24, 26, 27, 28, 32, 37, 42, 78, 79, 80, 82, 87, 92, 93 Vasculitis, 26, 56, 93 Vasoconstriction, 4, 10, 36, 79, 93 Vasodilatation, 12, 23, 83, 93 Vasodilation, 14, 15, 19, 33, 82, 93 Vasodilator, 26, 74, 85, 93 Vasodilator Agents, 26, 93 Vein, 25, 26, 72, 83, 86, 93 Venous, 26, 88, 93 Venules, 33, 74, 75, 79, 93 Veterinary Medicine, 51, 93 Villous, 75, 93 Vinblastine, 37, 93 Vinca Alkaloids, 93 Viral, 71, 93 Virulence, 92, 93 Viruses, 73, 90, 93, 94 Viscosity, 10, 71, 74, 94 W White blood cell, 72, 84, 87, 94 Wound Healing, 20, 94 X X-ray, 86, 89, 94

Raynaud's disease

100